Fortification and Bioavailability

Food Fortification

 

Food fortification is the addition of vitamins and minerals to foods and water and has been the most direct policy intervention to improve nutrition in Western countries (World Bank, 1994). This includes food enrichment in which nutrients are added at the level that existed before food processing (e.g., adding the iron back that was lost during the milling of wheat flour) or fortification in which nutrients are added at levels higher than exist in foods (e.g., iodine in salt). Food fortification, instead of enrichment, is the approach in most developing countries because dietary intake of a number of micronutrients is inadequate. Fortification of flour with iron in many Western countries has been attributed to a reduction in anemia. Fortifying a food consumed by the entire population with any nutrient needs to be safe for the entire population and will not meet the entire nutrient requirements of the vulnerable groups.

Specific foods that are only consumed by vulnerable groups also have been fortified to meet higher requirements of these groups. Examples of these include fortifying baby cereals with iron in some Western countries which reduced iron deficiency in these countries. Fortified complementary foods are being developed and introduced in developing countries to provide more micronutrients to young children. Foods, often called “vehicles” for fortification, which have been used for food fortification are displayed in the table below.

The private food industry is responsible for food fortification but in many countries, the public health sector works in partnership with the food industry to fortify foods or makes fortification mandatory. There is a price differential between fortified and unfortified foods which can be a deterrent to the food industry fortifying a food and consumers buying it, if the cost is passed onto the consumer. The “fortificant” used to fortify the food may be taxed at the point of importation which also increases the cost of the food. In countries where consumers demand fortified foods, the private sector is motivated to voluntarily fortify foods. Where consumers do not know about the benefits of a fortified and are not motivated to buy it, a single food company may not be motivated to voluntarily fortify a product. The food industry in developing countries may not have the resources to market the product and thus are competing with products which are less expensive. Mandatory food fortification (requiring all companies to fortify foods with specific nutrients) can “level the playing field” for companies that are interested in fortification. When there are many small companies producing a food production (e.g., salt), it makes it more difficult to enforce mandatory fortification. In countries with fluid borders, unfortified foods from other countries may reduce the effectiveness of a food fortification program.

Fortificants (or the form of the micronutrient used to fortify foods) vary widely in cost, bioavailability, and their appearance in foods. Fortified foods need to be tested during the development phase to ensure these foods can be manufactured easily and consumers like them. Price, taste, appearance and other considerations need to be assessed. Marketing these foods to the relevant target groups is needed for most fortified foods. For example, consumers may be wary of adding something to their food. Mothers need to have information about how to use a fortified complementary food appropriately in their children’s diet. The fortified complementary food may not have much impact if the child is not eating it. Click here for a comprehensive manual on food fortification.

Biofortification

 

Biofortification uses plant breeding and/or modern technology to enhance the nutrient content of commonly consumed food staple crops. Micronutrient rich traits can be identified within most of the staple crops which would significantly improve the nutrient status (for iron, for example) of the populations who consume them and will reach remote populations that do not have access to centrally-fortified foods and supplements (Bouis, 2003). Decreasing the content of inhibitors of iron absorption may also be possible as long as it does not reduce crop yield. (Welch, 2002). This approach is highly sustainable. After the investments are made to develop new seeds for crops with higher nutrient content, the current costs and germplasm can be shared internationally (Bouis, 2003). Some examples of nutrients and crops that are being developed and relevant to reducing anemia include:

  • Iron biofortification of rice, beans, and sweet potato
  • Beta-carotene (the precursor of vitamin A) biofortification of sweet potato, maize, and cassava.

Click here and here for additional information on biofortification.

 

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