Abstract
‘Discretionary fortification’ refers to the addition of vitamins and minerals to foods at the discretion of manufacturers for marketing purposes, but not as part of a planned public health intervention. While the nutrients added may correspond to needs in the population, an examination of novel beverages sold in Toronto supermarkets revealed added nutrients for which there is little or no evidence of inadequacy in the population. This is consistent with the variable effects of manufacturer-driven fortification on nutrient adequacy observed in the US. Nutrient intakes in excess of Tolerable Upper Intake Levels are now observed in the context of supplement use and high levels of consumption of fortified foods. Expanding discretionary fortification can only increase nutrient exposures, but any health risks associated with chronically high nutrient loads from fortification and supplementation remain to be discovered. Regulatory bodies are focused on the establishment of safe levels of nutrient addition, but their estimation procedures are fraught with untested assumptions and data limitations. The task of determining the benefits of discretionary fortification is being left to consumers, but the nutrition information available to them is insufficient to allow for differentiation of potentially beneficial fortification from gratuitous nutrient additions.
Highlights
IntroductionIi) Several beverages were fortified with nutrients for which no population dietary assessment has been conducted– pantothenic acid, vitamin E, or chromium
Food fortification has long been employed as a strategy to address demonstrated problems of nutrient insufficiency in populations
Discretionary fortification is distinct from voluntary fortification programs implemented by public health authorities to address specific population health problems
Summary
Ii) Several beverages were fortified with nutrients for which no population dietary assessment has been conducted– pantothenic acid, vitamin E, or chromium It is impossible for food manufacturers, regulators, or consumers to gauge how the products relate to current intake levels or needs in the population. Iv) Whereas the calibration of nutrient additions to the energy content or gram weight of particular food vehicles is critical to managing exposure when fortification is implemented as a public health measure, the energy content of products in this study ranged from 0 to 230 kcal/serving (mean = 113 kcal), and low- and zero-calorie products were as likely as more energy dense ones to contain nutrients in excess of requirements. The fortification of calorie-free beverages that might be regarded as alternatives to water (i.e., ‘vitamin waters’) suggests the potential for consumption of multiple servings, heightening nutrient loads
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