Abstract
Historically, food fortification has served as a tool to address population-wide nutrient deficiencies such as rickets by vitamin D fortified milk. This article discusses the different policy strategies to be used today. Mandatory or voluntary fortification and fortified foods, which the consumer needs, also have to comply with nutritional, regulatory, food safety and technical issues. The ‘worldwide map of vitamin fortification’ is analysed, including differences between develop and developing countries. The vitamins, folate and vitamin D, are taken as practical examples in the review of the beneficial effect of different strategies on public health. The importance of the risk–benefit aspect, as well as how to identify the risk groups, and the food vehicles for fortification is discussed.
Highlights
Food fortification has served as a tool to address population-wide nutrient deficiencies such as rickets by vitamin D fortified milk
An example of success in food fortification programmes can be found in the United States, where great efforts have been made within public health officials and educators, the private industry and epidemiological evaluation [2]
Thereafter in 1932, milk was fortified with vitamin D, and again, this was heavily supported by the medical community because of the prevalence of rickets in children [2]
Summary
The main examples are folic acid fortified wheat or maize flour to reduce the risk of neural tube defects (NTD) and limitation of fortification of foods with certain nutrients such as vitamin D. The main public health measure for primary prevention of NTD in many countries is the recommendation of folic acid supplements taken periconceptionally amongst women who are planning a pregnancy.
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