Adding Nutrients to Nature

A Long and Fortified Road

The history of food fortification is ancient. The earliest recorded instance was in 400 B.C., when the Persian physician Melanpus suggested that adding iron filings to wine could enhance soldiers’ strength. The modern fortification of food began in the first half of the 20th century (in 1833 a French agricultural scientist urged his government to add iodine to salt to prevent goiter, but it wasn’t until the 1920s that this suggestion was put into practice). The 1920s, 30s and 40s saw the addition of iodine to salt, vitamins A and D to margarine, vitamin D to milk, and vitamins B1, B2, niacin and iron to flour and bread.

The fortification of food continued to gain momentum during World War II, according to Max Kamien, writing in a 2006 issue of the Medical Journal of Australia. “By 1943, the US Army would not purchase any flour or bread that was not fortified. In the UK, calcium, thiamine, niacin and iron were added to bread. In some cases, this was poorly absorbable powdered iron obtained from grinding up old railway lines.” Dietary staples such as bread and milk were especially good foods to fortify since they were staples.

In the 1950s obstetricians began to wonder whether diet had something to do with neural tube defects such as spina bifida; the incidence of such birth defects appeared to be more common in lower socioeconomic populations and in babies conceived in the winter, when fresh produce was less available. The missing micronutrient turned out to be folic acid (from the Latin folium, for leaf), a B vitamin which was isolated from spinach in 1941.

The enrichment and fortification of foods can now proudly claim many public health success stories: iodine in salt and bread to prevent goiter; vitamin D in milk and dairy products to prevent rickets; thiamine, niacin and riboflavin in bread to prevent beri-beri and pellagra; and fluoride in drinking water to reduce cavities. And yet, fortification has also been met with resistance and controversy. There have been objections from people who protest any “tampering” with the food and water supply. But, perhaps more surprisingly, there has also been opposition from some nutritionists who feel that a better solution would be education on the benefits of a well-balanced diet. (Even more controversial have been proposals, such as the one in Australia in the 1980s, to fortify beer because of vitamin B deficiencies among alcoholics.)

In affluent societies, it is easy to think of nutrition mostly in terms of optimum personal health. But in the developing world, improved nutrition is much more fundamental: good, basic meals make it possible for children to go to school and adults to work, which translates into healthier and more productive communities. And adding key vitamins, minerals and other nutrients to staple foods is a cost-effective way to make a dramatic difference in the lives of hundreds of millions of people. Deficiencies of iron, vitamin A and zinc are ranked among the World Health Organization’s top 10 leading causes of death through disease in developing countries. Iodine deficiency, for example, which by some estimates affects close to a billion people, is the most common preventable cause of mental retardation worldwide. LESS

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But fortified foods these days are reaching well beyond the recommended daily allowances for vitamins and minerals. The frontier of fortification is now functional foods. If green tea has health benefits, why not add green tea extract to cookies or granola bars? If omega-3s, which are found in salmon, have been shown to reduce the risk of heart disease and diabetes, why not add them to orange juice or bread or cereal or frozen pizza or flour tortillas or eggs or even margarine, which was once loaded with trans fats! LESS

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