Food Enrichment and Fortification

Food Enrichment and Fortification

February 2, 2024

Joy Stepinski, MSN, RN-BC

Vitamins and supplements have an intriguing past that plays a role in our health decisions.  Not only are they available in pill form, but they also are added to the food supply. Fortification and enrichment are two words often found on packaged foods. During manufacturing, vitamins are removed due to the effects of heat, light, and temperature because of processing. The stability and long shelf-life require food to be stripped of its nutritional value. For instance, the milling of flour removes up to 80% of its natural thiamin [1].

In 1939, the American Medical Association requested that nutrients be added back into processed food. As a result, fortification and enrichment became the norm. Enrichment implies the restoration of nutrients to the natural pre-processed levels. Fortification is a little different and refers to the addition of vitamins or minerals to food products.

The history of fortification in the United States goes back approximately 100 years ago with the idea to improve public health nutritional deficiencies. Iodized salt met an iodine deficiency, endemic especially in the Great Lakes region, Appalachia, and the northwest [2] from lack of nutrients in the soil [1]. Currently, 90% of American households have access to iodized salt. Fortification also exists with many food products, such as the addition of Vitamin D to milk in 1931 [3]; niacin, riboflavin, thiamin, and iron to flour in 1941 [4]; calcium to orange juice [3]; and many others commonly found on grocery store shelves today.

Although fortification has been considered beneficial for certain instances, the debate on treating an entire population with these additives continues. As in the words of Catherine Price, author of Vitamania: How Vitamins Revolutionized the Way We Think About Food, “There’s a consequence: not only are we missing out on whatever other important dietary chemicals might be present in unprocessed food, but the constant supply of synthetic vitamins blinds us to our own dependence on them” (p. xiii).

Relying on single nutrients relates to the idea of reductionism. T. Colin Campbell describes this well in his book Whole: Rethinking the Science of Food. Reductionism is the belief that the small parts have greater weight than the whole big picture. In other words, a single active ingredient is assumed to make food healthy [5]. However, often nutrients do not function by themselves. Our body was created to obtain just the right amounts from whole food.

As seen in recent years, daily nutritional needs tend to be answered by manufacturers with synthetic additives. Yet, ignoring the nutritional value of whole food can be detrimental. The human body is not necessarily meant to use nutrients in isolation. When a whole food is consumed, such as an apple, countless chemical reactions take place that do not occur with a synthetic supplement. Side effects and adverse events are possible with manufactured supplements and may interfere with prescribed medications. Adding these supplements to the food supply for the general public may not be entirely beneficial or safe.

What does this mean for your health-related decisions? Instead of focusing on the quantity of vitamins listed on the package label, consider if the particular food truly supports health. Does consuming a manufactured food filled with synthetic vitamins overlook the importance of a nutritionally-dense whole food (such as a fruit or vegetable)? This is worth keeping in mind to support whole health.

References:

1.    Price, C. (2016). Vitamania: How vitamins revolutionized the way we think about food. Penguin Books.

2.    Leung, A. M., Braverman, L. E., & Pearce, E. N. (2012). History of US iodine fortification and supplementation. Nutrients, 4(11), 1740-1746. https://doi.org/10.3390/nu4111740

3.    Nestle, M. (2002). Food politics. University of California Press.

4.    Institute of Medicine (US) Committee on Use of Dietary Reference Intakes in Nutrition Labeling. (2003). Overview of food fortification in the United States and Canada. Dietary Reference Intakes: Guiding Principles for Nutrition Labeling and Fortification, 45-47.

5.    Campbell, T. C. (2014). Whole: Rethinking the science of nutrition. BenBella Books.