Why Is Food Fortification Necessary?
Food fortification is adding vitamins, minerals, or essential micronutrients to common consumables or edible items ranging from staple foods like wheat, rice, sugar, salt, oil, etc. It is an effective strategy in terms of nutrition enhancement as per the daily required dietary intake. It does not require any global behavioral changes or modification in diet patterns because of the variation in cuisines, methods, and food sources. Global surveys have shown food fortification as an efficient method to fight nutrient-based deficiency diseases like rickets, pellagra, beriberi, goiter, etc.
What Are the Types of Micronutrient Deficiencies?
Deficiencies in one or more of the micronutrients essential to our metabolic body functions, such as iron, zinc, or vitamin A, is a global problem that results in malnutrition, especially in low and middle-income countries. The individuals of such populations are compromised on their physical and cognitive needs. Food fortification strategies are nutrition-based programs globally that are cost-effective and have demonstrated improved consequences in health, economic and social welfare worldwide.
Most cases of undernutrition are seen in the maternal and child-related sector, which results in approximately 45 percent of worldwide deaths as per prevalence rates and research in children under five years in low and middle-income countries (LMIC). Another widespread problem in LMICs is due to lack of affordability; people live with "hidden hunger," which causes a lack of essential vitamins and minerals in their daily diet. Deficiencies in these essential micronutrients, especially iron, zinc, and vitamin A, can hinder physical and cognitive capacity and create a vicious global cycle of malnutrition-related diseases. For example, around 7.3 percent of diseases worldwide are linked to iron and vitamin A deficiency, which in turn, contributes to the deaths of nearly one million children annually. The World Health Organization (WHO) also estimates that approximately 42 percent of children less than five years of age and around 40 percent of pregnant women worldwide are anemic, and those pregnant suffering from severe anemia would be twice as susceptible to death after pregnancy. Lack of micronutrients would cause abnormalities in the uterus, leading to low birth weight infants or infants born with brain and spinal defects as metabolic requirements are high during pregnancy, prenatal and postnatal development.
What Are the Types of Fortification?
The fortification of staple foods has improved dietary diversity and effectively decreased micronutrient deficiencies. The types of food fortification include:
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Large-Scale Food Fortification (LSFF): The micronutrients are added on a large scale during the processing phase to commonly consumed foods and condiments, for example, salt, flour, oil, sugar, etc. LSFF programs are frequently initiated or regulated by local governments.
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Point-Of-Use Fortification: Addition of vitamins and minerals to food that is already cooked and ready to be eaten.
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Biofortification: In this method, the food crops are grown by adding essential biofortified nutrients, protein, etc., to improve the nutritional value of the crop. Examples exist of several social projects for biofortification with amino acids and proteins. Common biofortification projects include the iron biofortification of rice, beans, maize, etc.
What Are Some Global Implementation Strategies?
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Salt iodization is a good example and the most common form of fortification for public health and welfare. It was implemented globally through community planning between 1990 to 2008. According to the survey reports, iodized salt consumed exponentially increased from 20 to 70 percent globally. Post this phase, nearly 130 countries followed the mandatory protocol of iodized salt.
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Wheat flour fortification was introduced in the year 1942, and ever since date, 85 countries have mandated the use of wheat fortification.
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In North and South America, fortification is done by adding folic acid to wheat flour, which significantly lowers the risk of the predisposition of infants to congenital disabilities.
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Edible oils are also good examples of being increasingly used for fortification, like oil fortification with vitamin A.
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Many countries have also mandated milk fortification, especially vitamins A and D, iron and folic acid, calcium, etc., that helps provide children with nutrition, health, and immunity benefits.
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Sugar was fortified by adding vitamin A in the 1970s in Latin America and Guatemala in 1975.
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Over 140 countries have followed this mandate of global guidance or regulation for fortification programs of essential ingredients for daily dietary intake.
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Most fortification programs vary from country to country based on individual needs, staple ingredients, and the overall intake of local foods. As per current statistics, nearly 140 countries are implementing the national salt iodization program, and in 102 countries, it's mandatory. While in 85 countries, at least one kind of cereal grain like maize, rice, or wheat is fortified with iron or folic acid, and in almost 40 countries, edible oils, margarine, sugar, etc., are fortified with vitamins A and D.
Conclusion
Fortified food is thus considered a significant reformation in improving nourishment and immunity. Especially in large-scale populations and in lower socioeconomic countries, it is the need of the hour, as people are more susceptible to micronutrient deficiencies, and that would be averted or minimized within a short period with the benefit of food fortification.
