Today with the increasing awareness of food and nutrition in the world, we have linked various physical and cognitive disabilities with the quality of food we eat. Deficiencies in one or more micronutrients such as zinc, iron and vitamin A are widespread in low economic classes and developing countries (Prakash., 2008). This could be due to various reasons including low income, less exposure to education, low affordability and hence less nutrition.
Another reason is that human diets mainly consist of processed foods these days (Cherry et al., 2019) . These practices have significantly expanded the amount of variety on our serving plates, nonetheless, some micronutrients can be lost during food processing. Even cooking in that case, can alter the amounts of various nutrients in food. Processes like blanching, boiling, microwaving and steaming affect the content of micronutrients in vegetables (Seongeung et al ., 2017). We all know that consumption of such foods with less nutrients over a period of time can cause deficiencies in the long run.
Sometimes the staple food of various regions of India can lack particular nutrients, due to the soil of the region or because of the inherent inadequacy of the normal diet. The nutrient uptake of plants is directly related to the soil quality (Maha., 2008). This can be another reason why people do not meet their daily requirements of micro and macro nutrients. So, fortification of various foods can be an effective way of fighting these nutrient deficiencies.
According to the World Health Organization :
Fortification is the practice of deliberately increasing the content of one or more micronutrients (i.e., vitamins and minerals) in a food or condiment to improve the nutritional quality of the food supply and provide a public health benefit with minimal risk to health. As well as increasing the nutritional content of staple foods. The addition of micronutrients can help to restore the micronutrient content lost during processing.
Vehicles for food fortification
The term vehicle refers to a medium of transporting the micronutrients in the body through foods. The type of vehicle for fortification that will be most appropriate and effective in a given country depends on several factors including: the prevalence of certain micronutrient deficiencies, the population most affected, dietary compositions, available infrastructure, capacities for food processing and production systems, as well as national regulations.
The main fortification vehicles are as follows :
1.Large scale food fortification-
This impactful and cost-effective intervention can reach billions of people by making commonly consumed foods such as wheat, rice, edible oil and condiments (such as salt), more nutritious. It also helps in combating vitamin and mineral deficiencies and protecting human health.
Industrial or large-scale food fortification (LSFF) is the addition of micronutrients during processing to commonly consumed foods. LSFF programs can be categorized as either mandatory—meaning they are initiated and regulated by the government—or voluntary where food processors add nutrients to their foods on their own volition but are still governed by regulatory limits.
- Mandatory fortification programs are increasingly common, especially when it comes to iodized salt. Salt iodization is perhaps the most common form and between 1990 and 2008, the number of households globally consuming iodized salt rose from 20 percent to 70 percent. Currently, over 130 countries have mandated iodized salt. Much before salt, Vanaspati was fortified with Vitamin A and D in 1953 (Anjuli et al ; 2018).
- Voluntary fortification is the process by which a food manufacturer chooses to add one or more micronutrients to processed foods in compliance with government regulations and standards. (Rebecca Olson et al ., 2021)
In contrast to LSFF where nutrients are added during post-harvest processing, biofortification is the process by which food crops are grown to improve their nutritional value. Biofortification projects mainly concentrate on boosting iron, zinc and provitamin A (beta-carotene) in different food crops through plant breeding or agronomically (mineral fertilizer).
Biofortified staple foods cannot deliver as high a level of minerals and vitamins per day as supplements or industrially fortified foods, but they can help by increasing the daily adequacy of micronutrient intakes among individuals throughout the life cycle (Bouis et al. 2011
Research has identified the advantages of this agronomic approach, specifically it targets poor families living in remote rural areas with no or limited access to industrially fortified foods. These families often rely on subsistence farming and can grow, consume and sell their own fortified crops. Additionally, when targeted correctly, biofortification can enable food systems to deliver more nutritious foods cost-effectively.
In case of plant breeding, with transgenic crop technology, the genes of interest are inserted directly into the plant genome and the resulting recombinant proteins which are expressed may not be feasible under conventional plant breeding programs. Expected benefits of consumer traits has been estimated for some genetically modified (GM) crops as compared to their conventional counterparts.
3.Point-of-use or home fortification–
Point-of-use fortification is the addition of vitamins and minerals to food that has been cooked and is ready to be eaten. Formerly known as “home fortification”, the WHO adopted the term “Point-of-use” in 2012 to reflect the many settings where this type of intervention can take place such as in schools and refugee camps. point-of-use fortification of complementary foods with micronutrient powders (MNPs) as a key intervention for improving micronutrient intake. MNPs are single-dose packets containing multiple vitamins and minerals in powder form that can be sprinkled onto food without affecting the taste or colour. The original purpose of “Sprinkles” (original branding) was to provide iron and other nutrients for treating anaemia and iron deficiency (Klaus K et al : 2021)
What are the advantages of fortified foods ?
- The first and the most important advantage is that they are cost effective. Foods that are high in certain nutrients or supplements can be expensive. Foods such as eggs and milk can be fortified with omega 3 fatty acids to match the omega 3 levels of fish that are relatively expensive.
- They prevent nutrition-related illness. When you don’t get enough nutrients, you might have a deficiency. Fortified foods have helped to reduce rates of nutrient deficiency-related illnesses like rickets (caused due to deficiency of Vitamin D). An important thing to note is that you might still not be eating as much as experts recommend.
- They’re helpful in pregnancy. Pregnant women need more food than normal because they’re feeding a growing baby. Even when you’re eating more, you might still not get enough vitamins. Fortified foods can fill the gap. For example, folic acid is added to many fortified products. Getting enough folic acid in your diet during pregnancy lowers the risk of birth defects. Foods that are fortified with folic acid include: enriched breads, flours, pastas, rice, and cornmeal and certain fortified breakfast cereals.
- They protect older adults. As you age, your body absorbs fewer vitamins and minerals. Fortified foods can help maintain healthy micronutrient levels to keep your bones strong, help your digestion.
- Some important nutrients that are present only in animal foods. Fortified foods help make sure you get enough nutrients if you’re vegetarian or have other dietary needs.
- Fortification requires neither changes in existing food patterns – which are notoriously difficult to achieve, especially in the short-term – nor individual compliance.
What to look for in foods in order to identify that they are fortified?
In October 2016, FSSAI operationalized the Food Safety and Standards (Fortification of Foods) Regulations, 2016 for fortifying staples namely Wheat Flour and Rice (with Iron, Vitamin B12 and Folic Acid), Milk and Edible Oil (with Vitamins A and D) and Double Fortified Salt (with Iodine and Iron) to reduce the high burden of micronutrient malnutrition in India. The ‘+F’ logo has been notified to identify fortified foods.
To summarize, fortification may be purely a commercial choice to provide extra nutrients in food, while other times it is a public health policy which aims to reduce the number of people with dietary deficiencies within a population. Not to forget that it also comes with various challenges which is a global debate. While fortified foods contain increased amounts of selected micronutrients, they are not a substitute for a good quality diet that supplies adequate amounts of energy, protein, essential fats and other food constituents required for optimal health.
No matter what, you can’t cover poor nutrition by adding extra vitamins. Desserts made with enriched flours and fortified breakfast cereals coated in sugar aren’t healthy options. The typical diet is already full of processed foods, added sugars, and refined grains. Avoid foods that contain added sugars, have trans fats, or are high in sodium.
While fortified and enriched foods can certainly add to a healthy diet, they aren’t enough by themselves. You still need to eat a well-rounded, varied diet that is loaded with vegetables and other whole foods. You cannot rely on fortification or enrichment to get all of the nutrients you need.
FSSAI (Food Safety and Standards Authority of India) supports this idea and has also titled food fortification as a ‘complementary strategy’ rather than a ‘replacement of balanced, diversified diets’ to address malnutrition. As explained by FSSAI, fortification only bridges the gap between the need and actual consumption of required micronutrients through food.