History and Rationale:-
The concept of food fortification dates back to the early 20th century, with notable examples including the addition of iodine to salt to prevent goiter and vitamin D to milk to combat rickets. Fortification became a public health strategy to tackle nutrient deficiencies that were common even in developed countries. There is no dispute that food fortification is a proven approach for addressing the dietary inadequacies of micronutrients like iodine, and Vitamins B1 and B2. India has successfully implemented the mandatory use of iodine fortified common salt (since 1989) and reduced the prevalence of iodine deficiency disorders (IDD) below the public health significance level. This has been achieved in a very systematic way, initially by conducting studies in goiter endemic locations to prove the efficacy and effectiveness of iodine fortification, then testing the strategy in other locations, and finally making the use of iodised salt mandatory with monitoring and risk assessment mechanisms in place. Since dietary available Iodine was very less, fortification was made a universal strategy in 2005-06 by GOI. (The Gazette of India, 2018).
Common Fortified Nutrients
1. Vitamins:
Vitamin D: added to dairy products and cereals to support bone health.
B Vitamins (B1, B2, B3, B6, B12, and folic acid): Commonly added to cereals and flour to prevent deficiencies that could lead to anemia and neurological issues.
2. Minerals:
Iron: Added to cereals, flours, and rice to prevent iron-deficiency anemia.
Calcium: Fortified in juices, plant-based milk alternatives, and cereals to support bone health.
Iodine: Added to table salt to prevent thyroid-related issues.
Benefits of Fortified Foods
1. Nutritional Improvement: Fortification helps increase the intake of essential nutrients that people might otherwise lack in their diet, thereby improving overall health.
2. Prevention of Deficiencies: It plays a crucial role in preventing diseases caused by nutritional deficiencies such as rickets, scurvy, and beriberi.
3. Public Health Impact: Fortified foods have been instrumental in reducing the prevalence of conditions like neural tube defects, thanks to folic acid fortification.
Types of Fortification
1. Mass Fortification: This involves adding nutrients to foods consumed widely by the general population, such as staple foods like flour, rice, and milk.
2. Targeted Fortification: Nutrients are added to foods consumed by specific groups, such as infants, pregnant women, or elderly individuals.
3. Market-driven Fortification: Food manufacturers add nutrients to products for competitive advantage and consumer health benefits, often seen in cereals, beverages, and snacks.
Conclusion Fortified foods represent a critical public health intervention, addressing micronutrient deficiencies and improving the nutritional quality of the diet. While they offer significant benefits, it is essential to balance fortification with potential risks, ensuring that it is part of a comprehensive strategy to improve nutrition and health outcomes.