Foods with added nutrients

Vitamins and minerals have been added to many foods over many years. In some cases fortification is a legal requirement; the addition of thiamin, niacin, calcium and iron to white and brown flour is mandatory, as is the addition of vitamins A and D to margarine. In some cases fortification is as a result of expert recommendation, such as where a type of food typically replaces another nutrient-rich food: vegetable protein foods can be fortified to compensate diets without meat, and soya products can be fortified (usually with calcium) to compensate diets without dairy foods. Breakfast cereal fortification is almost universal, although this is voluntary. Some foods are fortified to support particular marketing/advertising strategies, and to communicate health and added value to consumers.

The addition of nutrients to some foods reduces the chances of poor nutrient status in many people, either because of inappropriate food choices, or as a result of nutrient requirements that would be difficult to achieve from unfortified foods alone. For example, vitamin D is only found naturally in a few foods (oily fish, eggs, fatty meat) and in typical UK diets, fortified margarine and breakfast cereals provide a very significant component of vitamin D intakes.

In 1996, the US government made the addition of the B vitamin folic acid to many cereal and grain products mandatory. This was driven by the scientific research showing that higher levels of folic acid in the mother during the very early stages of pregnancy very much reduced the chances of neural tube defects (e.g. Spina Bifida) in the developing baby. Data support the improved folic acid status in the US population since the national fortification policy, and reduced number of babies born with spinal handicap. The Food Standards Agency has recently completed a consultation setting out options for improving the intake of the vitamin folate for young women in order to reduce the number of neural tube defect (NTD) affected pregnancies in the UK. This coincides with the publication of the Scientific Advisory Committee on Nutrition's (SACN) final report on Folate and Disease Prevention in which SACN recommends the implementation of mandatory fortification of flour with folic acid in the UK.

Another policy issue currently under discussion in the UK is the risk of excessive intakes of micronutrients, and the particular contributions from both supplements and fortified foods. In 2003 the Food Standards Agency Expert Group on Vitamins and Minerals reviewed the scientific data on high intakes, and defined Safe Upper Levels (SULs). The European Commission are consulting on ‘maximum and minimum amounts for vitamins and minerals in foodstuffs’ to support the European-wide regulation of food fortification practices. Discussions will focus on the best regulatory balance between consumers having choices and possible health benefits from fortified foods (and supplements) versus not being misled or put at risk from the adverse effects of high or unbalanced intakes of micronutrients. 

The information was correct at issue. For personal dietary information, a local dietitian is the best source of information.

Want to be sure the dietitian you consult is registered? Check the Health Professions Council search facility of dietitians registered in the UK (www.hpc-uk.org)

Issue date: September 2006
Re-write: April 2007