Food fortification is the process whereby nutrients (vitamins and minerals) are added to food. This normally happens during or directly after manufacturing.
Food products may be fortified for the following reasons:
- To replace nutrients removed during processing (e.g. when flour is milled, thereby removing bran and germ).
- To supplement a diet lacking essential nutrients.
All foods contain micro-nutrients to a greater or lesser degree and not all foods contain the same amount. Therefore, a balanced diet is the ideal way of ensuring adequate intake of all the essential micro-nutrients. Fortification is however an important intervention that can be considered where this is not possible (e.g. due to consumption of traditional diets or for financial reasons).
Policy - Need
Many countries have an official fortification policy and in South Africa it is mandatory for maize meal and bread flour (and thus indirectly all products containing these as ingredients) to be fortified with a blend of vitamins and minerals. It is also mandatory for all table salt to be fortified with iodine. The types of vitamins and minerals and fortification levels are prescribed by law. Mandatory fortification should however not be confused with products such as certain breakfast cereals which are fortified by their manufacturers for commercial reasons.
Before considering a fortification policy there should be scientific evidence that it is needed. The following evidence should be forthcoming if a fortification scheme is to be regarded as resting on a sound scientific basis:
- Evidence that there is need for the nutrients to be added by fortification (this will be evident from nutritional status surveys).
- Evidence that the food selected as a vehicle for the nutrient must reach the population at risk.
- Evidence that the amounts of fortifying substances provided are sufficient to satisfy the proven need when the food is consumed in normal quantities by the population at risk.
- Proof that the fortification medium is regularly consumed in important quantities by those in need of fortification.
- Evidence that the fortification can be easily carried out in practice, i.e. is technically feasible for the particular food to be fortified, and that the added micro-nutrients can be evenly distributed throughout the food that is to be fortified.
- Evidence that the fortifying substances or preparations do not appreciably alter the appearance, taste, physical characteristics, shelf-life or cooking properties of the food.
- Evidence that the fortifying substance or preparation/s are free from bacterial contamination or toxicity.
- Evidence that the cost of fortification does not result in a significant increase in the cost of the food fortified.
- Evidence that the food selected does not seriously interfere with the utilisation of the nutrient and the nutrient is biologically available (i.e. is fully taken up by the body) in the form in which it is added and remains stable in the food throughout the shelf life of the fortified product.
Renewed and intensive studies on food fortification are being carried out world-wide. Fortification has been shown to be one of the very best global initiatives for improving public health, particularly for at-risk categories such as young children, pregnant or lactating women and the elderly or infirm. It is extensively supported by governments, NGOs and manufacturers of staple foods.
Malnutrition, with emphasis on under-nutrition, is one of the major problems to be addressed urgently in South Africa. Nutrition status surveys over the past number of years have confirmed this and specific deficiency diseases have been identified, for example pellagra (deficiency in certain B-group vitamins), poor eyesight and resistance to infection (vitamin A deficiency), anaemia (iron and folic acid deficiency) and goitre (iodine deficiency).
The South African staple food fortification program has been in place since 2003 and is reviewed periodically to ensure it meets the changing nutritional and health needs of the population.
Updated for F.A.C.S. by NSu (2017)