More than two-thirds of Americans don’t eat fruits or vegetables at least twice a day, and most don’t meet the
Worldwide, more than 2 billion people have micronutrient deficiencies because they aren’t getting enough essential vitamins and minerals each day. Many Americans also aren’t meeting the requirement for vitamins and minerals, especially children.
Fortified and enriched foods were introduced in the 1930s and 1940s. They were intended to help boost vitamin and mineral intake with foods that adults and children were already eating, like grains and milk.
Fortified foods are those that have nutrients added to them that don’t naturally occur in the food. These foods are meant to improve nutrition and add health benefits. For example, milk is often fortified with vitamin D, and calcium may be added to fruit juices.
An enriched food means that nutrients that were lost during processing are added back in. Many refined grains are enriched. Wheat flour, for example, may have folic acid, riboflavin, and iron added back in after processing. This is intended to restore its original vitamin levels.
Historically, fortifying foods has been widely successful in the United States. Common diseases that are caused by nutrient deficiencies, like rickets and pellagra, have been virtually eliminated.
Even though fortification has increased vitamin and mineral consumption in the United States, there haven’t been studies on nutrients other than folic acid that show that fortified foods are improving our health. There are also concerns that fortified and enriched foods may be causing people to get harmful amounts of certain vitamins and minerals.
Fortified and enriched foods can be a part of a healthy, nutrient-rich diet. But whether or not they’re beneficial depends on age and a few other factors.
Children are particularly vulnerable to nutrient deficiencies. Without added vitamins and minerals, many children and teens don’t meet daily nutrient requirements. Fortified and enriched foods are important sources of nutrients for kids, especially for iron, zinc, and B vitamins.
Unfortunately, many fortified or enriched foods are heavily processed and packaged. They often come with high sodium, fat, and sugar content. Fortification doesn’t make them inherently healthy or good for you.
Many younger children are also at risk of overdosing on some added vitamins, according to a report from the Environmental Working Group (EWG). The report showed that many fortified foods currently available contain levels of vitamins that aren’t appropriate for children. Many children may also exceed daily recommended values by eating a variety of fortified foods throughout the day, or by eating more than one serving. Nearly half of children ages 2 to 8 get too much zinc, and 13 percent consume too much vitamin A. These overdoses are potentially dangerous.
Fortified and enriched foods, especially foods not formulated for children, may not be safe for all children. The EWG recommends that children eat products with no more than 20 to 25 percent of the adult recommended daily value for vitamin A, niacin, and zinc. You can find this value on the nutrition label. While it’s still important to keep an eye on these nutrients, tweens and teens may benefit from including fortified or enriched foods in a balanced diet.
While adults also
- calcium
- magnesium
- dietary fiber
- vitamins A, D, E, and C.
Older adults and pregnant women are especially vulnerable to vitamin deficiencies.
People with special diets also need to be aware of potential vitamin deficiencies. Vegans, for example, can benefit from foods fortified with vitamin B-12.
However, adults can overconsume certain vitamins with enriched or fortified foods, especially if they are also taking supplements.
Pregnant women and older adults can get too much vitamin A. It can cause birth defects, and high levels of vitamin A have been linked to hip fractures in older adults. While many women still have low folate intake, foods fortified with folic acid can cause people to get too much, according to the Harvard T.H. Chan School of Public Health.
Outdated daily value guidelines are also a concern. The U.S. Food and Drug Administration’s (FDA) recommendations have not been updated since they were introduced in 1968. The current guidelines conflict with the levels that the Institute of Medicine of the National Academies consider to be safe. This means that many fortified or enriched foods may be within the FDA’s guidelines, but may in fact have more than is necessary or safe.
In some cases, fortified or enriched foods are helpful. They can fill in the gaps and increase a particular vitamin and mineral consumption that would otherwise be less than the recommended value.
But it’s also easy to get too much. These foods can contribute to nutrient overdoses. Be aware of how much of each nutrient you are eating. Don’t forget to include foods that don’t come with a nutrition label, like dark leafy greens. Keep an eye on serving sizes to make sure you’re not overdosing on added vitamins or minerals.
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 nutrient-poor 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.
Q:
Is it worth spending more money to buy fortified foods at the store?
A:
I may recommend fortified whole grains to a pregnant woman or child if their diet is otherwise inadequate in folate and the potential of deficiency is too risky. I rarely tell people to seek out fortified or enriched foods unless they are at risk for a deficiency or already have one. My approach is to recommend as many whole, plant foods as possible to obtain nutrients in their original, natural form and then fill in any gaps with targeted recommendations. Processed foods are the ones most often enriched, which may encourage people to consume more processed foods, not less.
Natalie Butler, RD, LDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
