Fortification and health: challenges and opportunities.

Fortification is the process of adding nutrients or non-nutrient bioactive components to edible products (e.g., food, food constituents, or supplements). Fortification can be used to correct or prevent widespread nutrient intake shortfalls and associated deficiencies, to balance the total nutrient profile of a diet, to restore nutrients lost in processing, or to appeal to consumers looking to supplement their diet. Food fortification could be considered as a public health strategy to enhance nutrient intakes of a population. Over the past century, fortification has been effective at reducing the risk of nutrient deficiency diseases such as beriberi, goiter, pellagra, and rickets. However, the world today is very different from when fortification emerged in the 1920s. Although early fortification programs were designed to eliminate deficiency diseases, current fortification programs are based on low dietary intakes rather than a diagnosable condition. Moving forward, we must be diligent in our approach to achieving effective and responsible fortification practices and policies, including responsible marketing of fortified products. Fortification must be applied prudently, its effects monitored diligently, and the public informed effectively about its benefits through consumer education efforts. Clear lines of authority for establishing fortification guidelines should be developed and should take into account changing population demographics, changes in the food supply, and advances in technology. This article is a summary of a symposium presented at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2014 on current issues involving fortification focusing primarily on the United States and Canada and recommendations for the development of responsible fortification practices to ensure their safety and effectiveness.

Whole grains health claims in the USA and other efforts to increase whole-grain consumption.

In response to the 1990 Nutrition Labeling and Education Act, the Food and Drug Administration approved seven health claims that addressed the relationship between broad food categories and risk of certain chronic diseases. These claims are based on scientific consensus that includes epidemiological, animal and clinical research. The Food and Drug Administration also established a process to petition for new health claims that address substance-disease relationships supported by adequate scientific and specific regulatory requirements. The whole grain-cancer and heart disease authoritative statement health claim approved in July 1999 followed a completely different process mandated by the Food and Drug Administration Modernization Act of 1997. It is based on an authoritative statement made by a government body that represents scientific consensus and is supported by other scientific agencies and organizations. The scientific basis for the claim published in Diet and Health reflects a comprehensive and deliberative review of epidemiological, animal and human studies by the National Academy of Sciences Committee on Diet and Health. Health claims used on whole grain products can attract the attention of health-conscious consumers and are important tools in communicating health messages. However, the US public consumes substantially fewer whole-grain servings than recommended by US dietary guidance. Reasons given by consumers for not purchasing wholegrain foods include colour, price, softness, texture, moisture content and taste. Developing tastier value-added wholegrain foods along with simple coordinated messages from industry, the scientific community, public health experts and government will help consumers identify, purchase and consume more wholegrain products.