Discretionary fortification may ‘discourage healthier eating’: Study

Health Canada’s proposal to allow discretional fortification of select food products may actually discourage healthier eating, according to a new study from the University of Toronto.

Writing in the European Journal of Clinical Nutrition Jocelyn Sacco and Valerie Tarasuk report that nutrient intakes would actually decrease as a result of consuming foods slated for discretionary fortification. This would be because consumers would reduce intake of foods like vegetables and fruit, meat and alternatives, milk products, they said.

Discretionary fortification has been allowed in the US since the early 1990s as well as Europe. However, according to the Canadian researchers, the potential implications of such a practice for the health of a population “have been the subject of little research”. What studies have been done have indicated a positive impact on nutrient intakes, they noted.

“The effect of discretionary fortification on food selection and dietary patterns has not been examined,” added the Toronto-based scientists, “but as concerns about the growing prevalence of obesity mount, manufacturers’ use of nutrient additions to market foods of otherwise low nutritional value is coming into question.”

The new paper adds to a previous article by Sacco and Tarasuk published in the Journal of Nutrition in 2009 (Vol. 139, No. 10, pp. 1980-1986). That article described Health Canada’s proposed discretionary fortification policy as being “misaligned with the nutritional needs of Canadians because it is not rooted in an assessment of current nutrient intake patterns”.

To better understand current nutrient intakes, the Toronto-based researchers used 24 hour dietary recall data from the 2004 Canadian Community Health Survey to assess fortifiable food intakes and dietary quality.

Results showed that younger age groups consumed the highest proportion of fortifiable foods as a percentage of energy intake. Indeed, the highest contributions to energy intake of fortifiable foods was observed for 14 to 18 year old girls, with 36 percent, compared with 19 percent for men over the age of 70.

“The fortifiable foods that contributed the most to energy intakes were baked goods and beverages, and this was consistent across all age/sex groups,” explained the researchers.

An inverse association between fortifiable food intakes and the number of servings of foods like fruit and vegetables, dairy products, and meat was observed for most age and gender groups. These inverse associations also extended to vitamins A, D, B6 and B12, potassium, magnesium, zinc, and fiber, report the researchers.

What does it mean?

Commenting on their results, Sacco and Tarasuk note that many of the foods that would be eligible for fortification are also identified as ‘foods to limit’, including salty snacks, soft drinks, cakes and pastries, cookies, chocolate and candies, ice cream, and fruit-flavored drinks.

“Therefore, Health Canada’s proposed discretionary fortification policy is at odds with national dietary recommendations,” they wrote.

“The apparent contradiction between the kinds of foods slated for nutrient additions under the proposed discretionary fortification policy and those recommended in Canada’s Food Guide is not surprising, given the very different goals underpinning these two initiatives.”

“As discussions to develop international standards for discretionary fortification continue (Codex Alimentarius Commission, 2007), it is important that we understand the broader public health implications of discretionary fortification policies on food consumption patterns, particularly in the context of a growing prevalence of obesity,” they concluded.

Source: European Journal of Clinical Nutrition

Volume 65, Pages 313-320, doi:10.1038/ejcn.2010.261

“Discretionary addition of vitamins and minerals to foods: implications for healthy eating”

Authors: J.E. Sacco, V. Tarasuk