Dangers of Food Fortification and Enrichment
Of all the things we can add to food, vitamins and minerals may seem the most benign, if not beneficial! Most of us wouldn’t think twice if we saw them on an ingredient list.
After all, added vitamins stand out innocently - or even as saviors - against thickeners, oils, and other additives that you can’t pronounce unless you’re a doctor of linguistics.
But you should beware! Fortification and enrichment of food products with so-called “health halos” are not as innocent or helpful as they seem. Read on to learn why at Elmhurst we believe that less is always more.
Fortification vs Enrichment: What's the Difference?
If you read a Nut Milk package, you may see an ingredient like “vitamin and mineral blend,” with the scientific names of its components written alongside. This is an example of fortification and/or enrichment.
Fortification and enrichment are similar in that both involve adding nutrients – most often vitamins and minerals – to make a product “healthier.” There is also an important distinction between the two.
- What does fortification mean? A fortified food is one with added nutrients (most often vitamins and minerals) meant to boost nutrient density, treat or prevent disease, and promote general well-being. Examples of fortified foods include orange juice with vitamin D and iodized salt. 1
- What does enrichment mean? An enriched food loses its nutritional value during processing, so then the food companies add synthetic versions of these nutrients back into the food to try and restore or enhance its original nutrient density. Examples of enriched foods include skim or low-fat milk with vitamin D and wheat flour with folic acid, riboflavin, and iron. 1
Fortification and Enrichment Rationale & History
Fortification and enrichment are responses to a sobering shared reality: most people are nutrient-deficient. More than two-thirds of Americans do not consume the FDA-recommended number of fruits and vegetables per day. Children are especially vulnerable to nutrient deficiencies because of their growth needs, and evidence suggests that adults are typically deficient in calcium, magnesium, and vitamins A, D, E, and C. 2
Beginning in the 1920s, government agencies and food policy advocates started pushing enrichment and fortification in an attempt to decrease nutrient deficiencies in the general population. The intent was not to alter dietary habits, per se, but to increase micronutrient intakes through foods Americans were already consuming. For example, companies began adding iodine to table salt to combat a high incidence of goiter (enlarged thyroid gland due to iodine deficiency) in the United States. 3
Additionally, the Food & Drug Administration enforced a mandate of adding folic acid to grain products (such as cereals and breads) to prevent neural tube defects in newborn babies.4
Are Fortification and Enrichment Good or Bad?
Although fortification has increased the intake of vitamins and minerals in the United States, there is little evidence to suggest that adding nutrients (other than folic acid) has improved our health. In fact, there are concerns that fortifying and enriching foods may be harming us. 5,6
Some Problems with Fortification & Enrichment
Companies Often Add Vitamins at Dangerous Levels
This level may be up to 100% of the recommended daily allowance in a single serving, possibly causing you to exceed the limit. Most people do not exhibit deficiencies to such an extent to warrant this much. Hyper-fortified foods, in extreme cases, can result in toxicity overload and irreversible organ damage.7,8
Examples of problems from overconsuming vitamins A, E, B9, B12, calcium and iron include:
- Too much-added vitamin A reduces bone density in older adults, increases the risks of birth defects and liver damage, and is associated with higher overall mortality risk.
- Too much-added vitamin E can increase the risk of stroke.
- Too much added folic acid (vitamin B9) can decrease immunity or mask a vitamin B12 deficiency (commonly seen in vegetarians).
- Too much-added calcium can cause kidney stones.
- Too much iron raises the risk of diabetes and heart problems in individuals with hemochromatosis, a genetic condition that causes the body to store excess iron in the liver, heart, and pancreas.
Fortification and Enrichment Upsets Nature’s Packaging
Your body does not absorb individual nutrients added to processed foods as efficiently compared to nutrients naturally occurring in whole foods. In short, all nutrients in whole foods have a purpose, working in concert to enhance the uptake and bioavailability of each other. A simple example is skim milk fortified with vitamins A and D. Skim and low-fat milk have been processed to remove the fat, thereby losing the fat-soluble vitamins A, D, and K. Although vitamins A and D are added back, our bodies cannot absorb them without a fat vehicle, nor can they function optimally without the assistance of vitamin K. 9
Vitamins added to Foods are Less Bioavailable
Nutrient bioavailability refers to the proportion of nutrients your body can absorb and use. Most food companies inject synthetic versions of vitamins and minerals, which your body may process differently (or not at all) compared to the natural, food-based versions.
Synthetic Vitamins Lack Immune-Boosting Substances
All-natural foods contain a trove of antioxidants and phytonutrients that scientists have yet to identify, let alone replicate. A group of physicians from university schools of public health around the country published a review in the Annals of Internal Medicine asserting that dietary supplements carry few potential benefits and, in some cases, are more harmful than helpful. 8
Elevated Levels of Certain Vitamins & Minerals Can Interact with Prescription Medications
Fortified foods and supplements can pose specific risks for people who are taking prescription medications, including decreased absorption of other micronutrients, treatment failure, and increased mortality risk. For example, calcium supplements have been found to interact dangerously with some heart and thyroid drugs. 11
Vitamins Often Only Need to Be Added Because They Were Originally Taken Out
While the foundation of most of what we eat is healthy, nutritious food, unfortunately, the nutrients within often end up being lost during the heavy processing that occurs to create the final product that ends up on the store shelves. If vitamins and minerals are being added back to foods, how bad must the processing have been to knock out all the healthful goodness that was already there?
Forced into foods or taken independently as supplements, vitamins and minerals often lose their best effects. The best way to avoid this is to consume whole foods with nutrients in their intended balance.
A Call to Action to Align with Better Nutrition Strategies
“For healthy people eating varied diets adequate in calories, there is little or no evidence that fortification improves health,” says Marion Nestle, Ph.D., M.P.H., a professor of nutrition, food studies, and public health at New York University. 12
While many brands may try to remedy the poor nutritional value of their products through the addition of vitamins and minerals, Elmhurst chooses a different approach.
Through our innovative HydroRelease™ method, we disassemble and then reassemble all the components of our source ingredients (nuts, seeds, or oats, depending on the product in question) to preserve its full nutritional integrity. All Elmhurst products deliver your vitamins and minerals in the form nature intended; staying true to its source ingredient—never fortifying, never enriching. Our full collection of healthy and delicious dairy-free plant milks, creamers, and spreads includes:
- Original Nut Milks: Cashew Milk
- Unsweetened Nut Milks: Almond Milk, Walnut Milk, Cashew Milk, Hazelnut Milk, Coconut Cashew Milk
- Oat Milks: Original, Unsweetened, Barista Edition Oat Milk
- Barista Editions: Barista Edition Pistachio Milk, Barista Edition Oat Milk, Barista Edition Almond Milk
- Plant-based Creamers: Unsweetened Original, French Vanilla, Caramel Macchiato, Pistachio Creamer, Chai Spice
- Dairy-Free Sour Cream
Escape the futility and deception of fortification and enrichment with a sincerely simpler, better choice!
References
- Fulgoni VL, 3rd, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? The Journal of nutrition. 2011;141(10):1847-1854.
- Agriculture. USDoHaHSaUSDo. 2015 – 2020 Dietary Guidelines for Americans. 2015; 8th:https://health.gov/dietaryguidelines/2015/. Accessed August 8, 2019, 2019.
- Leung AM, Braverman LE, Pearce EN. History of U.S. iodine fortification and supplementation. Nutrients. 2012;4(11):1740-1746.
- Crider KS, Bailey LB, Berry RJ. Folic acid food fortification-its history, effect, concerns, and future directions. Nutrients. 2011;3(3):370-384.
- Berner LA, Keast DR, Bailey RL, Dwyer JT. Fortified Foods Are Major Contributors to Nutrient Intakes in Diets of US Children and Adolescents. Journal of the Academy of Nutrition and Dietetics. 2014;114(7):1009-1022.e1008.
- Hamishehkar H, Ranjdoost F, Asgharian P, Mahmoodpoor A, Sanaie S. Vitamins, Are They Safe? Adv Pharm Bull. 2016;6(4):467-477.
- Datta M, Vitolins MZ. Food Fortification and Supplement Use-Are There Health Implications? Critical reviews in food science and nutrition. 2016;56(13):2149-2159.
- Guallar E, Stranges S, Mulrow C, Appel LJ, Miller ER, III. Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements. Annals of Internal Medicine. 2013;159(12):850-851.
- Albahrani AA, Greaves RF. Fat-Soluble Vitamins: Clinical Indications and Current Challenges for Chromatographic Measurement. Clin Biochem Rev. 2016;37(1):27-47.
- Thiel RJ. Natural vitamins may be superior to synthetic ones. Medical hypotheses. 2000;55(6):461-469.
- Hendel CC, L. What You Need to Know About Supplements and Drug Interactions. 2015; https://www.consumerreports.org/vitamins-supplements/supplement-and-drug-interactions/. Accessed August 8, 2019, 2019.
- Cooper L. Why Fortified Foods and Supplements Are Risky. 2016; https://www.consumerreports.org/diet-nutrition/why-fortified-foods-and-supplements-are-risky/. Accessed August 8, 2019, 2019.