Q: What’s the difference between enriched and fortified foods, and how did they get that way?
Starting in the 1920s, the federal government addressed several diseases caused by nutritional deficiencies. It encouraged food manufacturers to add certain nutrients to specific foods.
The earliest example of adding something to a food product to address a public health issue was adding iodine to table salt.
In the late 1890s, between 26% and 70% of children living in the Great Lakes, Appalachian, and the Pacific Northwest regions suffered from enlarged thyroid glands due to goiter, a disease caused by iodine deficiency. Called the “Goiter Belt,” the soil of these regions contained little or no natural iodine, and livestock in these areas was also suffering from goiter.
In the 1830s, a French chemist observed that goiter was less prevalent in areas in France that consumed salts that naturally contained iodine, leading to the discovery that iodine treated and prevented it.
Doctors first tried giving iodine as drops given to children. Still, accidental overdoses created problems, but adding a small amount of iodine in the form of iodide to salt would treat and prevent goiter of both children and livestock.
In 1922 the Michigan Medical Society set up a committee to implement the addition of iodine to table salt, working with salt suppliers to create a market for this new,“iodized” version. By 1924, iodized salt became available at groceries across the state and country. Over the next decade, the incidence of goiter plummeted.
Today, table salt is available in both iodized and non-iodized versions sitting side-by-side on your grocery shelf. Every box of iodized salt can be identified by the presence of a statement “this salt contains iodide, a necessary nutrient.” Curiously, iodine is also present in today’s cow milk and dairy products due to the use of sterilizing agents containing iodine used in processing the milk.
Cow’s milk is another food fortified to address a nutritional deficiency. In the 1930s, many children suffered from rickets, a dietary lack of vitamin D that causes bones to become soft, causing leg deformities in children and broken bones in adults.
Because most children drank cow’s milk, they added vitamin D to it. One approach was to add cod liver oil to milk, which made it taste “fishy.” Another method involved irradiating the milk, converting an inactive form of vitamin D in the milk into its active form. Eventually, a more straightforward process of adding vitamin D concentrate to milk prevailed, creating today’s “fortified” milk.
In the 1930s and 1940s,nearly 7,000 people died every year in the United States from pellagra. Pellagra and another nutritional deficiency, beriberi, became rampant when new techniques in milling grains stripped off the tough outer covering of wheat, corn, and rice. This process produced white rice from brown rice and resulted in much finer wheat flour that was preferred by bakers and consumers for making bread and other baked goods.
Those outer coverings of grains were good sources of vitamins B1 (thiamine), B2 (riboflavin), B3 (niacin), and iron, and when removed from grain during the milling process contributed to an alarming rise in nutritional deficiency diseases. Pellagra is caused by a deficiency of niacin, while beriberi is from a lack of thiamine.
In 1940, there was a disturbing incidence of poor nutritional status among young men enlisting for service during World War II. In May 1941, President Roosevelt’s National Nutrition Conference for Defense recommended that flour and bread be enriched with vitamins B1, B2, B3, and iron. By the middle of 1942, 75% of white bread in the United States used this new “enriched” flour.
Today, most flours, cereals, and cereal products, corn products, bread, noodles, and macaroni/pasta are made with enriched flour. There is substantial evidence that inadequate folic acid intake during early pregnancy can cause severe birth defects like spina bifida.
To address this, in 1998, the B vitamin folic acid (folate) was added to the official description of enriched flour in the United States. In 2016 the FDA approved the voluntary addition of folic acid to corn masa flour, used in tortillas, tortilla chips, and tamales.
Here Are 2 Final Facts About Food Fortification in the United States:
- Food fortification by manufacturers and processors is voluntary.
The Food and Drug Administration (FDA) does not require mandatory fortification of food. Non-fortified versions can be sold as long as they are not labeled as fortified or enriched.
- Calcium fortification of food is not standardized.
Unlike enriched flour or fortified cow milk, there is no industry standard for adding calcium to foods. Extra calcium can be foundin calcium-fortified orange juice and several kinds of milk, such as dairy, almond, and soy.
