Abstract
Food fortification with micronutrients continues to be one of the possible policy options to tackle micronutrient malnutrition as it is considered a more sustainable and cost-effective method available to improve public health, especially when it is mandated [1, 2]. Food fortification can provide relatively rapid solutions to address low micronutrient intakes at a population level, as it does not require complex behaviour change and enables maintenance of traditional dietary patterns [3–5]. Whilst it is adopted in a number of developing countries where it remains one of the key strategies to tackle these serious issues, a relatively small proportion of foods are currently fortified on a mandatory basis in the Western Europe. Given the persistence of pockets of micronutrient malnutrition within Europe and a patchy approach to food fortification globally, questions can be raised about public health policy realities that act to constrain wider use of food fortification.
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Abbreviations
- EU:
-
European Union
- EC:
-
European Commission
- SME:
-
Small and medium enterprise
References
Greiner T. Fortification of processed cereals should be mandatory. Lancet. 2007;9575:1766–8.
Fletcher RJ, Bell IP, Lambert JP. Public health aspects of food fortification: a question of balance. Proc Nutr Soc. 2004;63(4):605–14.
American Dietetic Association. Position of the American Dietetic Association: fortification and nutritional supplements. J Am Diet Assoc. 2004;105(8):1300–11.
Serra-Majem L, Ortega R, Aranceta J, et al. Fortified foods. Criteria for vitamin supplementation in Spain. Public Health Nutr. 2001;6A:1331–4.
Allen L, de Benoist B, Dary O, Hurrell R, editors. Guidelines on food fortification with micronutrients. Geneva: World Health Organization and Food and Agriculture Organization of the United Nations; 2006.
World Health Organization, United Nations Children’s Fund and International Council for the Control of Iodine Deficiency Disorders. Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers. 3rd ed. Geneva: WHO; 2007.
Darnton-Hill I, Nalubola R. Fortification strategies to meet micronutrient needs: successes and failures. Proc Nutr Soc. 2002;61(2):231–41.
Timotijevic L, Barnett J, Brown K, et al. The process of setting micronutrient recommendations: a cross-European comparison of nutrition-related scientific advisory bodies. Public Health Nutr. 2011;14(4):716–28.
Sichert-Hellert W, Kersting M, Alexy U, Manz F. Ten-year trends in vitamin and mineral intake from fortified food in German children and adolescents. Eur J Clin Nutr. 2000;54(1):81–6.
Darnton-Hill I. Overview: rationale and elements of a successful food-fortification programme. Food Nutr Bull. 1998;19(2):92–100.
Lawrence M. Challenges in translating scientific evidence into mandatory food fortification policy: an antipodean case study of the folate-neural tube defect relationship. Public Health Nutr. 2005;8(8):1235–41.
Dhonukshe-Rutten RA, Timotijevic L, Cavelaars AE, et al. European micronutrient recommendations aligned: a general framework developed by EURRECA. Eur J Clin Nutr. 2010;64 Suppl 2:S2–10.
Houghton LA, Gray AR, Rose MC, et al. Long-term effect of low-dose folic acid intake: potential effect of mandatory fortification on the prevention of neural tube defects. Am J Clin Nutr. 2011;94:136–41.
Hurrell R, Ranum P, de Pee S, et al. Revised recommendations for iron fortification of wheat flour and an evaluation of the expected impact of current national wheat flour fortification programs. Food Nutr Bull. 2010;31(1 Suppl):S7–21.
Horton S. The economics of food fortification. J Nutr. 2006;136(4):1068–71.
Bonner G, Warwick H, Brnardo M, et al. Fortification examined. How added nutrients can undermine good nutrition. London: The Food Commission (UK) Ltd; 1999.
Tedstone A, Browne M, Harrop L, et al. Fortification of selected foodstuffs with folic acid in the UK: consumer research carried out to inform policy recommendations. J Public Health. 2008;30(1):23–9.
Fuller-Deets MA, Dingwall R. The ethical implications of options for improving the folate intake of women of reproductive age. Nottingham: Institute of Science and Society, University of Nottingham; 2007.
Griffiths M. Communication strategies to optimize commitments and investments in iron programming. J Nutr. 2002;132(4 Suppl):834S–8.
Uauy R, Hertrampf E, Reddy M. Iron fortification of foods: overcoming technical and practical barriers. J Nutr. 2002;132(4 Suppl):849S–52.
Crane NT, Wilson DB, Cook DA, et al. Evaluating food fortification options: general principles revisited with folic acid. Am J Public Health. 1995;85(5):660–6.
Ramakrishnan U, Yip R. Experiences and challenges in industrialized countries: control of iron deficiency in industrialized countries. J Nutr. 2002;132(4 Suppl):820S–4.
Manoff RK. Social marketing: New imperative for public health. 1st ed. New York: Praeger; 1985.
Frewer L, Scholderer J, Lambert N. Consumer acceptance of functional foods: issues for the future. Br Food J. 2003;105(10):714–31.
Shepherd R, Raats M, editors. The psychology of food choice, Frontiers of nutritional science, vol. 3. Cambridge: CABI; 2006.
Lambert N. Diet, phyto-chemicals and cancer. In: Frewer L, Schifferstein R, Risvik E, editors. Food choice in Europe. Munich: Springer; 2001. p. 131–51.
Brown KA, Timotijevic L, Barnett J, et al. A review of consumer awareness, understanding and use of food-based dietary guidelines. Br J Nutr. 2011;106(1):15–26.
Subar A, Bowering J. Fortified food: considerations in purchase, awareness of nutrient addition, and reasons for usage. J Nutr Educ. 1989;21:133–8.
Stockley L, Lund V. Use of folic acid supplements, particularly by low-income and young women: a series of systematic reviews to inform public health policy in the UK. Public Health Nutr. 2008;11(8):807–21.
Siró I, Kápolna E, Kápolna B, et al. Functional food. Product development, marketing and consumer acceptance–a review. Appetite. 2008;51(3):456–67.
Zechendorf B. What the public thinks about biotechnology. Biotechnology. 1994;12(9):870–5.
Henson S, Annou M, Cranfield J, et al. Understanding consumer attitudes toward food technologies in Canada. Risk Anal. 2008;28(6):1601–17.
Whitmarsh L. Behavioural responses to climate change: asymmetry of intentions and impacts. J Environ Psychol. 2009;29(1):13–23.
United Nations Children’s Fund. The state of the world’s children 2011: Adolescence—An age of opportunity. New York: UNICEF; 2011.
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Timotijevic, L., Timmer, A., Ogunlade, A. (2013). Food Fortification as a Global Public Health Intervention: Strategies to Deal with Barriers to Adoption, Application and Impact Assessment. In: Preedy, V., Srirajaskanthan, R., Patel, V. (eds) Handbook of Food Fortification and Health. Nutrition and Health. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-7110-3_18
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