The Role of Fortification and Dietary Supplements in Affluent Countries: Challenges and Opportunities

Abstract

This chapter asks whether there is a role for enrichment/fortification and/or dietary supplements in highly industrialized countries today, and what challenges and opportunities exist regarding their use. It considers fortification and supplementation together because both affect total nutrient exposures and both are popular in developed countries. Fortification increases the nutrient density of certain foods in specific ways. Dietary supplements of some types add nutrients in another, more concentrated, form. Other important determinants of dietary quality—such as variety in servings of food groups, moderation of nutrient or food intakes, balance of macronutrients, and variety of foods within and across food groups—must be achieved with other nutritional strategies. Dietary supplements that provide nutrients that are low or lacking in the diets of specific population subgroups have beneficial effects, but care should be taken to avoid over-promising the benefits of fortification and supplementation; a well-balanced diet is critical to optimal health. The public health rationale for non-nutrient supplements (plant food supplements) is unclear. Neither fortification nor supplementation can remedy all the diet-related problems of affluent countries, many of which also require dietary diversity, balance, and moderation in eating habits to achieve more healthful optimal food patterns.