The concept of food fortification is initially fairly mundane, conjuring up images of Vitamin-D fortified milk and folic acid added to our loaf of bread. Sure, it’s something that we just take for granted because that’s the way it is, right? Let’s investigate a little further and have a look at the implications that are hiding under the surface.
The mandatory and voluntary fortification of food in Australia is governed by FSANZ. The major point to be considered before fortification is deemed necessary is whether or not the deficiency of the nutrient in question is a public health issue. Mandatory fortification is then only implemented if it is the most effective solution. The scenario that is familiar to many of us will be folic-acid enriched bread. Maternal folate deficiencies have been shown to cause neural-tube defects in developing foetuses, and as a result, it was deemed appropriate to fortify all bread products with folic acid as of September 2009. Due to the widespread consumption of bread products, the at-risk population is targeted (as well as everyone else not at risk).
Enough of the old-news, what’s the point of bringing this up now? Food fortification is getting pretty high-tech. You may have heard the term functional food: a food that has added health benefits apart from basic nutrition. Products such as omega-3 enriched eggs to boost our brain health, plant sterols in our cheese to lower cholesterol, and – my personal favourite – probiotic chocolate to improve our gut bacteria. Who would have thought? Consumers are expecting more and more from the foods we eat. I hold close the saying ‘let food be thy medicine’, but are we asking too much? Remember that fortification is traditionally used to address a nutrient deficiency, presenting as a public health issue, not as an added bonus that we get with our snacks.
Let’s take a look at the plant sterol fortification of cheese. A relative new-comer to the market is Kraft’s LiveActive reduced-fat cheese, made with plant sterols designed to reduce cholesterol levels. Plant sterols are found naturally in fruits, vegetables, nuts and cereals and have been shown to reduce LDL cholesterol, when eaten in the recommended amount. What many people do not realise is, if you do not have a sufficient quantity of the fortified-product, the cholesterol-reducing benefits will not be effective, so it is important to eat the correct serving size.
As for probiotic chocolate, what happened to good old yoghurt? One must wonder, why don’t we just eat the nuts, dairy, fruits and vegetables? Yes, there might be the added benefit of cholesterol reduction or digestion improvement, but following a well-balanced diet according to the AGHE would have all your bases covered anyway. It is concerning that a consumer with see this cheese’s ‘special cholesterol-lowering power’ or this gut-friendly chocolate and then figure that they can be lax in other areas, such as not having that side salad, or putting an extra piece of bacon on their plate. Such marketing hype can lead to consumer confusion and misinterpretation and it seems that the line between what is necessary and what is ‘trendy’ has been blurred.
A key criteria listed in FSANZ fortification policy is that permission to fortify a food should not create inconsistencies with the national dietary guidelines, that is, it should not encourage increased consumption of discretionary foods. Perhaps the plant sterol fortification of cheese will have a carry-on effect. Will consumers see this cheese and assume it relates to other cheeses as well? thereby increasing consumption of a potential high fat, high salt product?
Dr Julie Woods, senior lecturer on public health at Deakin, raises an important point,
‘[Fortification] is not a panacea for the poor nutritional intakes we currently see, such as a high intake of discretionary foods and low intake of nutrient dense foods. It should not be used to medicalise our food supply’.
The fact of the matter is, we can’t use fortified functional foods to make up for a poor diet. Fortified foods, much like supplementation, should not be used as a replacement or substitute for naturally occurring, nutrient-rich whole foods. A balanced diet rich in various fruits and vegetables, nuts, whole grains, dairy and lean protein is generally sufficient for the majority of the population.