History and Current Market Place

Food fortification has been practiced for several decades in developed countries. Historically, certain staple foods have been fortified to alleviate deficiency diseases in the general population, such as the iodization of salt to alleviate goiter, addition of vitamin D to milk to prevent rickets, and enrichment of cereal products with thiamin and niacin to alleviate beriberi and pellagra. For example, in the US, fortification began with the iodization of salt in the State of Michigan in 1924. The practice of salt iodization had spread rapidly throughout the rest of the country by 1928. With the revolution of nutritional science and the elucidation of chemical structures of several nutrients in the 1930s, the production of synthetic preparations of nutrients became possible. By 1934, vitamin D was routinely being added to milk. Although an effort to enrich cereal flours and products with B vitamins and iron started in the 1930s, the enrichment program began in earnest only in 1941 with about 40% of the flour in the country being fortified by 1942. Furthermore, in 1951, the Committee of Food and Nutrition of the National Research Council recommended the addition of vitamin A to table fats (margarine). Several other developed countries experienced similar initiation and implementation of food fortification as a strategy to alleviate nutrient deficiencies in the general population. More recently, cereals fortified with folic acid have been introduced in several countries to increase the folic acid intake of women of childbearing age and reduce the rates of neural tube defects, and the results are already measurable. Foods commonly fortified in developed countries are listed in Table 1.

Although the original intent of food fortification was to correct or prevent widespread nutrient deficiencies, the focus now has shifted in developed countries to optimal intakes of nutrients for the prevention of chronic diseases and for overall health and well-being. Classic nutrient deficiency

Table 1 Foods commonly fortified in developed countries



Cereal grain flours and

Thiamin, riboflavin, niacin iron, and


folic acid

Milk and milk products

Vitamins A and D

Fats and spreads

Vitamins A and D



Ready-to-eat breakfast

Many vitamins and minerals


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