PubMed · 4498737
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E Morse. 1974. Vitamin supplements.. https://pubmed.ncbi.nlm.nih.gov/4498737/
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OBJECTIVE: To describe how a risk analysis can be applied to food fortification, with emphasis on voluntary fortification and intake levels that might exceed usual dietary levels. DESIGN: Use of the risk analysis model as a frame to classify nutrients according to the risk of exceeding upper safe intake levels. Furthermore, to apply the model when discussing possible consequences of liberal fortification practices on eating behaviour and disease patterns. SETTING: The discussion on food fortification presently going on internationally. RESULTS: Micronutrients can be classified according to their safety margin, i.e. the size of the interval between the recommended intake and the upper safe level of intake. We suggest that nutrients with a small safety margin, i.e. for which the upper safe level is less than five times the recommended intake, be placed in a category A and should be handled with care (retinol, vitamin D, niacin, folate and all minerals). Category B comprises nutrients with an intermediate safety margin (vitamins E, B6, B12 and C), while nutrients that according to present knowledge are harmless even at 100 times the recommendation (vitamin K, thiamin, riboflavin, pantothenic acid and biotin) are categorised as C. DISCUSSION: The risk analysis model is a useful tool when assessing the risk of both too low and excess intakes of single micronutrients, but can also be applied to analyse the consequences of fortification practices on eating behaviour and disease patterns. Liberal fortification regulations may, for example, distort the conception of what is healthy food, and drive consumption towards a more unhealthy diet, contributing to the plague of overweight and concomitant increased risk of degenerative diseases. CONCLUSION: The impact of fortification practices on the total eating pattern of a population should become an integrated part of the discussions and regulations connected to the issue.
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For more than 50 years, the United States federal government has regulated food fortification. During this time, the nutritional situation in the United States has improved greatly, whereas scientific information about the role of vitamins and minerals in human growth and development has increased exponentially. Concurrently, government authority to regulate food fortification has declined. This paper provides a brief history of U.S. food fortification policy and describes the contribution of food fortification to U.S. nutrient intakes. The paper highlights future directions of food fortification in the United States in light of these important developments, and addresses the issue of risk and the need to balance deficiency and toxicity in a generally well nourished population.