Why is this research valuable?
There is considerable debate regarding the balance of processed versus whole foods in a healthful diet. To inform this debate, ILSI North America has developed a comprehensive evaluation of the contributions of natural, fortified, enriched, and dietary supplement food sources to total nutrient intakes. These data will be an important scientific resource as future food fortification policy is deliberated and the benefits of processed and whole foods continue to be debated in the scientific, media, and consumer arenas.
Fortification Database Available
The ILSI North America Fortification committee recently sponsored development of a database with estimates of intrinsic, fortification, and enrichment nutrients for foods reported consumed in 2009-2010 and 2011-2012 releases of the NHANES and What We Eat In America (WWEIA). Fortification nutrients of interest for the database are vitamins A, C, D, E, B6 and B12, and folate, thiamin, riboflavin, niacin, iron, zinc, calcium, magnesium and potassium. Foods assumed to be fortified and/or enriched were identified in the FNDDS‐SR Links files used to process WWEIA 2009‐2010 and 2011‐2012. For each food identified as a fortified or enriched item, values for the applicable intrinsic, fortification and enrichment nutrient components per 100g food were estimated. Further details of the database can be found below.
This database is available for use by researchers skilled in NHANES analysis. Please provide the following information:
- Demonstrated expertise in NHANES analysis
- Topic of interest and research questions to be addressed
We ask that any resulting publications acknowledge that the database was developed with support from the ILSI North America Fortification Committee.
Should others approach users for access to the database, we ask that they be referred to ILSI North America so that we can understand breadth and scope of use.
Please contact us for more information at email@example.com
The ILSI North America Technical Committee on Fortification has sponsored past research evaluating the contribution of nutrients added to foods through fortification and enrichment to total nutrient intakes in the United States, and commissioned development of a database using National Health and Nutrition Examination Survey (NHANES), What We Eat In America (WWEIA) from 2003-2004 AND 2005-2006 releases (Fulgoni et al., 2011, Berner et al., 2014). An updated database has been developed from the 2009-2010 and 2011-2012 NHANES and WWEIA releases.
Fortification nutrients of interest for the database are vitamins A, C, D, E, B6 and B12, and folate, thiamin, riboflavin, niacin, iron, zinc, calcium, magnesium and potassium.
Foods assumed to be fortified and/or enriched were identified in the FNDDS‐SR Links files used to process WWEIA 2009‐2010 and 2011‐2012. For each food identified as a fortified or enriched item, values for the applicable intrinsic, fortification and enrichment nutrient components per 100g food were estimated.
Three primary approaches were used to estimate nutrient levels:
- estimate fortification or enrichment nutrients by comparing nutrient levels in fortified and non-fortified or enriched and unenriched forms of the otherwise same food;
- assume all fortification nutrients were added to a fortified food; or
- estimate intrinsic levels of nutrients in a fortified food using available nutrient and food composition data and calculate fortification nutrients by difference. Nutrient values estimated for each food used to process the FNDDS were combined to generate estimates of intrinsic, fortification, and enrichment nutrients per 100 g of each food code.
For each food code and each of the 15 nutrients of interest, the sum of intrinsic, fortification, and enrichment nutrients corresponds to the nutrient value in FNDDS.
Fulgoni et al assessed contributions of micronutrients to usual intakes derived from all sources (naturally occurring, fortified and enriched, and dietary supplements) and compared usual intakes to the Dietary Reference Intake for U.S. residents aged ≥2 y according to NHANES 2003-2006 using the National Cancer Institute method to assess usual intakes of 19 micronutrients by source. Most of the population had total usual intakes (from dietary intakes and supplements) above the estimated average requirement (EAR) for several nutrients. However, more of the population had total usual intakes below the EAR for vitamins A, C, D, and E (34, 25, 70, and 60%, respectively), calcium (38%), and magnesium (45%). Enrichment and/or fortification largely contributed to intakes of vitamins A, C, and D, thiamin, iron, and folate. The percentage of the population with total intakes greater than the tolerable upper intake level (UL) was very low for most nutrients, whereas 10.3 and 8.4% of the population had intakes greater than the UL for niacin and zinc, respectively. Without enrichment and/or fortification and supplementation, many Americans did not achieve the recommended micronutrient intake levels set forth in the Dietary Reference Intake.
Given the numerous shortfall micronutrients identified in the diets of US children and adolescents, Berner et al evaluated ranked food sources contributing to their micronutrient intakes and impact of fortification on nutrient adequacy and excess among US children and adolescents. Additionally they ranked food sources of added nutrient intake and compared rankings with those based on total nutrient intake from foods. The National Cancer Institute method was used to determine usual intakes of micronutrients by source. The impact of fortification on the percentages of children having intakes less than the Estimated Average Requirement and more than the Upper Tolerable Intake Level was assessed by comparing intakes from intrinsic nutrients to intakes from intrinsic plus added nutrients. Specific food sources of micronutrients were determined as sample-weighted mean intakes of total and added nutrients contributed from 56 food groupings. The percentage of intake from each grouping was determined separately for total and added nutrients. Without added nutrients, a high percentage of all children/adolescents had inadequate intakes of numerous micronutrients, with the greatest inadequacy among older girls. Fortification reduced the percentage less than the Estimated Average Requirement for many, although not all, micronutrients without resulting in excessive intakes.
The current database can be used to estimate updated intakes of nutrients added for fortification or enrichment purposes. Ultimately, information on nutrient intakes from added sources could be used to better align intakes with nutrient needs.
EB 2014 - The Impact of Fortification in the U.S. Diet: A Case Study in Children
This article is a summary of a symposium presented at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2014 on current issues involving fortification focusing primarily on the United States and Canada and recommendations for the development of responsible fortification practices to ensure their safety and effectiveness.
This paper examines the impact of fortification on nutrient adequacy and excess among US children and adolescents.
This article discusses and evaluates the value of fortification, the success of current fortification efforts, and the future role of fortification in preventing or reversing nutrient inadequacies.
To better understand the implications of Daily Value revisions, assuming that manufacturers choose to maintain current label claims for micronutrients from voluntarily fortified foods, we modeled intake of 8 micronutrients using NHANES 2007-2008 data
This study modeled the implications for eight micronutrients based on two potential methods, proposed by the FDA for recalculating DVs using the newer Dietary Reference Intakes.
Experimental Biology 2014 – Saturday Morning Session.
ILSI North America supported several events at Experimental Biology 2013.
ILSI North America work was presented at this event.
In an environment of over-consumption, it is of great interest that Americans simultaneously fail to meet the Dietary References Intakes (DRIs) for many nutrients. Fortification is a way to supplement intakes of the population at large without having to rely on consumer choice. The Forticiation Committee’s workshop will provide attendees with an improved understanding of the value of fortification and the success of current fortification efforts and practices. Additionally the workshop will address the potential future role of fortification in nutrient adequacy, which includes benefits and risks.