Health Canada's discretionary food fortification policy may be too much of a good thing: U of T researchers
By Jennifer Little

Toronto - A move to permit manufacturers to add nutrients to foods at their discretion could result in some Canadians consuming too much of a good thing, according to new research from the Faculty of Medicine.

In a paper published online Aug. 19 in The Journal of Nutrition, Professor Valerie Tarasuk and PhD student Jocelyn Sacco of nutritional sciences examine the impact of Health Canada's proposed discretionary fortification policy on nutritional adequacies and excesses in the Canadian population. The researchers caution that the proposed policy is misaligned with current food intake patterns and if implemented, this policy could put some children and adolescents at risk.

"We are worried that nutrient additions are not being led by evidence of public health needs. Some of the nutrients proposed for fortification could be helpful but some are nutrients we don't need more of," Tarasuk said.

Health Canada's proposed discretionary food fortification policy, which was outlined in 2005, defines 15 nutrients permitted for addition in select foods, the majority of which fall outside the four main food groups. The proposed policy also permits increases in the nutrients added to breakfast cereals. Sacco took six of the permitted nutrients and working with existing data on Canadians' dietary intakes, she modelled several scenarios to examine what would happen if the policy was implemented. The analysed nutrients were vitamin A, vitamin C, magnesium, folate, niacin and calcium. The scenarios ranged from increased fortification of breakfast cereals only to full implementation of the maximum amount of fortification possible in all allowable foods, including breakfast cereals, to assess the maximum possible impact of discretionary fortification. These scenarios did not account for the consumption of nutrient intakes from supplements (e.g., multivitamins), which would naturally increase exposure further.

Full implementation of Health Canada's proposed discretionary fortification policy as modelled by the U of T researchers showed reductions in the inadequate intake of vitamin A, vitamin C, magnesium, folate and calcium in some age/sex groups; however, intakes of folate, niacin, vitamin A and calcium rose above the tolerable upper intake level, particularly among younger age groups.

The authors also noted that there is no evidence of inadequacies for niacin or several other nutrients slated for addition, including thiamin and riboflavin. This raises the question of what benefit will come from adding more of these nutrients to the food supply. The proposed policy also permits the addition of biotin, pantothenic acid and vitamin E, all nutrients for which nationally representative data are unavailable - so neither benefit nor risk can be assessed.

Depending on eating habits and supplement use in the population, the practice of increased fortification may expose some subgroups to risks of excessive intakes without any possibility of benefits.

"Unless massive education programs are mounted to help consumers evaluate fortified products, the general population cannot be expected to know the difference between beneficial and unnecessary nutrients," said Tarasuk. "If the policy is implemented, the marketing and consumption of discretionarily fortified foods needs to be monitored closely to assess its implications for the health of Canadians."