National food fortification: a dialogue with reference to Asia: policy in evolution.
Food fortification generally refers to the addition of micronutrients and other favourably bio-active food components to food-stuffs where there are recognised deficiencies in the target population. Each forticant has had or could have regulatory implications. It is understandable, although arguable, in the face of a limited food supply skewed, for the majority, in the direction of starchy staples of low essential nutrient density. Efforts, with plant breeding, to biofortify such foods are underway and likely to be safer, more sustainable and affordable than chemical additions. Unfortunately, with an increasingly refined and naturally tasteless food supply (salty, fatty, sugary and starchy), and where energy requirements are falling because of physical inactivity, micronutrient fortification is being used as a nutritional "fix-it' strategy. In Asia, there are several critical micro- nutrients. No one national fortification program can deal with all deficiencies is likely to be highly selective for the nutrients which have the greatest advocacy or are most recognisable. They also leave the other health promoting food properties like intactness, nutrient spectrum, and phytonutrient content un-addressed. A variety of food-stuffs, with different biological origins, is the preferred approach. Where an optimal food system is not in place, there may be justification for fortification if there is regular monitoring and surveillance of the food supply and health outcomes occurs; is a clear cost-risk-benefit advantage in such a strategy; are programs in place to improve the nutritional value of the basic food supply and is an "exit strategy' for the fortification program.
Wahlqvist
Mark L
ML
Center for Health Policy Research and Development, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, Taiwan 350, RCO. profmlw@nhri.org.tw
D001208:Asia; D003362:Cost-Benefit Analysis; D005518:Food Preferences; D005527:Food, Fortified / Q000191:economics; D006801:Humans; D044342:Malnutrition / Q000517:prevention & control*; D018977:Micronutrients / Q000008:administration & dosage* / Q000009:adverse effects; D018673:Nutrition Policy; D009753:Nutritive Value; D030821:Plants, Genetically Modified; D018570:Risk Assessment
D018977:Micronutrients