Discretionary addition of vitamins and minerals to foods: implications for healthy eating.
OBJECTIVE
Health Canada proposes to allow manufacturers to add vitamins and minerals to a wide variety of foods at their discretion, a practice that has long been permitted in the United States and Europe. With Health Canada's proposed exclusion of staple and standardized foods from discretionary fortification, questions arise about the nutritional quality of the foods that remain eligible for fortification. To better understand the implications of this policy for healthy eating, this study examined the contribution of foods eligible to be fortified to the dietary quality of Canadians.


METHODS
Using 24-h dietary recall data from the 2004 Canadian Community Health Survey, the relationship between intake of fortifiable foods and indicators of dietary quality was assessed.


RESULTS
The mean percentage contribution of fortifiable foods to usual energy intake ranged from 19% among men over the age of 70 years to 36% for girls aged 14-18 years. Fortifiable food (as a percentage of total energy) was inversely associated with intake of vegetables and fruit, meat and alternatives, milk products, fiber, vitamins A, B6, B12 and D, magnesium, potassium and zinc. Fortifiable food was positively associated with dietary energy density, total energy intake and grain products. Few relationships were found for folate, vitamin C, iron, calcium, sodium and saturated fat.


CONCLUSIONS
Consumption of foods slated for discretionary fortification is associated with lower nutrient intakes and suboptimal food intake patterns. Insofar as adding nutrients to these foods reinforces their consumption, discretionary fortification might function to discourage healthier eating patterns.
Faculty of Medicine, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.
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D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001361:Avitaminosis / Q000517:prevention & control; D002170:Canada; D002648:Child; D002675:Child, Preschool; D004032:Diet / Q000592:standards*; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000008:administration & dosage*; D009313:National Health Programs / Q000331:legislation & jurisprudence; D018673:Nutrition Policy; D009751:Nutritional Requirements; D009753:Nutritive Value; D017678:Sex Distribution; D014815:Vitamins / Q000008:administration & dosage*; D055815:Young Adult
D008903:Minerals; D014815:Vitamins