title: Micronutrient Food Fortification for Residential Care: A Scoping Review of Current Interventions.
abstract: Malnutrition is common in residential care environments, primarily due to poor intake. Micronutrient deficiency, although poorly investigated to date, is also reported to be high. Improving the nutrient density of consumed foods is a potential mechanism to promote increased nutrient intake. A scoping review was conducted to: (1) explore the evidence on micronutrient food fortification strategies, (2) identify candidate nutrients and food vehicles for successful food fortification, and (3) identify gaps for future research.
  
  
  
  The scoping review framework of Arksey and O'Malley was used. A comprehensive search strategy of 4 electronic databases (MEDLINE, EMBASE, CINAHL, and Web of Science) was completed. Two reviewers were involved in screening and data extraction for all selected articles.
  
  
  
  A total of 4394 relevant articles were identified for screening, and application of inclusion/exclusion criteria resulted in 6 food fortification studies (8 citations; 1 study had 3 citations). Overall, vitamin D (n = 5 studies) and calcium (n = 4 studies) were the most common micronutrients fortified; milk products, margarine, bread, and pureed foods were fortification vehicles. Most studies fortified below the RDA recommendation and did not include clinical outcomes. Samples were small and intervention periods were short (3-6 months).
  
  
  
  Fortification is a viable strategy for improving the nutrient density of foods consumed in residential care. Although disparate, this literature suggests the potential for further undertaking of fortification to prevent micronutrient deficiencies among residents and future research should consider multinutrient preparations and clinical outcomes.
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Ivy T Y
authors.initials: IT
authors.lastname: Lam
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada. Electronic address: hkeller@uwaterloo.ca.
authors.forename: Heather H
authors.initials: HH
authors.lastname: Keller
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Kaylen
authors.initials: K
authors.lastname: Pfisterer
authors.affiliation: Department of Food Science, University of Guelph, Guelph, Ontario, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Duizer
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Ken
authors.initials: K
authors.lastname: Stark
authors.affiliation: Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Duncan
mesh_terms: D000368:Aged; D005260:Female; D005527:Food, Fortified; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D018977:Micronutrients
chemical_list: D018977:Micronutrients
keywords: Micronutrient; food fortification; residential care