The New World of Vitamin and Mineral Fortification

The New World of Vitamin and Mineral Fortification
bySteve Myers

In its oldest, simplest form, fortification involved a few keyvitamins and minerals added to certain staple foods either to replenishnutrients lost during processing or to address specific health-related nutrientdeficiencies, especially in children. Todays fortification efforts are morerobust and involve many popular foods and nutrients. In fact, fortification hasmorphed into functional foods, as various nutraceutical ingredients become morewell accepted for their healthy, disease-fighting benefits, and as the modernlifestyle demands more out of each hurried gulp or bite.

In 1924 the United States started adding iodine to table saltto address iodine deficiency; as a result, the prevalence of goiter fell fromabout 40 percent to below 10 percent, and iodine deficiency was mostlyeradicated by 1930.¹ At that time, vitamin and mineral deficiencies were linkedto numerous health conditions burdening Americans, including rickets (vitaminD/calcium), pellagra (niacin) and scurvy (vitamin C). Since then, several basicnutrients have been added to major nutrition sources to address public healthproblems and, more recently, emerging health and lifestyle concerns.

According to 2001 research, fortification has greatly improvednutrient deficiencies in the United States.² Scientists examined nine nutrientsand found fortification substantially improved intakes of all nutrients studied,except for calcium. Breakfast cereal was responsible for the increased intakesof all nutrients except vitamin C, for which juice made the biggestcontribution.

Many diseases associated with vitamin or mineral deficiencythat were rampant in the United States 60-plus years ago are virtuallynonexistent today, said Udi Alroy, marketing director for Biodar. With manycommon, widespread macronutrient deficiencies and associated diseases all buteradicated in America, the focus of fortification has shifted from classicnutrient deficiency diseases to chronic disease prevention and overall healthand wellness.

Max Motyka, director of the human products division of AlbionAdvanced Nutrition, explained the trend is actually toward a higher level offortification, which is classified as functional foods. In this newerfortification sector, we are seeing health issues addressed, includingpremenstrual syndrome (PMS), osteoporosis, immune system health and more tocome, he added. Among the functional products Motyka expects to surface inthe future are iron added to soy milk and essential fatty acids (EFAs) added toa variety of foodsaimed at neurological development, learning abilities andmany other exciting areas of American quality of life.

According to data from the Health and Wellness Trends Databaseof the Natural Marketing Institute (NMI), use of fortified and functional foodsby the general population is on the rise, with around two-thirds of thepopulation currently using such products in 2004. What these customers want areproducts formulated for health concerns related to age, gender, healthproblem/goal (diabetes, weight loss, etc.) and lifestyle categories (smokers,athletes, etc.).

One of the most notable functional trends is beverages,including fortified waters, energy and sports drinks, juices and milk. RamChaudhari, Ph.D., chief scientific officer for Fortitech Inc., noted there isparticular interest worldwide in beverages that feature organic, natural orenergy-enhancing ingredients, especially those with strong scientific support.He listed taurine, natural caffeine (guarana, kola nut, etc.), antioxidants andlycopene as hot beverage ingredients. Liz Sloan, president of Sloan Trends,added other popular beverage ingredients include omega-3 in milk for hearthealth and cognitive development, and various forms of protein in drinks forenergy enhancement. In fact, she said sports/energy drinks, soy-based drinks anddrinkable yogurts are among the fastest growing health food categories, postingbetween 10 percent and 30 percent growth rates during the 2003 to 2004 period.Reporting a similar increased demand for probiotic and prebiotics fortification,Chaudhari said, Fortitech expects to formulate more premixes for beverage anddairy-based products with these ingredients.

The beverage category is swelling. Two very importanttrends are vitamin waters and other transparent beverages, as well as chewables,said Paul Flowerman, president of P.L. Thomas, which represents four companiesinvolved in fortification. Sloan agreed, projecting sales of flavored water,another hot beverage category, will reach $800 million by 2009. Chaudhari addedas fortified waters grow in popularity, Fortitech is creating more custompremixes that address the unique fortification challenges of this beveragecategory.

One such unique challenge to beverages, especially waters, canbe issues of transparency. While additives such as carotenes can providepigments that create a desired color, other ingredients need to refrain fromcontributing color to the finished beverage. NutraLease, an Israeli supplier,tackles this issue with nanoemulsions, fatty micelles of 10 nm to 30 nm indiameter which engulf an ingredient such as coenzyme Q10 (coQ10) or alipid-soluble vitamin. These micelles are transparent in a beverage, protectthe nutrients from degradation in the solution and enhance their bioavailabilityby a documented process of adhering to the intestinal wall and releasing thenutrients for absorption, Flowerman explained.

When it comes to foods, cereal is the most fortified. It is astaple food for children, therefore presenting a reliable way for parents toensure their children get the basic nutrition, including vitamins and minerals.The main evidence [for the appeal of fortified cereals] is that all breakfastcereals around the world are fortified, Alroy said. Currently, cerealmanufacturers are extending the category to nutritional barscompanies such asKellogg and Nestlé have a wide range of fortified nutritional bars.

The list of fortified foods has gotten longer. Manyexciting areas are being improved to better the quality of life of Americans,Motyka said. Dairy products, cereals, flours, juices and breads are allgood potential food forms to fortify.

The list of ingredients storming the fortified foods front isbeing led by carotenoids, EFAs and phytonutrients. Fortification companies havenoted lycopene, lutein, beta-carotene, plant sterols and flavonoids areincreasingly popular.These ingredients are backed by an expanding body ofscience demonstrating numerous health benefits.This has spawned an environmentripe for use of health claims for specific ingredients, which have beenincreasingly addressed by the Food and Drug Administration (FDA) and otherhealth authorities worldwide. Alroy explained marketers and manufacturers arelooking for new active ingredients that will carry such claims for two reasons:as a health message to consumers and for product distinction in a competitivemarketplace. Ingredients such as folic acid, soy and lycopene are popularbecause health officials have highlighted the importance of these substances. Insome cases, FDA has either approved claims or is considering claims for suchemerging ingredients.Alroy noted early fortification ingredients were used and marketed according torelation to government-promoted RDAs (recommended daily allowances), which isnot yet the case for new fortification ingredients that lack RDAs. Despite thelack of RDAs, manufacturers are including new ingredients such as carotenoidsand omega-3s on nutrient content labeling.

In addition to RDAs, common nutrient deficiencies promptedearly fortification projects. As old deficiencies became resolved, newdeficiencies emerged. According to the NMI database, between onequarter andone-third of the population believes their diet is deficient in variousnutrients, including fiber, omega-3s, soy, iron, vitamin C, general antioxidantsand calcium. Arif Vazirally, managing director for Global Calcium Inc., said hiscompany is increasing its calcium production capacity by 50 percent to meetsurging global demand. Similarly, Health Focus data shows shoppers have mostincreased their use of calcium, followed by omega-3s, vitamin C, generalfortified foods, antioxidants, B vitamins, folic acid, iron and vitamin D. In2004, top cancer prevention expert Harold Newmark said if the governmentrequired vitamin D and calcium to be added to foods, a 20-percent reduction incolon cancer deaths and osteoporosis fractures could be achieved.³ Sloan pointedout the U.S. Surgeon General, in a 2004 report, highlighted the importance ofphosphorus, another up-and-coming ingredient, in conjunction with calcium. Shesaid additional fortification ingredient trends include vitamin C forinflammation and immune health; iron for increased energy; zinc and choline forcognitive functioning in children; DHA (docosahexaenoic acid) for pregnant womenand fetal brain development; and magnesium for heart health.

Worldwide, fortification is a hot market in both developed anddeveloping countries. The Global Alliance for Improved Nutrition (GAIN) reportedmore than two billion people, nearly all from developing countries, lackmicronutrients such as iron, vitamin A, iodine and folic acid in their diets.The groups goal is to substantially improve the nutritional status of atleast 600 million people in up to 40 developing countries by 2007, primarilythrough fortification of commonly consumed foods. Launched at a 2002 United Nations (UN) special session onchildren, GAIN is a Swiss-based informal alliance of private and public sectorcompanies around the world and is partially funded by Bill Gates and certainU.S., Canadian, German and Dutch government humanitarian agencies. GAINsefforts will bring fortified foods to countries such as Burkina, China, Ghana,Pakistan, Vietnam, South Africa, Dominican Republic, Morocco, Nigeria andZambia. Many private companies, including BASF, Fortitech and HighChem, arealready onboard.

This worldwide urgency for fortified foods has presentedcompanies with good opportunities that can potentially impact business and thehealth of humanity. [Companies in] China, Brazil, Africa, Saudi Arabia,Pakistan, Bangladesh and other countries are approaching us at an everexpandingrate, Motyka said. He noted these countries are searching for bioavailableand organo-leptically acceptable ways to fortify a variety of staple foods withmineral ingredients.

The situation is different in the United States and thecountries of Europe, where basic fortification has been going on for manydecades. The fortification trends in the United States are morecomplex in light of a favorable regulatory environment and market demandsassociated with the baby boomer segment, Chaudhari said. Alroy added whilethe U.S. market has already expanded from dietary supplements tofortified foods and beverages, the market for functional foods in Europe hasonly recently bloomed. Consumers in Europe are more aware of the ingredientsin processed foods and are willing to pay a premium for natural and healthyfoods, he said.

Flowerman added while U.S. consumers have given priority tocereals, clear beverages and nutrition bars, the European market is abuzz aboutfortified yogurts, especially those involving prebiotics and probiotics. Also,Europeans are very concerned about GMO (genetically modified organism), identitypreserved and BSE/TSE (mad cow disease) issues. Thus, vegetarian and/or veganapplications are preferred, addressing the need for products that areallergen-reduced, BSE-free and not from animal sources.

Overall, the innovation among fortification ingredientsuppliers is largely scientificbioavailability and delivery systems. Vitaminsand minerals can be fragile and chemically sensitive to their environment,especially in the presence of oxygen, heat, pressure and water, all of which candestroy or decimate nutrient content. To counteract this, many manufacturershave put surplus amounts of a nutrient overage into a product, toensure the final processed food has the right amount of nutrient. Innovativedelivery systems, such as liposomes and microencapsulation, can protectnutrients from hostile reactions and eliminate the need for overage in fortifiedfood production. Microencapsulation also provides sustained-release andtastemasking some vitamins and minerals have notoriously bad tastes. In aNovember 2000 member survey by the American Academy of Pediatrics, 87 percent ofdoctors reported unpleasant palatability as a key reason children fail to takemedications. Flavor issues particularly plague certain minerals, including iron,copper and manganese, which often have a metallic taste.The amino acid in amineral chelate can lower the minerals coordination number, thereby reducingthe metallic taste. Chelation is also a way to make sure ingredients reach theabsorption stage in the body. Motyka explained minerals surrounded by and boundto amino acids, in a stable form and at a small molecular weight, bettertransport across the intestinal wall and are, thus, more readily absorbed.

Linda Douglas, Ph.D., manager of scientific affairs for GTCNutrition, noted ingested minerals can interact with each other, resulting incompetition for absorption. Moreover, it is known that calcium and magnesiumare more effective taken together, she said. A mineral source supplying ameaningful amount of calcium, magnesium and trace minerals is, therefore, moredesirable than just supplying calcium alone.

Another new frontier in fortification is multiple nutrientformulas for use as ingredients in fortified or functional foods. Suchformulated ingredients can help manufacturers develop products for a specifichealth concern or even for a specific gender, age or lifestyle. Formulas forheart health, blood sugar control and weight control are popular, as areformulas tailored to mens issues, such as prostate health, and senior issues,such as bone health. Likewise, athletes and active groups are drawn to energyand recovery formulas.

As fortification morphs into functional foods, manufacturersshift their product development focus from common, widespread deficiencies tospecific health issues in specific demographic populations. While issues ofregulation, stability, bioavailability and finished product character (taste,appearance, etc.) will continue to challenge the fortification industry,technological development on ingredients and delivery systems, coupled withtarget marketing of the researched health benefits behind ingredients, willguide industry through the new world of fortification.

References

1. Backstrand JR. The history and future of foodfortification in the United States: a public health perspective. NutrRev. 60, 1:15-26, 2002.

2. Berner LA et al. Fortification contributed greatly tovitamin and mineral intakes in the United States, 1989-1991. Nutrition 131:2177-83, 2001.

3. Newmark HL et al. Should calcium and vitamin D be addedto the current enrichment program for cereal-grain products? AmerJ Clin Nutr. 80, 2:264-70, 2004.