fortification and supplementation

Question 1

what is fortification

Answer 1

The practice of deliberately increasing the content of essential micronutrients (vitamins and minerals) in a food to improve the nutritional quality of the food supply and to provide health benefit with minimal risk to health.

The addition of nutrients to foods irrespective of whether or not the nutrients were originally present in the food.

Question 2

what is enrichment

Answer 2

The addition of nutrients to a food to replace nutrients lost during processing.

Question 3

what is restoration

Answer 3

Nutrients unavoidably lost during processing, storage or handling are replaced

Question 4

what is substitution

Answer 4

Nutrients added to produce a substitute product with similar nutritive value, e.g. voluntary addition of Ca to soya based drinks.

Question 5

what does fortification help us with

Answer 5

achieve recommended intakes.

Question 6

why do manufacturer add nutrients to foods

Answer 6

To differentiate them from other products and provide a competitive advantage.

Question 7

the choice of foods that can be fortified depend on what

Answer 7

The dietary habits of the population.

Technological limitations (e.g. vitamin B12 is unstable in acid conditions).

Question 8

what staple foods have been fortified

Answer 8

Cereal products (e.g. flour & breakfast cereals)

Milk products (e.g. low fat milk powders are sometimes fortified with vitamins A & D).

Sugar, oil and salt are also fortified in some countries.

Question 9

what safety and technical considerations have to be taken into consideration when fortifying foods

Answer 9

Intakes of the nutrients from unfortified foods.

Anticipated consumption of the food to be fortified.

Bioavailability of the added nutrients.

Likely impact of fortification on overall intake of the nutrient(s).

Risk of excessive intakes of the added nutrients by ‘extreme’ consumers of a food.

Sensory qualities.

Question 10

how are fats and spreads currently fortified

Answer 10

voluntary fortification of vits A & D.

Question 11

how are cereal and wheat products currently fortified

Answer 11

mandatory fortification of wheat flour (except wholemeal) with Fe, B1 & niacin, and all flours (except wholemeal & some self-raising varieties) with Ca.

Question 12

how are breakfast cereals currently fortified

Answer 12

many fortified on voluntary basis.

Question 13

how are food products for vegans and vegetarians currently fortified

Answer 13

fortified voluntarily with vitamin B12.

Question 14

how are infant foods currently fortified

Answer 14

fortified with Fe & vitamin D.

Question 15

what are the 5 types of fortification

Answer 15

Mass fortification
Targeted fortification
Market-driven fortification
Household & community fortification
Biofortification of staple foods

Question 16

what is mass fortification

Answer 16

The addition of 1 or more micronutrients to foods commonly consumed by the public.

Usually instigated, mandated and regulated by Government.

Question 17

what is target fortification

Answer 17

Foods aimed at specific subgroups are fortified to increase intakes in particular groups

Question 18

what is market driven fortification

Answer 18

Voluntary fortification of processed foods.

More widespread in industrialised countries.

Question 19

what is household and community fortification

Answer 19

Combination of supplementation & fortification, with a focus on complementary foods for young children.

Approaches include micronutrient powder (“sprinkles”), crushable tablets, soluble tablets and fat-based spreads.

Question 20

what is Biofortification of staple foods

Answer 20

Breeding and genetic modification of plants to improve nutrient content and/or absorption.

Efficacy and effectiveness needs to be proven, whilst considering safety, cost and impact on the environment.

Question 21

what the definition of supplements

Answer 21

Concentrated sources of nutrients or other substances with a nutritional or physiological effect that are marketed in “dose” form (e.g. pills, tablets, capsules, liquids in measured doses).

Question 22

the EU, legislation regulates what about supplements

Answer 22

the vitamins, minerals and substances used as their sources, which can be used in their manufacturing.

For other ingredients, the European Commission protects consumers against potential health risks and maintains a list of substances known/suspected to have adverse effects on health and controls their use.

Question 23

what does the eat well guide say about supplements

Answer 23

“Most people can get all the nutrients their body needs by eating healthily. However, some people do need certain supplements.”

If you are planning a pregnancy, you should take a daily 400 μg folic acid supplement from the time you stop using contraception until the 12th week of pregnancy.

Everyone should consider taking a daily supplement containing 10 μg vitamin D during autumn and winter

Question 24

what are the recommendations for cancer prevention through supplements

Answer 24

high dose dietary supplements are not recommended for cancer prevention
you should aim to meet nutritional needs through diet alone

Question 25

Trials of high dose supplements have not consistently demonstrated what

Answer 25

the protective effects of micronutrients suggested by observational studies.

Some trials have shown unexpected adverse effects.
For most people, it is possible to obtain adequate nutrition from a healthy diet.

Question 26

what are the risks of supplementation

Answer 26

Most are safe if taken in the correct dose.

Internet products may not meet UK standards.

Water-soluble versus fat-soluble vitamins.

Wasting money!

Interactions with medications.

Cod liver oil dangerous for pregnant women.

Avoid vitamin E supplements for people with CVD.

Effervescent vitamin supplements may contain ~1g salt per tablet.

Question 27

who needs vit D supplements

Answer 27

10 micrograms per day (everyone).

Question 28

who needs folic acid supplements

Answer 28

400 micrograms per day (women trying to conceive and in first 12 weeks of pregnancy).

Question 29

who needs vit B12 supplements

Answer 29

vegans if not consuming fortified foods.