There is currently an absence of empirical data on the impact of discretionary fortification on the distribution of usual nutrient intakes in the population. This lack of data makes it difficult to estimate the amount of a nutrient that must be added to food to have the desired effect on an identified nutrient inadequacy. As a temporary alternative, fortification levels could be matched to the criteria for meeting nutrient content claims as “good” or “excellent” sources of nutrients, consistent with the modeling approach recommended in Guiding Principle 12. Recognizing that the defining conditions for these claims may change in the future, the committee recommends using these criteria with outcome modeling as a potentially effective approach to increasing the availability of selected nutrients in the food supply and facilitating communication of this benefit to consumers. The committee recommends using these criteria as a scientifically sound approach, even if the defining criteria for claims should change.
GUIDING PRINCIPLE 14. Potential changes to certain long-standing discretionary fortification practices should be carefully reviewed because they may be central to the maintenance of nutrient adequacy in the population.
Discretionary fortification of the food supply has evolved over time in the United States. This evolution has created a dynamic relationship between the micronutrient content of the food supply and the dietary adequacy and nutritional status of population groups. For example, in the United States many breakfast cereals have been fortified with vitamins and minerals at about 15 to 25 percent of the DV per serving since the 1970s. Since the 1980s some orange juice products have been fortified with calcium at 30 percent of the DV per 8 fl oz, an amount equivalent to that contained in 8 oz of milk. Regular use of these products could contribute meaningfully to nutrient intake in many segments of the population. Berner and colleagues (2001) demonstrated that discretionary fortification of some food products moved the “… median or the 25th percentile intakes from below to above the RDA …” for a number of different nutrients.
As indicated previously the committee recommends the use of existing food composition and dietary supplement databases to assess the level of dietary adequacy in selected population groups. It is the committee’s understanding that individual food items that have been fortified under discretionary fortification policies in the United States cannot be readily identified as such in the current U.S.