nutrient deficiencies in the population. In 1924 iodine was first added to salt on a voluntary basis in an attempt to address the prevalent health problem of goiter in the United States. This program was begun only after a number of prominent national health organizations of the time, the American Public Health Association, the Council on Foods and Nutrition of the American Medical Association (AMA), and the Committee on Food and Nutrition of the National Academy of Sciences, recommended this step based on new research demonstrating that sodium iodide prevented goiter (Quick and Murphy, 1982). This initial fortification effort was followed in 1933 by the fortification of milk with vitamin D based on recommendations from similar groups. The addition of vitamin D to milk was originally accomplished by irradiating milk or by feeding the cows irradiated yeast. This technique was replaced in the 1940s by the simpler and more effective method of adding vitamin D concentrate to milk, as is currently practiced today (Quick and Murphy, 1982).
In the 1930s and 1940s specific deficiency disease syndromes were first identified and documented in the United States (Foltz et al., 1944; McLester, 1939; Williams et al., 1943). Based on this new science, in 1940 the Committee on Food and Nutrition (now the Food and Nutrition Board [FNB]) recommended the addition of thiamin, niacin, riboflavin, and iron to flour (NRC, 1974). About that time FDA first established a standard of identity for enriched flour that identified specific nutrients and amounts required for addition to any flour labeled as “enriched” in order to improve the nutritional status of the population (FDA, 1941). The approach of using a standard of identity, which establishes the specific type and level of fortification required for particular staple food to be labeled as enriched, has remained a key aspect of fortification regulations and policy in the United States. These standards have been amended over the years, but they continue as the basis for the addition of thiamin, niacin, riboflavin, folic acid, and iron to enriched flour, with the addition of calcium as optional.
Concurrent with these activities, the nutritional status of Americans was being questioned as a result of the poor nutritional status of young men enlisting for service during World War II. These concerns led to the National Nutrition Conference for Defense in May 1941, convened by President Roosevelt. An outcome of this conference was the recommendation for flour and bread enrichment using the existing standards developed by FDA (Quick and Murphy, 1982).
Although the original FDA standard was not amended to include bread for several years, the enrichment of bread began in 1941 as a