regulations to include fortification of all milks in 1975, eliminated rickets as a public health problem beginning in the late 1970s (Cheney and Lee, 1994).
The “positive list” approach to fortification was initiated with the 1964 regulations. The inclusion of a list of food that may be fortified, as well as the specific micronutrients and maximum levels to which they may be added, is viewed by Health Canada as a successful fortification program that addresses inadequacies and protects the population from excesses of fortificants (Cheney, 2000; Health Canada, 1999). Extensions to food fortification are guided by policies first enunciated in 1971 (Canada, 1971) and later in accordance with the general principles for the addition of essential nutrients to foods of the Codex Alimentarius Commission4 (1994).
Fortification of food in Canada is also permitted to maintain nutritional equivalence for substitute food, to restore nutrients lost during manufacturing, and to ensure the nutrient composition of a special-purpose food in a carefully regulated fashion. The principles in the Codex Alimentarius Commission’s (1994) general principles include definitions and approaches for fortification that cover issues such as “… safety, nutrient interactions, bioavailability, technical feasibility, and choice of food vehicle … ” (Health Canada, 1999, p. 29).
Canadian regulations apply to all food sold in Canada, regardless of where it is produced. Canada permits discretionary fortification with defined limits, and therefore it does not have a reference standard for levels of nutrient addition.
In 1998 Health Canada began a policy review of the addition of vitamins and minerals to food through an iterative consultation process that resulted in the 1999 publication of new proposed policy recommendations (Health Canada, 1999). This proposal includes five recommendations that continue to support the existing fortification policies. One important change, however, is the proposal for discretionary fortification, as indicated in Recommendation 1c, which states:
“The Codex Alimentarius Commission was created in 1963 by FAO and WHO to develop food standards, guidelines and related texts such as codes of practice under the Joint FAO/WHO Food Standards Programme. The main purposes of this Programme are protecting health of the consumers and ensuring fair trade practices in the food trade, and promoting coordination of all food standards work undertaken by international governmental and non-governmental organizations” (Codex Alimentarius Commission, 2003).