Updated 22nd February 2023
Fortified foods: What they are, the benefits, and the risks
Fortified foods are enhanced with extra nutrients, like vitamins, minerals, fiber, and protein.
For example, some manufacturers fortify breakfast cereals with extra fiber, and some plant-based milks and spreads have added vitamin B12.
In this article, we explore the research behind fortified foods and take a close look at their benefits and limitations.
What are fortified foods?
Fortification, in a diet context, means adding nutrients to food. It may boost levels of existing nutrients or add nutrients that the food didn’t have.
During processing, ingredients can lose some of their natural nutrients. Manufacturers may then make up for this loss.
But why the need for fortified foods in the first place?
Some global populations have widespread nutrient deficiencies. To address this, many countries have laws requiring food suppliers to fortify certain grains, such as flour, rice, and maize.
Fortifying foods also helps specific groups of people get enough nutrients.
These groups include, for example, people who have restrictive diets or food allergies, as well as children, pregnant people, and older adults.
Some common fortified foods include:
milk and milk products
It’s important to bear in mind that while these foods are fortified, some are also ultra-processed. And eating a lot of ultra-processed food isn’t good for your health.
The United States and the United Kingdom regulate fortified foods. In the U.S., the Food and Drug Administration (FDA) does this to ensure that foods aren’t over- or under-fortified.
Similarly, the U.K. government has strict rules and regulations for food manufacturers.
But do fortified foods really work?
The benefits of fortified foods
Below, we take a look at some benefits of fortifying food.
Preventing deficiencies that lead to illness
In some cases, having a nutrient deficiency can lead to ill health. This is why some governments make sure that certain foods are fortified.
Today, for example, most of the flour in the U.S. is fortified with iron and the B vitamins thiamin, niacin, riboflavin, and folic acid.
Meeting dietary requirements
Fortified foods can be especially helpful to people with restricted diets. This type of diet may be a choice or a way to address an allergy or illness.
For example, some vegetarian and vegan diets lack certain vitamins, such as B12. In these cases, plant-based milks, breakfast cereals, and spreads that are fortified with the vitamin can be a good option.
Also, an iodine deficiency can be an issue for some vegans because animal products are the most common sources of iodine. But fortified, or “iodized,” salt can help provide enough iodine.
One more example: A person with lactose intolerance might avoid milk products. As a result, they may not get enough calcium and vitamin D. So, fortified alternative milks can help.
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During pregnancy, the body needs more nutrients, so there can be a higher risk of nutrient deficiencies.
These deficiencies can also affect the fetus, potentially causing health conditions and atypical development.
One example, which we mentioned above, involves a folic acid deficiency. This increases the risk of neural tube defects.
During pregnancy, a person might also develop a deficiency in calcium, vitamin C, or vitamin D.
So, fortified foods can help ensure that people get the nutrients they need during pregnancy.
Growth and development in children
Kids’ bodies are constantly developing, so getting enough nutrients is crucial.
Studies show that nutrient deficiencies, including those of iron, zinc, and vitamin D, can get in the way of development and cause lifelong problems.
Nutrition in older adults
As we get older, we absorb certain nutrients less efficiently. This can increase the risk of malnourishment.
Older adults can struggle to take in enough protein and energy, which can lead to muscle loss. And research has shown that fortifying foods may counteract malnutrition and weight loss.
For example, a review that looked at data from several studies suggests that fortified foods can help older adults improve their protein and calorie intake.
The limitations of fortified foods
Despite the benefits of fortification, there are possible downsides.
Disguising unhealthy foods
Some unhealthy foods, like ultra-processed breakfast cereals, advertise that they're high in fiber or certain vitamins and minerals. This could be true — but they may also be high in added sugar, salt, or unhealthy fats.
The added nutrients may encourage people to eat more of these products, rather than choosing naturally nutrient-rich foods like nuts, fruits, and vegetables.
But at high doses, it can damage the fetus, though this is very rare.
If you’re pregnant, it’s important to speak with a doctor before taking supplements.
Other micronutrients, such as zinc and niacin, can also cause problems in high doses.
However, it’s very rare to overdose on vitamins or minerals from fortified foods. But if someone has fortified foods plus high-dose vitamins, the risk increases, and the side effects can range from mild to severe.
In general, fortified foods can be a useful part of a well-balanced diet. They can be a safe way to help improve your health.
At ZOE, we know that everyone’s nutritional needs are different. But a well-balanced diet is important for everyone. So, if you’re concerned about any deficiencies, speak with a healthcare provider, who can recommend ways to increase your intake.
In many countries, fortified foods play an essential role in supporting public health.
However, keep in mind that fortified ultra-processed foods are still ultra-processed.
Anemia and growth. Indian Journal of Endocrinology and Metabolism. (2014). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266864/
Body composition, changing physiological functions and nutrient requirements of the elderly. Annals of Nutrition and Metabolism. (2008). https://www.karger.com/article/Abstract/115339
Eating, diet, & nutrition for lactose intolerance. (2018). https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/eating-diet-nutrition
Effectiveness of food-based fortification in older people. A systematic review and meta-analysis. Journal of Nutrition, Health, and Aging. (2016). https://pubmed.ncbi.nlm.nih.gov/26812514/
Folic acid fortification and supplementation. (2022). https://www.cdc.gov/ncbddd/folicacid/faqs/faqs-fortification.html
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Food fortification and supplement use — Are there health implications? Critical Reviews in Food Science and Nutrition. (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692722/
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Fortified foods are major contributors to nutrient intakes in diets of US children and adolescents. Journal of the Academy of Nutrition and Dietetics. (2014). https://pubmed.ncbi.nlm.nih.gov/24462266/
Fortified foods: Guidance to compliance on European Regulation. (2021). https://www.gov.uk/government/publications/fortified-foods-guidance-to-compliance-with-european-regulation-ec-no-1925-2006-on-the-addition-of-vitamins-and-minerals-and-certain-other-substances-to-food/fortified-foods-guidance-to-compliance-on-european-regulation-ec-no-19252006-on-the-addition-of-vitamins-and-minerals-and-certain-other-substance
Health risks from long-term consumption of micronutrient fortified foods. Global Journal of Nutrition and Food Science. (2019). https://irispublishers.com/gjnfs/fulltext/health-risks-from-long-term-consumption-of-micronutrient-fortified-foods.ID.000513.php
How much is too much? (2014). https://www.ewg.org/research/how-much-too-much
Neural tube defects. (n.d.). https://www.hopkinsmedicine.org/health/conditions-and-diseases/neural-tube-defects
Nutritional deficiencies in the pediatric age group in a multicultural developed country, Israel. World Journal of Clinical Cases. (2014). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023304/
Nutritional status and the influence of the vegan diet on the gut microbiota and human health. Medicina. (2020). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073751/
Overview of food fortification in the USA & Canada. https://www.ncbi.nlm.nih.gov/books/NBK208880/
Questions and answers on FDAs fortification policy. (2015). https://www.fda.gov/media/94563/download
Vitamin A and pregnancy: A narrative review. Nutrients. (2019). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6470929/
Vitamins, supplements and nutrition in pregnancy. (2020). https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/
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