"...all doctors should be able to diagnose and treat nutritional deficiencies."

Royal College of Physicians. Nutrition and Patients: A Doctor's Responsibility. London 2002

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This page has been printed from the www.stewartnutrition.co.uk web site.


Fortification of Foods

The addition of micronutrients to commonly consumed staple foods is a cheap and effective way of improving nutrient intake for the population as whole or for vulnerable groups.  A policy of fortification of food began in the US in 1924 with the fortification of salt with iodine.  In the 1930s vitamin D was added to milk and in the 1930s there was voluntary fortification of flour with the B vitamins thiamin, riboflavin and niacin as well as iron.  This became mandatory in 1943. 

In the UK since the 1940s there has been mandatory fortification of white flour with calcium, iron, vitamins B1 – thiamin and B3 - niacinB1, B2 and margarines with vitamins A and D.  These measures have helped to reduce the burden of many previously common deficiencies.

Other commonly fortified foods include:

  • Breakfast cereals (B group vitamins and iron)
  • Soya milk (calcium, vitamin D and some also have vitamins A, B2 – riboflavin and iodine added)
  • Infant formula milks and many baby foods (a comprehensive spectrum of vitamins and minerals)
  • The Food Standards Agency recommends that a variety of foods will shortly be fortified with folic acid as has been the case in the US for several years

Additionally animal feeds are often fortified with vitamin A and trace elements which will boost the content of meat, milk and milk products as a result.  Dairy cow’s teats are often sterilised with iodine- containing solutions which result in dairy foods providing nearly 50% of the UK population’s intake of this mineral and the virtual eradication of iodine deficiency.

Developing countries have seen the success of food fortification programmes in developed countries and are embracing these as the most cost-effective method of preventing and treating many endemic deficiencies.  The choice of food to be fortified and the nutrients to be added may vary considerably from country to country.  Commonly fortified staple foods include salt (iodine), flour (iron), oil (iodine and vitamin A), and sugar (vitamin A). 

In developed countries some more expensive foods such as sports drinks and snack bars are fortified but these contribute little to the prevention of deficiencies in the population.



Copyright Dr. Alan Stewart M.B.B.S.M.R.C.P. (UK)M.F. Hom.
47 Priory Street, Lewes, East Sussex. BN7 1HJ
Tel 01273 487003 Fax: 01273 487576