Contribution of voluntary fortified foods to micronutrient intake in The Netherlands

Purpose In the Netherlands, voluntary fortification of foods with micronutrients is allowed under strict regulations. This study investigates the impact of voluntary food fortification practices in the Netherlands on the frequency and type of fortified food consumption and on the micronutrient intakes of the Dutch population. Methods Data of the Dutch National Food Consumption Survey (2012–2016; N = 4314; 1–79 year) and the Dutch Food Composition Database (NEVO version 2016) was used. To determine if voluntary fortified foods could be classified as healthy foods, criteria of the Dutch Wheel of Five were used. Habitual intakes of users and non-users of voluntary food fortification were calculated using Statistical Program to Assess Dietary Exposure (SPADE) and compared. Results Within the Dutch population, 75% could be classified as user of voluntary fortified foods. Consumed voluntary fortified foods were mostly within food groups ‘Fats and Oils’, ‘Non-alcoholic Beverages’ and ‘Dairy products and Substitutes’ and fell mostly outside the Wheel of Five. Voluntary foods contributed between 9 and 78% to total micronutrient intake of users. Users had up to 64% higher habitual micronutrient intakes, compared to non-users. These higher intakes resulted into lower risks on inadequate intakes, and did not contribute to increased risks of excessive intakes. Conclusion Although voluntary fortified foods increased micronutrient intakes, most of these foods cannot be classified as healthy foods. Future studies should study the association between higher micronutrient intakes and (potential) excessive intakes of e.g. saturated fat and sugar to better understand the role of voluntary fortified foods in a healthy food pattern.

Hydrosoluble and Liposoluble Vitamins: New Perspectives through ADMET Analysis

Background and Objectives: The present study demonstrates that apart from the well-known toxicity of liposoluble vitamins, some hydrosoluble vitamins may also exert toxicity; thus, routine supplementation with vitamins or ingestion of fortified foods should not be considered harmless. The study addresses the possible correlations between the physico-chemical properties and the side effects of vitamins when taken in high doses or for a too long a period. Materials and Methods: The FAFDrugs4.0 computational tool was used for computational assessment of the ADMET profile of several hydro- and liposoluble vitamins. Results: ADMET analysis revealed the following major data: vitamin B3 and B13 showed reduced structural complexity; thus, a relative toxicological potential may be exerted. Vitamins B1 and B7 were found to have good oral absorption and thus good bioavailability, while Vitamin B3 was found to have decreased oral absorption. In addition, all of the liposoluble vitamins reflected higher complexity, much greater than most of the potentially therapeutically-proven compounds. Conclusions: The present study emphasizes the importance between the physico-chemical properties of vitamins and their possible toxicological impact.

Sources of vitamin D for humans

Both vitamin D insufficiency and deficiency are now well-documented worldwide in relation to human health, and this has raised interest in vitamin D research. The aim of this article is therefore to review the literature on sources of vitamin D. It can be endogenously synthesised under ultraviolet B radiation in the skin, or ingested through dietary supplements and dietary sources, which include food of animal and plant origin, as well as fortified foods. Vitamin D is mainly found in two forms, D3 (cholecalciferol) and D2 (ergocalciferol). In addition to the D3 and D2 forms of vitamin D, 25-hydroxy vitamin D also contributes significantly to dietary vitamin D intake. It is found in many animal-derived products. Fortified food can contain D3 or D2 forms or vitamin D metabolite 25-hydroxy vitamin D. Not many foods are a rich source (> 4 μg/100 g) of vitamin D (D represents D3 and/or D2), e.g., many but not all fish (5–25 μg/100 g), mushrooms (21.1–58.7 μg/100 g), Reindeer lichen (87 μg/100 g) and fish liver oils (250 μg/100 g). Other dietary sources are cheese, beef liver and eggs (1.3–2.9 μg/100 g), dark chocolate (4 μg/100 g), as well as fortified foods (milk, yoghurt, fat spreads, orange juice, breakfast grains, plant-based beverages). Since an adequate intake of vitamin D (15 μg/day set by the European Food Safety Authority) is hard to achieve through diet alone, dietary supplements of vitamin D are usually recommended. This review summarizes current knowledge about different sources of vitamin D for humans.

Ingestion of supplements and fortified food with iodine on the breast milk iodine concentration in deficiency areas: a systematic review

Introduction: The level of iodine in breast milk may be inadequate and compromise the health of this, both due to excess and lack, some population groups remain deficient because of the low consumption of iodate salt, because there is an in- crease in consumption of other sources of iodine, such as supplements and fortified foods. Objective: To evaluate the effect of the consumption of fortified foods and nutritional supplements with iodine on mater- nal milk levels. Methodology: Systematic review based on the Prism method, using the descriptors provided by DeCS. The reading, selec- tion and analysis of the methodological quality of the articles was done by two researchers independently. Results: From 346 abstracts, 6 were eligible. The median iodination range between the studies ranged from 75 to 600 μg in supplements and 150 and 225 μg in fortified foods with effect on increased iodine concentration of breastmilk (BMIC), achieving the adequacy of the median BMIC in 4 of the 6 studies. Conclusion: Iodine ingestion through supplements or fortified foods results in improved iodine levels in breast milk. Keywords: Iodine; supplements; fortified foods; breastmilk; iodine concentration.

Assessment and Updating of the Fortification Model from 2006

In 2006 the, the Panel on Nutrition, Dietetic Products, Novel Food and Allergy in the Norwegian Scientific Committee for Food Safety (VKM) adapted a Danish model for assessing applications concerning food fortification into Norwegian conditions. The fortification model is presently used by the Norwegian Food Safety Authorities as a tool in the management of applications on food fortification. The model from 2006 was based on intake calculations from dietary surveys from 1997-2000. Since then, new national dietary surveys have been published. These are the comprehensive nationwide Norwegian dietary surveys among adults (Norkost 3, 2010-2011), among young children (Småbarnskost, 2007) and infants (Spedkost, 2006-2007). The Norwegian Food Safety Authority has requested VKM to implement the new data into the fortification model from 2006. In the model from 2006 it is assumed that 25% of the energy in the diet can be derived from fortified foods and drinks. Information from the Norwegian Food Safety Authority, including about a pilot study for Norkost 3 suggested that the overall intake of fortified foods and drinks was marginal. From management of applications for fortified foods, the Norwegian Food Safety Authority also experienced that there are few fortified foods on the market in Norway. The Norwegian Food Safety Authority has therefore requested VKM to evaluate whether the assumption that 25 energy percent (E%) deriving from fortified foods can be reduced to 15 E%, and if such a reduction will have health implications. In addition, the Norwegian Food Safety Authority has asked VKM to perform an evaluation of the safety factors in the model. VKM argues that the model for fortification should be based on the dietary intake of vitamins and minerals at the 95th percentile level in various age groups. This is in accordance with risk assessments performed in European Food Safety Authority (EFSA), and will assure that the dietary intake in a majority of the population will be covered, still within a reasonable secure use of dietary exposure calculations. Mean intake of vitamins and minerals from food supplements (among users only) was chosen, in an attempt to reduce the impact of those with a high intake of supplements. The intake at 95th percentile from the diet plus the mean nutrient intake from supplements is deducted from the tolerable upper intake level (UL) for each nutrient in each age group, giving the maximum amount of nutrients that can be “allocated” for food fortification. The maximum amount of a nutrient that can be “allocated” is then distributed over the energy intake at the 95th percentile level. In this manner an estimate is made showing which age group is most likely to have an excessive intake of a certain nutrient. VKM does not have access to any other information about available fortified foods on the Norwegian market than the information given by the Norwegian Food Safety Authority. However, based on this information, VKM considers that it seems reasonable that the energy intake from fortified foods is reduced to 15 E%. In this revised fortification model the assumption from 2006 that 25 E% of the total energy intake will be derived from fortified foods, have therefore been reduced to 15 E%. This adjustment implies that the addition of e.g. vitamin D, vitamin E, thiamine, riboflavin, niacin, folic acid, vitamin B12, vitamin C and calcium per 100 kcal can be increased without risk of exceeding UL. No changes are made for e.g. vitamin A, beta-carotene, magnesium, iron, zinc or copper. A more summary is presented in Table 1 and Appendix 1. The Panel on nutrition, dietetic products, novel food and allergy considers that this model for management of fortification will reduce health risk that could be caused by unauthorised food fortification.

Functional Foods: Components, health benefits, challenges, and major projects

Certain food components play a vital part in the benefit of our health and wellness. These foods, also known as “Functional Foods,” help in reducing or minimizing the risk of certain diseases and other conditions apart from providing fundamental nutrition. These foods include fortified foods, beverages, some nutritional supplements, fruits, vegetables, and whole grams etc. Many traditional foods with functional characteristics have been discovered, examined, and developed into beneficial components of new foods. By knowing which food is capable of providing specific health benefits, individuals can choose food and drink to improve their health

Towards Oxidatively Stable Emulsions Containing Iron-Loaded Liposomes: The Key Role of Phospholipid-to-Iron Ratio

To encapsulate soluble iron, liposomes were prepared using unsaturated phospholipids (phosphatidylcholine from egg yolk), leading to high encapsulation efficiencies (82–99%). The iron concentration affected their oxidative stability: at 0.2 and 1 mM ferrous sulfate, the liposomes were stable, whereas at higher concentrations (10 and 48 mM), phospholipid oxidation was considerably higher. When applied in oil-in-water (O/W) emulsions, emulsions with liposomes containing low iron concentrations were much more stable to lipid oxidation than those added with liposomes containing higher iron concentrations, even though the overall iron concentration was similar (0.1 M). Iron-loaded liposomes thus have an antioxidant effect at high phospholipid-to-iron ratio, but act as pro-oxidants when this ratio is too low, most likely as a result of oxidation of the phospholipids themselves. This non-monotonic effect can be of crucial importance in the design of iron-fortified foods.

Impact of Voluntary Folic Acid Fortification of Corn Masa Flour on RBC Folate Concentrations in the U.S. (NHANES 2011–2018)

Objectives Surveillance data have highlighted continued disparities in neural tube defects (NTDs) among infants of Hispanic women of reproductive age (HWRA) in the United States. Starting in 2017, the US Food and Drug Administration implemented voluntary folic acid fortification of corn masa flour to reduce the risk of NTDs. We assessed folate status, using red blood cell (RBC) folate concentrations, in HWRA (aged 12–49 y) before (2011–2016) and after (2017–2018) voluntary fortification of corn masa, stratified by acculturation factors (i.e., primary language spoken at home, length of time residing in the US). Methods Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 with available RBC folate concentrations for HWRA were analyzed. Additional analyses were conducted among HWRA whose only folic acid source was fortified foods (enriched cereal grain products (ECGP) only), including usual intake and NTD prevalence estimations based on previously published models. Results Overall, RBC folate concentrations (adjusted geometric means) among HWRA remained similar from 2011–2016 to 2017–2018, though RBC folate significantly increased in 2017–2018 among lesser acculturated HWRA consuming ECGP only. Concentrations for those who were born outside the US and resided in the US < 15 y increased from 894 nmol/L (95% CI: 844–946) in 2011–2016 to 1018 nmol/L (95% CI: 982–1162; p < 0.001) in 2017–2018. Primarily Spanish speaking HWRA who consumed ECGP only increased from 941 nmol/L (95% CI: 895–990) in 2011–2016 to 1034 nmol/L (95% CI: 966–1107; p = 0.03) in 2017–2018. We observed no significant changes in the proportion at risk of NTD (<748 nmol/L) and no changes in Bayesian model-based estimated NTD rates. Conclusions This early analysis following voluntary corn masa fortification found an increase in RBC folate concentrations in lesser acculturated groups relying on fortified foods as their primary folic acid source, though HWRA overall had no significant increase in folate concentrations. These early data suggests that there is remaining risk among Hispanics for folate sensitive NTDs; continued monitoring of folate status with NHANES will help assess the long-term efficacy of voluntary fortification. Funding Sources No funding sources outside of salaries.

Evaluating Interventions With Special Fortified Products and Complementary Feeding Recommendations to Best Achieve the Nutrient Adequacy in Filipino Complementary Diets

Objectives The objective of this study was to predict the intervention scenarios that best fulfil the nutrient adequacy in Filipino complementary diets in rural settings using linear programming (LP) analyses of special fortified foods, alone or in combination with complementary feeding recommendations (CFRs). Methods A cross-sectional survey was conducted in the municipality of Mercedes, Camarines Norte Province. Dietary intakes of breastfed children 6–8, 9–11 and 12–23 months of age (n = 297) were assessed using a multi-pass 24-hour recall method with 7-day food consumption frequency. Optifood, an LP tool was used to formulate age-specific CFRs and determine the extent to which special fortified foods, namely micronutrient powder (MNP), small-quantity lipid-based nutrient supplements (LNS-SQ) and fortified blended food with micronutrient powder (FBF + MNP), can contribute towards nutrient adequacy in complementary diets. Results LP analyses show that for 6–8 and 9–11-month-old infants, requirements for iron will be difficult to meet even with four serves of MNP per week, while for 9–11 and 12–23-month-old young children, calcium adequacy would remain a challenge even with daily serves of LNS-SQ per week. Adequacy for 11 modelled micronutrients could only be achieved if CFRs that modify current dietary patterns were fully adopted along with supplementation of LNS-SQ 5–7 times per week. Conclusions Adoption of food-based CFRs with special fortified products is necessary to best fulfil the gaps of essential micronutrients in the diets of rural Filipino children aged 6–23 months. The findings provide insight into the current program in the Philippines. The MNP supplementation with the usual ration of MNP 3 to 4 times per week would not be sufficient to ensure adequacy for iron in 6–8 and 9–11-month-old infants unless the frequency is increased to 5 times per week. Empirical intervention studies are needed to confirm the LP simulations and feasibility of the CFRs. Funding Sources The authors received no funding for this work.