ON FOOD fORTI - DOH Central Library - Department of Health

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started in Guatemala, followed by
Honduras and El Salvador. In Canada,
in 1943, flour was enriched with a series
of B-vitamins and iron and calcium, and
margarine was also fortified withvitamin
A. Whatwerethe resultsor thenutritional
impact of fortification? In 1944, some
clinical indicators of deficiencies'showed
an improvement, after the introduction
in 1943 and 1945 of the fortification of
flour and margarine. By 1948;percentage
.changes were seen as a result of vitamin
A supplementation as well. We can see,
anoverall improvement,basedon clinical
findings, after the population had been
given fortified foods. Thus, there is, in
a sense, a healthbenefitwhencertaintypes
of foods are fortified and this benefit can
be measured to ·show the contribution
of fortified foods to the h;aith of the
population. In America, prior to 1938,
before-the enrichment of bread and flour,
there was quite a high incidence of
pellagra, which is a deficiency of vitamin
B3, or niacin.
-..When fortification started in 1938,
,the,incidence due to pellagra dropped.
By 1943, enrichment wasmaridated in
particular states facing the problem and
there followed a drop in the' incidence
of pellagra. By 1948,22 states in America
decided to have mandatory enrichment
. of flours and bread with B-complex
A Report on Food Fortification 15
vitaminsand iron. In thePhilippines,way
back in 1947, there was an increased
prevalence of beriberi due to a deficiency'
of B1 because of the intake of polished
rice. You lose the nutrients here, because,
the nutrients are in the outer coating' of
the rice, so that there was quite a high
incidence of beriberi for some 100,000 of
the population. When rice was fortified,
'mortality due to beriberi dropped.
In 1992, in Rome, representatives
from manycountriesattended ajoinfFAD­
WHONutritiorialMeetingontheproblem
of Hidden Hunger.' From statistics on
vitaminAdeficiency alone, 70to 80million
children and women were afflicted and
mortalityamongchildrenwasin the region
of 300,000 per year. In the case of iron
deficiency, about 1 million children and
women were affected. Iron deficiency
increased the risk of premature birth and
maternal' death. Thus, in the meeting,
participants agreed that by the year 2000
deficiency in vitamin 'A and iron must
be eliminated. In the case of iodine, about
a billion people in the world suffer from
its -lack. In addition to these
micronutrients, the meeting stressed the
importance of B-complex vitamins,
calcium and zinc.
What are the health consequences
,of iron deficiencies? Anemia causes
lethargy, decreased' working capacity,
increased fetal-maternal deaths, impaired
,immuneresponse, arid, impairedlearning
ability. For iodine deficiency,
consequencesare hypothyroidism" goiter,