ON FOOD fORTI - DOH Central Library - Department of Health
ON FOOD fORTI - DOH Central Library - Department of Health
ON FOOD fORTI - DOH Central Library - Department of Health
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t<br />
started in Guatemala, followed by<br />
Honduras and El Salvador. In Canada,<br />
in 1943, flour was enriched with a series<br />
<strong>of</strong> B-vitamins and iron and calcium, and<br />
margarine was also fortified withvitamin<br />
A. Whatwerethe resultsor thenutritional<br />
impact <strong>of</strong> fortification? In 1944, some<br />
clinical indicators <strong>of</strong> deficiencies'showed<br />
an improvement, after the introduction<br />
in 1943 and 1945 <strong>of</strong> the fortification <strong>of</strong><br />
flour and margarine. By 1948;percentage<br />
.changes were seen as a result <strong>of</strong> vitamin<br />
A supplementation as well. We can see,<br />
anoverall improvement,basedon clinical<br />
findings, after the population had been<br />
given fortified foods. Thus, there is, in<br />
a sense, a healthbenefitwhencertaintypes<br />
<strong>of</strong> foods are fortified and this benefit can<br />
be measured to ·show the contribution<br />
<strong>of</strong> fortified foods to the h;aith <strong>of</strong> the<br />
population. In America, prior to 1938,<br />
before-the enrichment <strong>of</strong> bread and flour,<br />
there was quite a high incidence <strong>of</strong><br />
pellagra, which is a deficiency <strong>of</strong> vitamin<br />
B3, or niacin.<br />
-..When fortification started in 1938,<br />
,the,incidence due to pellagra dropped.<br />
By 1943, enrichment wasmaridated in<br />
particular states facing the problem and<br />
there followed a drop in the' incidence<br />
<strong>of</strong> pellagra. By 1948,22 states in America<br />
decided to have mandatory enrichment<br />
. <strong>of</strong> flours and bread with B-complex<br />
A Report on Food Fortification 15<br />
vitaminsand iron. In thePhilippines,way<br />
back in 1947, there was an increased<br />
prevalence <strong>of</strong> beriberi due to a deficiency'<br />
<strong>of</strong> B1 because <strong>of</strong> the intake <strong>of</strong> polished<br />
rice. You lose the nutrients here, because,<br />
the nutrients are in the outer coating' <strong>of</strong><br />
the rice, so that there was quite a high<br />
incidence <strong>of</strong> beriberi for some 100,000 <strong>of</strong><br />
the population. When rice was fortified,<br />
'mortality due to beriberi dropped.<br />
In 1992, in Rome, representatives<br />
from manycountriesattended ajoinfFAD<br />
WH<strong>ON</strong>utritiorialMeetingontheproblem<br />
<strong>of</strong> Hidden Hunger.' From statistics on<br />
vitaminAdeficiency alone, 70to 80million<br />
children and women were afflicted and<br />
mortalityamongchildrenwasin the region<br />
<strong>of</strong> 300,000 per year. In the case <strong>of</strong> iron<br />
deficiency, about 1 million children and<br />
women were affected. Iron deficiency<br />
increased the risk <strong>of</strong> premature birth and<br />
maternal' death. Thus, in the meeting,<br />
participants agreed that by the year 2000<br />
deficiency in vitamin 'A and iron must<br />
be eliminated. In the case <strong>of</strong> iodine, about<br />
a billion people in the world suffer from<br />
its -lack. In addition to these<br />
micronutrients, the meeting stressed the<br />
importance <strong>of</strong> B-complex vitamins,<br />
calcium and zinc.<br />
What are the health consequences<br />
,<strong>of</strong> iron deficiencies? Anemia causes<br />
lethargy, decreased' working capacity,<br />
increased fetal-maternal deaths, impaired<br />
,immuneresponse, arid, impairedlearning<br />
ability. For iodine deficiency,<br />
consequencesare hypothyroidism" goiter,