Should we eat enriched or fortified foods?

In the trend for infusing food with nutrients, vitamins and minerals crop up in the most unlikely places. Scanning products in my local supermarket the other day, I spotted nuclear blue drinks and sweet yoghurts, cheese and milk all with labels proclaiming their virtue by way of them being ‘fortified’ or ‘enriched’ with healthy ingredients. They seem to be a wise choice. Supplying our bodies with the nutrients they need, in whatever form, must surely be better than a diet lacking in these daily essentials?

However, experts claim that in many cases an unadulterated food is a better choice. So what does it all mean? “The terminology is confusing,” admits Elaine Allerton, a dietician and spokesperson for the British Dietetic Association (BDA). “If a product is described as ‘enriched’ with something, then it means nutrients lost in the manufacturing process have been replaced or added back. A fortified food has nutrients added that were not there in the first place.”

With manufacturers interchanging these descriptions, it can make food shopping a minefield. Pumped-up foods are everywhere. There’s minerals added to smoothies, fish oils added to eggs, vitamin D added to fish fingers and even the most blatantly unhealthy sugary soft drinks now come enriched with an extensive list nutrients. Here’s our guide to the nitty gritty:

Is any of it necessary?

Some foods have mandatory fortification. After World War 2, the government called for margarine to be fortified with vitamins A and D as butter wasn’t available, a requirement that held until last year when it became voluntary to add them. Fortification of white flour with calcium, iron, thiamin and niacin was started in the 1930s and is still carried out today. Staple foods - flour and cereals - are considered the best carrier for extra nutrients because they are consumed in such high amounts. There is an ongoing debate about whether the flour should also be fortified with folic acid. Medical experts in the US, where it has been mandatory for the past 10 years, say the move has helped to reduce neural tube defects, including spina bifida.

But in the UK, manufacturers need only add this and other extra nutrients if they choose to. Everything else is voluntary, giving rise to debate not only about whether it's needed but whether it is ethically right for our food to be tampered with in this way when only a small portion of the population might need it. "It's definitely a contentious area," Allerton says. "We've been debating the folic acid fortification for 25 years in the UK and it's an issue that's as much about ethics as it is about science and health."

Is it really healthier?

There is some argument that fortifying and enriching foods is useful. You would, for example, need to consume some meat, oily fish and ten eggs every day to get the vitamin D you need solely from the diet. Slipping some extra into food seems a convenient option. “Most breakfast cereals are now fortified with a range of vitamins and minerals and they are a very big contributor to our overall nutrient intake, especially among children,” says Allerton. “A lot of people think it’s a better way to go than taking a supplement.”

Allerton says some people benefit from vitamin-enriched foods. “Adding calcium and vitamin D to yoghurts and orange juice is useful for people who don’t get outside much,” she says. “There are certain sectors of the population who have higher calcium requirements than the rest of us - coeliacs and people with inflammatory bowel disease - so it can also be helpful for them.”

But the key is to select carefully. It’s one thing to opt for an egg enriched with essential omega 3 fatty acids, another altogether to select a sugary bowl of breakfast cereal just to get some extra B vitamins. The argument for adding nutrients is less easy to swallow when added to products like these, fizzy sports drinks and sweet biscuits all of which carry claims to be healthier as a result.

Joanna Blythman, the investigative food writer and author of ‘Shopped’ says fortifying food and drink with synthetic vitamins and minerals is a time-honoured food industry technique for adding a halo of health to products that might not otherwise merit it. She argues that “giving a food a healthy profile” in this way is for marketing rather than public-health reasons.

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Are there any risks from getting your nutrients this way?

It seems like you can’t lose by opting for a healthy fortified food, but there are potential downsides. Last year a report by the US Environmental Working Group warned that are fortified foods are putting children and pregnant women at risk of overdosing on vitamins and masking unhealthy products.

According to the EWG report, millions of children under the age of eight get too much vitamin A, zinc and niacin from fortified foods and supplements, levels that are almost certainly replicated in the UK. Among the worst culprits were fortified breakfast cereals, 23 of which were highlighted as being excessively loaded with extra nutrients. “Multiple studies point out that cumulative exposures from fortified foods and supplements could put children at risk for potential adverse effects," reads the report.

For those who take supplements, the risks of overdosing are higher. According to the EWG's study, more than 10 million American children are overexposed to vitamin A, up to 17.2 million are overexposed to zinc and about 4.7 million are overexposed to niacin, all of which carry side effects ranging from nausea to toxicity in too high levels.

What to choose?

If in doubt, experts agree that we should go for foods that have not been synthetically altered. Despite the healthy-sounding ‘enrichment’, adding vitamins and minerals is, after all, a form of food processing. “It is far better to get your vitamins in their natural form,” says Allerton. “The less adulterated a food, the better it is for you.” Nature, then, remains the superior source of nutrients.

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