Manufacturers must take ‘balanced’ approach to fortification & supplementation for nutrient shortfalls

By Elizabeth Crawford contact

- Last updated on GMT

In America we tend to think more is better, but when it comes to solving the rising problem of malnutrition or hidden hunger – fortifying foods with higher levels of vitamins and minerals or creating supplements with nutrient levels that far exceed the daily recommended value is not the best approach according to a leading nutrition expert.

Speaking to Congressional staff on at the Capitol last week, Dr. Regan Bailey talked about the extent of hidden hunger in the US, who is disproportionately affected and the different ways manufacturers can help alleviate it.

“There are different shortfall nutrients in the American diet, and so the term hidden hunger can represent having adequate calories, but inadequate micronutrients or inadequate calories. And I think what we are seeing in America is we have adequate calories, but we have low nutrient dense diets,”​ Bailey told FoodNavigator-USA.

In particular, she said, the dietary guidelines call out vitamins A, C, D and E, as well as magnesium, calcium and potassium as nutrients people most at risk of not consuming enough.

Recent research conducted by Bailey and others shows that who is most at risk of nutrient shortfalls varies dramatically by income – a finding that is prompting some to call for changes in how the Supplemental Nutrition Assistance Program, or SNAP, can be used to address the problem.

“What we found in our latest study is that people who were less than 130% of the poverty income ratio, which is the eligibility criteria for SNAP, those were the ones of the two populations that were most at risk. Really it was the low and middle income people who have a much higher prevalence of inadequacy than those at the highest income,”​ she said.

One potential solution to ensuring low-income people have access to sufficient nutrients is to allow them to us their SNAP benefits to pay for supplements without any added cost to them. Currently, this is not allowed, but legislation moving through the House (HR 3841) could change that.

But are supplements the best way to address the risk of nutrient shortfalls? According, to Bailey the answer depends on the circumstances.

When people are not worried about how many calories that are consuming, the best answer might be diversification of the diet – so eating lots of different foods to ensure sufficient nutrient intake. But for people who already consume sufficient calories and are still deficient, fortification could provide a solution. The only problem here is it is not a targeted approach and some people who do not need the extra nutrients may still receive them. This leaves supplementation as a targeted approach to give extra nutrients to those who need them, without adding calories to the diet, Bailey said.

A major hurdle for the last two options is that many Americans today increasingly want their nutrition from whole, unprocessed foods, but Bailey suggests tough times call for tough measures. She acknowledges the desire for less processed foods, but says that without fortification, the risk of nutrient shortfalls would be higher.

But as with most things related to diet, moderation is key, and Bailey says drastically ramping up vitamin and mineral doses through fortification and potent supplements is not the answer either.

Rather, she said, the most appropriate option for manufacturers of foods and supplements is “to provide a mid-range level of fortification or doses in supplements.”

She explained, “We often see well above 100% of the daily value for certain foods as well as supplements, and really what we need is a more balanced approach.”

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