Vitamin fortification with

While the human body can remove an excess of any water-soluble vitamin, excesses of fat-soluble vitamins are more serious. Early arctic explorers discovered that the Inuit regarded seal liver and polar bear liver as taboo and must not be eaten. Those explorers who ignored this advice risked retinol poisoning as the livers of both these species are rich in retinol (vitamin A) that can not be excreted. The effects of retinol poisoning are extremely unpleasant. It is for this reason that fortification with fat-soluble vitamins is not likely to be undertaken. 

The mandatory fortification of margarine with Vitamin A is accomplished by the addition of p-carotene (pro-Vitamin A) and/or Vitamin A esters. The carotene level is adjusted for the desired color and the colorless esters (acetate, palmitate, etc.) are used to standardize the vitamin content. Addition of Vitamin D is optional. Fortification with Vitamin E is not permitted by the U.S. margarine standard, but recently some spreads fortified with Vitamin E have appeared in the marketplace in the United States, and fortification of both margarines and spreads has recently been done in Europe. The naturally occurring Vitamin E content of vegetable oil margarines available in the United States has been reported (227). 

Food fortification and designer foods specially formulated to prevent chronic diseases are enthusiastically advocated by the vitamin industry and its proponents (16). Unrestrained vitamin fortification added to unrestrained supplementation with these substances has now in some countries led to the potential for rather high cumulative amounts of intake in some populations. There is growing concern about the safety of chronically high doses of some of these, where the therapeutic margin between deficiency and toxicity may not be all that wide (15,17-19). 

In the following decades, consumer attitudes changed dramatically food and its quality evolved into a symbol of personality, expressed by the slogan you are what you eat . Health, fitness and diet became the precursors of all current trends up to the turn of the century. Today, especially wellness, well-being and a well-balanced lifestyle have to be added. The fortification with vitamins and minerals results in products that implicate pharmacological benefits, a trend which is increasingly called for by consumers. 

Lachance, P.A. 2000. Food fortification with vitamin and mineral nutraceuticals In Essentials of Functional Foods (M.K. Schmidl and T.P. Labuza, eds), pp. 293-302. Aspen Publishers, Inc., Gaithersburg, MD. 

However large RCTs, such as VISP (Toole et al. 2004) or VITATOPS (Anonymous 2010) have failed to document any significant effects of B vitamins on stroke prevention. Post hoc analyses, such as that of HOPE-2 (Saposnik et al. 2009) have suggested that folate, Bg and B12 could reduce stroke risk in patients with known CVD, mainly if patients were younger than 70 years, recruited from regions without folic acid food fortification, with higher baseline cholesterol and Hey levels, and not under antiplatelet or lipid-lowering... 

The most stable form of the vitamin is pyridoxal, and this form is used for vitamin fortification of food. Vitamin 85 loss is 45% in cooking of meat and 20-30% in cooking of vegetables. During milk sterilization, a reaction with cysteine transforms the vitamin into an inactive thiazolidine derivative (Formula 6.12). This reaction may account for vitamin losses also in other heat-treated foods. 

Tumours The association between intakes of folate, vitamin Bs and vitamin B12 and the risk of colorectal cancer in women has been examined. Food fortification with folic acid for 3-9 years was associated with an increased risk... 

Common cassava meals consisting of porridgelike mixtures of cereal grains, legumes, and other ingredients may be improved nutritionally by fortification with soy flour, skim milk powder, sugar, minerals, and vitamins. 

Fortification with vitamin D. 400 lU of vitamin D per quart (950 ml) are added to most milk and lowfat milk. This has been common practice for many years. It has contributed significantly to a reduction in the incidence of rickets in infants. Milk provides the necessary calcium and phosphorus, but vitamin D must also be present for normal calcification of bones and teeth. 

Meal Replacements. These products, which are often in the form of beverage powders or sweetened bars, are designed to be consumed with milk, water, or other beverage In lieu of the various mixtures of foods which usually constitute a meal. Federal regulations require that a typical serving of an item designated as a "meal replacement" provide at least 25% of the Recommended Daily Allowance (RDA) for certain specific nutrients. The macronutrients in these products are provided by various combinations of sugar, nonfat dry milk, soybean derivatives, and peanut butter and/or flour, whereas the required levels of micronutrients are usually met by fortification with selected minerals and vitamins. However, these products usually contain little or no fiber. 

Activity in the functional bakery and cereals products market has been very fragmented to date, and has tended to concentrate on two areas fortification with vitamins and minerals, and the benefits of high-fibre and oat-containing products. 

Milk is not a rich source of dietary folate compared to other foods however, as is the case for riboflavin, folate concentrations can be significantly increased in many dairy products due to microbial fermentation. Among dairy products, fermented milks are considered a good potential matrix for folate fortification because folate-binding proteins present in milk improve folate stability and enhance the bioavailability of both 5-methyltetrahydrofolate (the most predominant natural form of the vitamin) and folic acid (Jones and Nixon 2002 Aryana 2003 Verwei et al. 2003). However, due to the potential risks of fortification with folic acid, the elaboration of fermented milks containing elevated levels of natural folates would be a better suited alternative. 

Estimates of world demand iu 1979 were as high as 1300 x 10 lU of vitamin D. This was divided iuto thirds for Europe, the United States, and the rest of the world, respectively. Of this demand, 90% was estimated for animal-feed fortification and 10% for food and pharmaceutical uses. It is estimated that the demand will be 1500—1600 x 10 IU iu 1997 for animal usage and 100 x 10 IU for human use. The United States will require approximately 500 TU (1 trillion units = 25 kg i j -vitamin D or 17 t of resiu) for animal use and 30 TU (approximately 1 t of crystalline (7j -vitamin D ) for human use. This represents approximately 50 t of vitamin D resiu/yr for animal use worldwide and about 2.5 t of crystalline vitamin D for human use. A substantial proportion of the vitamin D is imported, and with all uses iucluded, it is estimated that 80—90% of the sales are of vitamin D. ... 

Iron-deficiency anaemia results from a discrepancy between iron availability and the amount required for production of red blood cells. The causes of acquired iron deficiency in so-called underdeveloped and developed countries must be differentiated. In underdeveloped countries, the main causes of iron deficiency are (a) the poor availability of iron in the diet due to low haem and high fibre and phytate content (D Souza et ah, 1987), and (b) chronic blood loss due to hookworm, schistosomiasis and malaria (Stoltzfus et ah, 1997 Olsen et ah, 1998 Dreyfuss et ah, 2000). Inflammation and vitamin A deficiency often interfere with the above causes of iron deficiency, causing a mixed type of anaemia. In underdeveloped countries diet improvement, iron fortification of natural foods and eradication of parasites will have a much higher impact than will refinement of diagnostic procedures and therapy of iron-deficiency anaemia. 

The infrared technique has been described in numerous publications and recent reviews were published by Davies and Giangiacomo (2000), Ismail et al. (1997) and Wetzel (1998). Very few applications have been described for analysis of additives in food products. One interesting application is for controlling vitamin concentrations in vitamin premixes used for fortification of food products by attenuated total reflectance (ATR) accessory with Fourier transform infrared (FTIR) (Wojciechowski et al., 1998). Four vitamins were analysed - Bi (thiamin), B2 (riboflavin), B6 (vitamin B6 compounds) and Niacin (nicotinic acid) - in about 10 minutes. The partial least squares technique was used for calibration of the equipment. The precision of measurements was in the range 4-8%, similar to those obtained for the four vitamins by the reference HPLC method. 

The fortification of these milk products with vitamin A is endorsed by the American Medical Association, with the concurrence of the Food and Nutrition Board, National Academy of Sciences, National Research Council and the Expert Panel on Food Safety and Nutrition of the Institute of Food Technologists (AMA 1982). The fortification of dried skim milk with vitamin A is viewed by the World Health Organization and the Food and Agricultural Organization (WHO 1977) as an important measure to combat vitamin A deficiency in developing countries, where 20,000 to 100,000 children yearly develop blindness from a lack of vitamin A in their diets (DeLuca et al. 1979). 

C Bower, NJ Wald. Vitamin B12 deficiency and the fortification of food with folic acid. Eur J Clin Nutr 49 787-793, 1995. 

Dietary supplementation with B vitamins is also highly effective in lowering homocysteine in most individuals with mild or moderate hyperhomocysteinemia. A meta-analysis of 12 randomized trials performed prior to folic acid fortification concluded that treatment with folic acid (0.5 to 5 mg daily) decreased homocysteine levels by 25%, and that the addition of... 

For prevention of disease in the elderly, the pregnant, or other susceptible groups, national fortification of food with vitamin B12 appears sensible and inexpensive but at present is not used and, in the absence of population screening s unlikely to be mandated by governmental edict. In general terms, the hematological manifestations of vitamin B12 deficiency are rapidly and fully correctable, although deficiencies of other micronutrients such as iron, folic acid, pyridoxine, copper, or vitamin C may be unmasked in the process and may limit the bone marrow s response until they are also corrected. 

Manufacturers also commonly convert the phenol form of the vitamins (with a free hydroxyl group) to esters, using acetic or succinic acid. The fortification of foods and feeds with oc-tocopherol esters is common because they are more stable and provide vitamin E activity when consumed. 

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