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attract greater moral scrutiny than those who are

purely dishonest, because their actions may have

more far-reaching effects. The modern food industry

has created much that is good, and Western con-

sumers today routinely have access to food of a var-

iety, quantity, quality, and safety, unparalleled at any

time in the past. By its very nature, the food industry

is an agent of social change. It takes and creates

opportunities to influence people, and by its conduct,

it risks, and may intend, catalyzing social change:

consequently, it exists within society as a kind of

moral agent. As part of society, the food industry

works to maintain respectability within society, but

those businesses that constitute the industry may, at

times, be tempted by forms of conduct that challenge

moral acceptability. Because consumers are becoming

increasingly dependent on the industry for their food,

and because the industry exercises increasing levels of

influence over society, the justification exists to scru-

tinize the moral values by which the industry operates

and the ethical nature of its conduct.

0004 The expression of moral and ethical concern over

matters relating to food is not new. Though the term

‘food ethics’ may have been formally established rela-

tively recently, Zwart suggested that food ethics has a

long history. He argues that, while modern food

ethics is concerned with food production, historically,

it was centered on consumption. Certainly, this res-

onates with ancient religious moral conventions that

prohibit the consumption of certain types of food

materials as well as the practices of vegetarians and

vegans, whose food choices are often defined by their

particular moral values. Today, food ethics is a

branch of moral philosophy that encompasses the

relationship of people, and society, with food and

the food supply system. In wealthy, Western societies,

food ethics is concerned mainly with the conduct of

the food businesses that make up the food supply

system and the methods by which food is produced

for, and marketed to, consumers. With the develop-

ment of the consumer society, people have been trans-

formed into consumers, whose function is to

consume, in accordance with the policies of govern-

ments and the strategic plans of businesses. The

degree to which people in Western societies have

come to rely on food businesses for their food – and

survival – has caused, and legitimizes, the develop-

ment of food ethics as a field of intellectual

inquiry. Modern food ethics is a response to the

industrialization and commercialization of the food-

supply system. Factors such as the increasing utiliza-

tion of science and technology in food manufacturing

and supply, the methods used in food marketing and

advertising, and the evolving dynamics a global food

marketplace create and energize the food ethics

debate. But food ethics does not respond solely to

food issues in the developed, Western world. The

problems of global food security, and food shortage

and malnutrition in developing countries, are primary

issues of food ethics, as recognized by the Food and

Agriculture Organization (FAO) of the United

Nations. The FAO also recognizes the use of biotech-

nology and genetically modified organisms in the

food-supply system as issues of food and agricultural

ethics. Food ethics has emerged to guide and inform

those who work within the food-supply system, and

those with a professional interest in the activities and

conduct of the system and the organizations that

constitute it.

Morality and Ethics

0005As human beings, we generally recognize certain

moral values and understand that moral principles

derived from moral values can act to guide and sta-

bilize the society within which we live, and inform

both social and cultural development. The word

‘moral’ originates from the Latin, moralis, while

‘ethics’ is derived from the Greek, ethos. Both words

equate to ‘custom’ and are sometimes used inter-

changeably, though different meanings can be

assigned in relation to the way in which we think

about morality and ethical behavior. Often, we con-

sider morality in terms of values, or standards of

conduct, that prescribe concepts of what is right and

wrong. In contrast, we judge what is ethical in terms

of the analysis and assessment of morally acceptable

behavior. For instance, an evaluation of the ethical

nature of a food business’ conduct would lead to a

review of the business’ moral values as the justifica-

tion for the conduct. Similarly, though rich nations

may recognize their moral duty to help feed poor

nations, translation into practice of the moral values

that give rise to the notion of duty relies on ethical

conduct that ensures the poor are fed. The ethical

assessment of conduct enables us to see that moral

values and principles exist and have been upheld.

Ethics is concerned with the application of moral

values and principles and, specifically, with concepts

of right and wrong, good and bad, duty, obligation,

virtue, freedom, and choice.

0006People interact with each other at a personal level,

and their moral values influence the ethical nature

of their conduct. Of particular interest to moral

philosophers, since the time of Socrates (c. 470–399

bc), has been the question ‘How ought we to live?’

The question embodies the concern that, for each of

us, our lives should be lived as good lives and that

the influence we have on other people’s lives will

then only be good. At its most basic level, ethics is

2608 FOOD ETHICS

concerned with our conduct as individuals in relation

to other people and, increasingly, in relation to other

species and the environment generally. However, the

infrastructure of modern society is complex, and

though, as private individuals, we may exert some

influence on society, the greatest source of influence

is often the organizations that operate within society.

Yet, organizations are made up by people, but when

the conduct of an organization is assessed in terms of

its ethical nature, paradoxically, the moral values

from which the conduct is derived are judged to

belong to the organization, and not the individuals

who make up the organization. Any examination of

the moral values and ethical conduct of the food

industry must concern the businesses that constitute

the industry and the executives who lead the busi-

nesses. Conduct that is perceived to reflect the moral

values of a food business is most likely to be based on

the moral values of the executives in charge of the

business and, specifically, the chief executive officer.

0007 Ethics is delineated as metaethics, descriptive ethics,

and applied ethics. Metaethics is a form of philosoph-

ical inquiry concerned with concepts, beliefs, and

meaning. Metaethics seeks to explain what is meant

by concepts such as good, bad, right, and wrong in

relation to the character or conduct of the moral

agent. It is a process of rational inquiry separate

from the ‘real-world’ domain of applied ethics, but

has significant bearing on the practice of applied

ethics. Descriptive ethics, as the name suggests, is

concerned with the study of the belief systems, moral

values, and ethical behavior of social groups and or-

ganizations. It is observational in method and some-

what disconnected from its subject matter, and so it

compares with sociology and anthropology. Applied

ethics contrasts with both metaethics and descriptive

ethics in that it is concerned with the translation of

moral values into ethical practices and the application

of ethics to practical problem-solving and decision-

making. Food ethics falls within the realm of applied

ethics, because it is concerned with the ‘real-world’

ethics in relation to the operation of the food supply

system and the conduct of the food industry.

0008 Many ethical issues exist in relation to the food-

supply system and the activities of the food industry.

Food businesses must deal with ethical issues in the

way in which they operate, e.g., in the sourcing of raw

materials from developing countries, in the methods

used to gain and hold market share, and in the way in

which products are promoted to consumers. Con-

sumers face ethical issues in the way in which the

food industry relates to them and, for instance, main-

tains respect for them. Problem-solving in applied

ethics relies on judgements made in relation to facts,

and the quality of facts is critical to decision-making

that is ethically defensible. Ethical judgements cannot

be made in isolation from ethical theory, and an

appeal to accepted concepts in moral theory and

systems of ethical thinking is usual. Five ethical the-

ories are commonly accepted as approaches to ethical

problem-solving and decision-making: the common-

good theory; deontological theory; utilitarian theory;

the theory of justice; and virtue theory.

The Common-good

0009Though we exist as individuals with our own desires

and goals, we generally recognize that our own good

is linked to the good of the community of which we

are a part. If we value the community and what it

stands for, we must allow that while we may expect

others to respect our interests, and in return we may

respect theirs, the interests of individuals must not be

placed above those of the community as a whole. As

individuals, we may strive to achieve our own goals,

but collectively, we must also recognize the import-

ance of achieving goals that are shared by, and bene-

fit, the community as a whole. In complex societies,

individuals exert only a small influence over the

common good compared with governments, institu-

tions, and the organizations that bear upon the social

and economic structures of society. Society must place

reliance on those in government, for instance, to rec-

ognize the common-good as it relates to all people,

and to maintain conditions and achieve objectives

that are similarly to everyone’s advantage. Social

and economic policies must be aimed at benefiting

all of society equally. Social institutions such as edu-

cation and public health provision, the legal system,

and the police and fire services are all common-goods.

Food businesses contribute to the common-good

through the provision of food and employment.

Sometimes, they become involved with society in

ways that appear altruistic and intended to further

the common-good, but, we must question the degree

to which they are able to place the interests of society

above their own interests. A supermarket chain pro-

viding computers to schools might appear intent on

benefitting the common-good, but such action may,

in reality, be self-interested and designed expressly to

gain access to children to influence the household

food purchasers of the future.

Deontological Theory

0010The term ‘deontological’ is derived from the Greek,

deontos, meaning duty. Deontological theory is con-

cerned with notions of duty, rights, and justice. It

proposes that we have a duty to tell the truth, not to

harm others, to keep promises and to respect the

privacy of others. Consequently, it recognizes the

right of others to: know the truth and be informed

FOOD ETHICS 2609

of issues that affect them; be protected from any

harms that may arise from our actions; receive what

has been promised to them in agreements and con-

tracts entered into freely; and be allowed privacy in

their personal lives provided their actions do not

violate the rights of others. The German philosopher,

Immanuel Kant (1724–1804), has had a profound

influence on the development of this class of ethical

theory. Significantly, his concept of the Categorical

Imperative, is proposed as a guide to right action. He

states that in matters of morality, we should act only

in ways that we would want to be universalized, i.e.,

ways that would be acceptable as the norm, and that

we should treat other people as ends-in-themselves

and not the means to our ends. In the marketing of

‘reduced fat’ foods, we often see truth sidelined and

weight-conscious consumers made the means to the

end of increased sales. Foods marketed with the sug-

gestion that they are healthy, because they have re-

duced fat levels, often contain substantial amounts of

energy from the carbohydrate content: a fact not

honestly revealed to consumers.

Utilitarianism

0011 As a consequentialist ethical theory, utilitarianism is

concerned with the outcomes of actions. Consequen-

tialism takes the position that the value of an action is

dependent on the ‘good’ of the consequences, but the

definition of ‘good’ is dependent on the moral agent

and may not be what is commonly agreed to be good.

To resolve this difficulty, Jeremy Bentham (1748–

1832) defined the ‘good’ as whatever yields the

greatest pleasure and the least pain, and proposed a

calculus of utility – hence the name utilitarianism – by

which to measure the balance between pleasure and

pain. The practical limitations of Bentham’s utilitar-

ian calculus led John Stuart Mill (1806–1873) to

define the ‘good’ as happiness. In utilitarian theory,

an action is morally right if it results in ‘‘the greatest

happiness for the greatest number.’’ The conduct of

the food industry as a whole appears, on the surface,

to accord with notions of utilitarianism. Through the

work of the industry, Western consumers are gener-

ally able to obtain nutrition of a very high standard,

and it would seem that the industry is well disposed to

provide for the greatest happiness of the greatest

number in matters of food.

Justice

0012 The desires, ambitions, and goals of human beings as

individuals can conflict with the good of others and

the common-good. Egoism is a form of consequen-

tialism that considers people to be self-interested

moral agents who will judge an act to be right if it

furthers their own interests, even to the exclusion of

others. If it is in their interests, egoists will act with

favoritism and discrimination, both of which, by gen-

eral moral agreement, are regarded to be unfair and

unjust. Ideas of justice are central to moral philoso-

phy. Aristotle (384–322 bc) proposed a system of

justice and considered that people should be treated

equally, unless there is some morally defensible reason

to treat them differently. John Rawls has recognized

that the stability of a society, or social grouping,

depends on the members of the society, or group,

feeling they are treated justly. In his book, A Theory

of Justice, he proposes a contractarian theory,

whereby social justice can be delivered only by ra-

tional agents who have dispensed with particular alle-

giances and interests, but who retain human needs and

dependencies. To enable rational agents to make deci-

sions for the benefit of society without the conflict of

self-interest, he creates the metaphor of the ‘veil of

ignorance,’ which shields agents from knowing their

role in society. Rawls’ ideas on justice, thought of as

justice-as-fairness, recognize the difficulty that those

in authority have in stepping outside the circle of their

own interests to act for the good of others. Accepting

that society generates benefits and burdens, he puts

forward the ‘difference principle’ as a moral require-

ment to ensure that the situation of the least well-off is

made as good as it can be, thereby working towards

justice-as-fairness. Ensuring that the poor have access

to an adequate diet is an issue of justice.

Virtue

0013A person who is virtuous in the way he lives will be an

ethical person. Aristotle’s theory of ethics is virtue

theory. He considered there are two kinds of virtue:

moral virtues or qualities of one’s character, and in-

tellectual virtues or qualities of one’s mind. Of the

moral virtues, he proposed 12, sitting in each case

midway between representatives of the vices of excess

and deficiency. So, the virtue of courage sits between

rashness and cowardice, and the virtue of patience

between irascibility and lack of spirit. Of the intel-

lectual virtues, he identified five primary virtues

(technical skill, scientific knowledge, prudence, intu-

ition, and wisdom) and four secondary virtues (re-

sourcefulness, understanding, judgement, and

cleverness). Today, people who exhibit the virtues of

courage, honesty, integrity, fairness, compassion,

generosity, fidelity, and self-control are most gener-

ally admired, for they are recognized as possessing

qualities to which we should all aspire. Though we

might believe that virtue is important to society, some

food businesses celebrate vices to further their own

interests, e.g., wickedness and sin made synonymous

with pleasure in chocolate, snack-food, and alcoholic

beverage advertisements.

2610 FOOD ETHICS

Ethical Decision-making

0014 The resolution of ethical problems will benefit from

reference to ethical theories, as well as the ethical

principles of respect for autonomy, nonmaleficence,

beneficence, and justice. Ethically defensible deci-

sion-making must be based on:

0015 identifying the benefits and harms likely to result

from alternative courses of action;

0016 selecting the course of action likely to yield the best

consequences and least harm for those affected;

0017 maintaining respect for the moral rights of those

affected;

0018 treating everyone equally and justly;

0019 valuing moral virtues and promoting the common

good.

Issues in Food Ethics

0020 A wide variety of food ethics issues exist. Those of

growing concern to consumers in the UK have been

identified by the Co-operative Wholesale Society, as

listed in Table 1. A detailed discussion of issues would

be beyond the scope of this article, and the following

examples have been selected for illustrative purposes.

Feeding the World’s Poor

0021 The United Nations’ Universal Declaration of

Human Rights states that everyone has the right to a

standard of living adequate for the health and well-

being of themselves and their family, including food,

clothing, housing, etc. The imbalance in the quality

and supply of food between the rich and the poor

people of the world marks one of the central injustices

of our time and a critical issue of food ethics. The lack

of food necessary to the health and well-being of the

poor is significantly a matter of economics as well as

politics, but the degree to which remedies to the

problem may be sought depends on the sense of

moral duty felt by the rich for the poor. In Western

societies, supermarkets exhibit a remarkable array of

food products, many of which are unnecessary to

either the health or happiness of consumers. With

the march of globalization, Western food businesses

are increasingly sourcing cheap food products in de-

veloping countries to maintain the array of products

available in supermarkets and to enhance profitabil-

ity. The extent to which farmers and growers in de-

veloping countries are able to benefit from this global

trade is questionable. The growth in ‘fair-trade’ or-

ganizations in response to the development of the

global food chain would indicate that justice is not

distributed equally throughout the chain. Questions

therefore arise about the food industry’s recognition

of its moral duty to suppliers in developing countries

and the ethical nature of the industry’s relationships

with them.

Marketing Food to Children

0022Given the inequalities of the world’s food supply, it is

ironic that the public health institutions of many

Western societies report increasing levels of disease

associated with the overconsumption of food. Fast-

foods, convenience foods, snack-foods, and confec-

tionery, as well as carbonated beverages, are placed at

the center of concerns over the quality of diets in

Western societies. Examination of advertising associ-

ated with these product groups shows how much

manufacturers and retailers depend on children and

young people for their markets. The value of children

to some kinds of food businesses is seen in the way in

which fast-food organizations operate synergistically

with movie companies, such as linking cartoon char-

acters with food products, when conditioning young

minds has been set as a marketing priority. Food

habits formed during childhood are extremely resist-

ant to modification and change. The ‘branding’ of

children’s minds with images of certain kinds of food

products to sustain the desire for products throughout

life may seem an effective strategy for some food

businesses. The practice raises many questions about

the moral duty of society to protect children, and

about the ethical conduct of the industry in making

children the means to its end of profitability.

Consumer Dependency

0023With the development of the food industry during the

last quarter of a century, food and cooking have been

tbl0001 Table 1 Cooperative wholesale society’s ‘food crimes’

1. Blackmail – ‘‘the insidious targeting of the public by global big

business putting huge marketing muscle behind products that

fail to fit with healthy eating advice’’

2. Contamination – ‘‘the unnecessary use of chemicals on land

and in livestock – interference with nature’s way’’

3. Grievous bodily harm – ‘‘the disregard of animal rights to keep

costs down or, even worse, to pamper our taste buds with so

called ‘luxuries’ ’’

4. Vandalism – ‘‘the destruction of the planet by the intensification

of food production systems’’

5. Cannibalism – ‘‘the practice of permitting animals to be fed with

the remains of their own species, or herbivores with animal

by-products, or giving animals feed made from the blood of

other animals’’

6. Pillage – ‘‘the careless exploitation of countries, cultures and

creeds by multinational concerns milking the so-called global

economy’’

7. Fraud – ‘‘the deliberate assault on the taste and appearance of

our food’’

Source: CWS (2000) The Food Crimes Report. Manchester, UK: The Co-

operative Wholesale Society.

FOOD ETHICS 2611

taken out of the kitchen and into factories. Many

people today do not learn the skills associated with

cooking in the home that were commonly held in the

past. Processed and prepared foods are attractive to

consumers. Such foods allow consumers to buy time

for activities other than cooking. Questions arise

about the ability of ‘food-ignorant’ consumers to

manage a balanced diet and any moral responsibility

the food industry has for the health and well-being of

consumers encouraged into dependence on the indus-

try for their food.

Limits to Added-value Products

002 4 Of the problems faced by the food industry, perhaps

the greatest is the physical limit on the amount of

food a consumer can eat in a day and the conse-

quences this has for the industry’s goal of continuous

economic growth. The innovation of ‘added-value’

food products that command higher prices and the

creation of a now vast range of such products has

generated new areas of profitability. The industry

maintains that it only responds to consumer demands.

Whether consumers actually demand so many new

products that making food choices becomes problem-

atic or whether the industry manipulates consumers

using sophisticated marketing techniques to create

markets for new products is debatable. In this, there

is a possible conflict with the idea that the industry is

utilitarian in nature; perhaps, alternatively, it is egois-

tic, according to the moral values of food-business

leaders. This is something of which food ethics may

bring a greater understanding.

Conclusion

002 5 Numerous questions can be asked about the moral

values of the food industry and the ethical nature of

its conduct. Food ethics provides a reasoned and

structured approach to answering questions and to

guiding the conduct of the industry such that it main-

tains respect for people and a common-good relation-

ship with society. In Western societies, people exist in

a state of mutual interdependence with the food in-

dustry. People as consumers rely on the industry for

their food, and the industry needs people to consume

its products to remain in business. The food industry

regards people not as individuals but as consumer

groups, categorized according to various socio-

economic criteria. For society to flourish, people as

the individuals who constitute society must also flour-

ish. The food industry has a critical part to play in

this, as the products of its endeavors are essential to

the life of people. Critically, they are consumed and

become part of people, affecting both their health and

well-being. The food industry has a moral duty to act

at all times for the good of people as individuals, not

merely as units of consumption. In this, food ethics is

of instrumental value to the industry’s decision-

making and strategic development, helping to ensure

that the basis of its existence is morally sound and its

conduct is ethically defensible, for the good of people,

society, and the industry itself.

Glossary

Autonomy a person’s capacity for self-determination.

Beneficence acting to benefit others.

Consumers people as purchasers and/or users of the

products and services provided by industry and com-

merce.

Food supply system the organization of business en-

tities and their activities operating to bring food and

food products to the food marketplace.

Non-maleficence acting so as to cause no harm.

Utility The basic unit of desirability as judged by the

agent who desires it.

Seealso: Biotechnology in Food Production; Food and

Agriculture Organization of the United Nations; Food

Safety; Legislation:InternationalStandards

Further Reading

Accum FC (1820) A Treatise on the Adulteration of Food

and Culinary Poisons. Exhibiting the Fraudulent Sophis-

tications of Bread, Beer, Wine, Spiritous Liquors, Tea,

Coffee, Cream, Confectionary, Vinegar, Mustard,

Pepper, Cheese, Olive Oil, Pickles and other Articles

Employed in Domestic Economy, and Methods of

Detecting Them. 2nd edn. London: Longman, Hurst,

Rees, Orme, and Brown.

BeauchampTLandChildressJF(1994)PrinciplesofBiomed-

icalEthics,4th edn. New York: Oxford University Press.

Bentham J (1988) The Principles of Morals and Legislation.

New York: Prometheus Books.

CWS (2000) The Food Crimes Report. Manchester, UK:

Co-operative Wholesale Society.

FAO (2001) Report of the Panel of Eminent Experts on

Ethics in Food and Agriculture. Rome: Food and Agri-

culture Organization of the United Nations.

Hassall AH (1855) Food and its Adulterations. London:

Longman, Brown, Green and Longmans.

Mepham B (ed.) (1996) Food Ethics. London: Routledge.

Mill JS (1960) Utilitarianism – Liberty – Representative

Government. London: J.M. Dent.

Rawls J (1973) A Theory of Justice. Oxford: Oxford Uni-

versity Press.

Sinclair U (1986) The Jungle. New York: Penguin Books.

UN (1948) Universal declaration of human rights. General

Assembly Resolution 217 A (III) of 10 December 1948

http://www.amnesty.org/aboutai/ughr.htm

Zwart H (2000) A short history of food ethics. Journal of

Agricultural and Environmental Ethics 12: 13–126.

2612 FOOD ETHICS

FOOD FORTIFICATION

M G Venkatesh Mannar, The Micronutrient Initiative,

Ottawa, Canada

Synopsis

0001 Vitamins and minerals (commonly termed ‘micro-

nutrients’) are essential for efficient energy metabol-

ism and other functions of the human body. Food

fortification is increasingly recognized as an effective

means of delivering micronutrients through com-

monly consumed foods. Fortification of foods can

provide meaningful amounts of the nutrient at

normal consumption of the food vehicle. The level

of fortification should take into account variations in

food consumption to ensure safety for those at the

higher end of the scale and impact for those at

the lower end. Fortification needs to be supported

by adequate food regulations and labeling, quality

assurance, and monitoring to ensure compliance and

desired impact.

Prevalence and Impact of Micronutrient

Deficiencies

0002 Many vitamins and minerals cannot be synthesized

by the human body. They must be provided by the

diet. They are necessary for the regulatory systems in

the body for efficient energy metabolism and for

other functions such as cognition, immune system,

and reproduction. The amounts needed are small –

micrograms or milligrams a day – so they are called

‘micro’ nutrients (Table 1). When intake of these

nutrients is inadequate, individuals and communities

suffer serious consequences, including learning dis-

abilities, impaired work capacity, illness, and death.

During rapid growth, micronutrient intake must

increase or else growth failure or deficiency diseases

develop. It is during these periods that deficiency

symptoms are most prevalent. For this reason, pre-

school-aged children, adolescents, and reproductive

age women are high-priority groups.

0003 Nearly one in three people living especially in

the developing world are affected by one or more

micronutrient deficiency. Iron and iodine deficiencies

are the most common and widespread nutritional

problems. About half the reproductive age women

in most of the developing countries suffer from

iron-deficiency anemia (IDA). Other high-risk groups

include preschool and school-age children and

adolescents. Iodine-deficiency disorders affect 20–

60% of people in different areas. Vitamin A defi-

ciency (VAD) has been widely recognized, though at

a lower clinical prevalence (around 1% in preschool

children). However, VAD at a subclinical level (based

on serum retinol assays) is thought to be around 10–

25%. This is associated with increased mortality and

morbidity risk in children and pregnant women.

There are other deficiencies that are certainly wide-

spread but far less well recognized, e.g., rickets in

young children, associated with calcium and vitamin

D deficiency. Dietary intake surveys and limited bio-

chemical indicators show that zinc deficiency is likely

as widespread as that of IDA. Selenium and other

micronutrients such as folate and vitamin E may

have major role in reducing risks of chronic disease

(e.g., cancers, heart diseases).

0004The major cause of micronutrient deficiencies is a

lack of adequate intake of bioavailable minerals and

vitamins from the diet. This is exacerbated by the fact

that commonly consumed foods and beverages (such

as rice, wheat, corn, legumes, tea, and coffee) are high

in inhibitors and low in enhancers of micronutrient

absorption.

Role of Food Fortification

0005Micronutrient deficiencies can be prevented and even

eliminated if populations consume adequate quan-

tities of the required micronutrients on a continuous

and ongoing basis. In addressing micronutrient

malnutrition in a country, a combination of interven-

tions involving promotion of a well-balanced diet,

improving food availability and micronutrient bio-

availability, and increasing food consumption, food

fortification, and pharmaceutical supplementation

need to be emphasized and implemented in a comple-

mentary manner. Among these options, food fortifi-

cation could play an important role to meet a

demonstrable need for a nutrient in the population

apparent from dietary, biochemical, or clinical

evidence.

0006Fortification is therefore one part of a range of

measures that influence the quality of food that in-

clude improved agricultural practices, improved food

processing, and storage and consumer education to

adopt good food-preparation practices. The role of

foods and specific nutrients and nonnutrients in pro-

viding beneficial nutritional and physiological effects

is also gaining attention. As consumer interest in the

link between diet and health increases, there are many

FOOD FORTIFICATION 2613

tbl0001 Table 1 Recommended dietary allowances (RDAs) for some essential micronutrients

Minerals Fat-solublevitamins Water-solublevitamins

Category Age or

condition

Calcium

(mg)

Phos-

phorus

(mg)

Mag-

nesium

(mg)

Iron

(mg)

Zinc

(mg)

Iodine

(mg)

Sel-

enium

(mg)

Vitamin

(mgRE)

Vitamin

D(mg)

Vitamin

(mg aTE)

Vitamin

K(mg)

Thiamin

(mg)

Riboflavin

(mg)

Niacin

(mgNE)

Vitamin

(mg)

Folate

(mg)

Vitamin

C(mg)

Vitamin

(mg)

Infants 0–6 months 400 300 40 6 5 40 10 375 7.5 3 5 0.3 0.4 5 0.3 25 30 0.3

7–12 months 600 500 60 10 5 50 15 375 10 4 10 0.4 0.5 6 0.6 35 35 0.5

Children 1–3 years 800 800 80 10 10 70 20 400 10 6 15 0.7 0.8 9 1.0 50 40 0.7

4–7 years 800 800 120 10 10 90 20 500 10 7 20 0.9 1.1 12 1.1 75 45 1.0

8–11 years 800 800 170 10 10 120 30 700 10 7 30 1.0 1.2 13 1.4 100 45 1.4

Males 12–14 years 1200 1200 270 12 15 150 40 1000 10 10 45 1.3 1.5 17 1.7 150 50 2.0

15–18 years 1200 1200 400 12 15 150 50 1000 10 10 65 1.5 1.8 20 2.0 200 60 2.0

19–24 years 1200 1200 350 10 15 150 70 1000 10 10 70 1.5 1.7 19 2.0 200 60 2.0

25–50 years 800 800 350 10 15 150 70 1000 5 10 80 1.5 1.7 19 2.0 200 60 2.0

51þ years 800 800 350 10 15 150 70 1000 5 10 80 1.2 1.4 15 2.0 200 60 2.0

Females 12–14 years 1200 1200 280 15 12 150 45 800 10 8 45 1.1 1.3 15 1.4 150 50 2.0

15–18 years 1200 1200 300 15 12 150 50 800 10 8 55 1.1 1.3 15 1.5 180 60 2.0

19–24 years 1200 1200 280 15 12 150 55 800 10 8 60 1.1 1.3 15 1.6 180 60 2.0

25–50 years 800 800 280 15 12 150 55 800 5 8 65 1.1 1.3 15 1.6 180 60 2.0

51þ years 800 800 280 10 12 150 55 800 5 8 65 1.0 1.2 13 1.6 180 60 2.0

Pregnancy 1200 1200 320 30 15 175 65 800 10 10 65 1.5 1.6 17 2.2 400 70 2.2

Lactation 0–6 months 1200 1200 355 15 19 200 75 1300 10 12 65 1.6 1.8 20 2.1 280 95 2.6

7–12 months 1200 1200 340 15 16 200 75 1200 10 11 65 1.6 1.7 20 2.1 260 90 2.6

Retinol equivalents. 1 retinol equivalent ¼ 1 mg of retinol or 6 mgofb-carotene.

As cholecalciferol. 10 mg of cholecalciferol ¼ 400 IU of vitamin D.

1mg of D-a tocopherol ¼ 1 a-TE.

1 NE (niacin equivalent) ¼ 1 mg of niacin or 60 mg of dietary tryptophan.

Source: National Research Council (1989) Subcommittee on the Tenth Edition of the Recommended Dietary Allowances. Washington, DC: National Academy Press.

opportunities for developing foods that can have

positive effects on health and performance.

0007 Food fortification involves the identification of

commonly eaten foods that can act as vehicles for

one or more micronutrients and lend themselves to

centralized processing on an economical scale.

0008 The Codex Alimentarius provides definitions for

terminology relating to the addition of nutrients to

foods. Fortification or enrichment means the addition

of one or more essential nutrients to a food, whether

or not it is normally contained in the food for the

purpose of preventing or correcting a demonstrated

deficiency of one or more nutrients in the population

or specific population groups. Restoration refers to

compensation for unavoidable nutrient losses during

the course of good manufacturing practice in the

preparation and preservation of food or during

normal storage and handling procedures. In many

countries, there are requirements for the compulsory

addition of micronutrients such as iron, niacin, and

thiamine to bread and flour.

0009 Fortification, when imposed on existing food pat-

terns, does not necessitate changes in the customary

diet of the population and does not call for individual

compliance. Often, it can be dovetailed into existing

food production and distribution systems. For these

reasons, fortification can often be implemented and

yield results within 2–3 years and be sustained over a

long period of time. It can thus be the most cost-

effective means of overcoming micronutrient malnu-

trition.

Effectiveness of Fortification

0010 The concept of nutrient fortification of staple foods

was developed in the early part of this century as a

means of dealing with micronutrient and vitamin

deficiency diseases that were prevalent in Europe

and North America. Salt was iodized in Switzerland

in the early part of the century. Margarine fortified

with vitamin A was introduced in Denmark in 1918.

During the 1930s and 1940s, milk was fortified with

vitamin A, and flour was fortified with iron and B

vitamins in a number of European countries and in

North America. In developed countries, where there

is a high dependence on processed foods, and indus-

tries are streamlined and automated, food fortifica-

tion has played a major role in the health of the

populations at large over the last 40 years, and several

nutritional deficiencies have been eliminated. In

addition to the virtual elimination of VAD and iodine

deficiency disorders (IDD) and the substantial reduc-

tion of IDA, diseases as varied as xerophthalmia,

pellagra, beriberi, rickets, goiter, and ariboflavinosis

have essentially disappeared. Several studies have

demonstrated the effectiveness of food fortification

in eliminating micronutrient deficiencies. The current

low levels of iron deficiency in the USA are attribut-

able to fortified sources. Almost a quarter of iron

intake in the US diet comes from fortified sources,

much of that from flour products. In Canada, flour

fortification with B vitamins began in Newfoundland

in 1944. Within four years, deficiencies that were

earlier found in nearly 20% of the population had

dropped to negligible levels.

0011In the developing world, there has been a rapid

growth in fortifying a wide range of foods. The

most successful global fortification experience is the

fortification of salt with iodine. Fortification of other

staple foods such as flour, oils, sugar, condiments,

dairy products, and a range of processed foods with

other micronutrients and vitamins are also increasing.

In Latin America, flour fortification is reaching sig-

nificant numbers of people, and sugar fortification

has taken hold in Central America. In Asia, the over-

all reach of fortified foods and its impact in eliminat-

ing micronutrient malnutrition is still small, but

growing.

0012In the last decade, the contribution of salt forti-

fication towards the virtual elimination of IDD in

developing countries has been substantial. In most

nations where IDD was recognized as a public

health problem at the beginning of this decade, an

average of 60–70% of all salt for human and animal

use is now iodized. The stage is set for the global

elimination of iodine deficiency disorders globally

by 2005.

0013Food fortification has also played a major role in

substantially reducing vitamin A and iron deficien-

cies. A national sugar fortification program in Guate-

mala has virtually eliminated VAD as a public health

problem. Flour fortification in Chile and Venezuela

are substantially improving iron status across all

sectors of the population. Today, in Latin America,

Asia, and Africa, consumers of fortified products as

varied as margarine, milk, noodles, and cornstarch

are substantially protected from a range of micro-

nutrient deficiencies.

0014Food fortification has to be an integral component

of the overall strategy to eliminate micronutrient

malnutrition. It involves opening new communica-

tion channels among the public health community,

research institutions, government regulators, food

companies, and a variety of civic and consumer

organizations. The inputs from these groups could

result in a new alliance focused on accomplishing

national development through elimination of micro-

nutrient malnutrition. Food fortification should also

be the preferred option to reach preschoolers and

primary graders.

FOOD FORTIFICATION 2615

Considerations for Planning a Food

Fortification Intervention

0015 Food fortification involves the identification of com-

monly eaten foods in a country or region that can act

as vehicles for one or more micronutrients and lend

themselves to centralized processing on an econom-

ical scale. In developed countries, a range of cereals

and cereal products, dairy products, processed foods

and beverages are fortified. In most developing coun-

tries, staple foods and condiments are the obvious

choice for fortification, given their consistent con-

sumption by large sections of the population. In

such situations, the choice of vehicles at the present

time is limited to a handful of foods and condiments:

cereals, oils and fats, sugar, salt, and sauces.

0016 Fortification of foods is aimed to provide meaning-

ful levels of the nutrient at normal consumption of the

food vehicle. Variations in food consumption may

affect the safety of those at the higher end of the scale

and the level of impact for those at the lower end. They

should also consider prorated intakes by young chil-

dren to ensure efficacious and safe dosages. Food

fortification also requires careful attention to food

regulations and labeling, and a careful assessment of

the technical and analytical limitations for compli-

ance with label declarations. The Codex Alimentarius

has adopted a number of basic principles set out in

Table 2 for the addition of nutrients to foods.

0017 Infants and children under the age of 24 months

consume a different dietary pattern than do older

individuals. There are no major differences in con-

sumption among children aged 2 years and older.

Where there are few centrally processed complemen-

tary foods, and consumption of such foods is infre-

quent and rare, careful research is needed on the best

ways to address micronutrient problems of infants.

0018Key considerations for planning and implementing

food fortification programs in countries are discussed

below.

Selection of Food Vehicles

0019The selection of a suitable vehicle and a fortificant

that deliver the micronutrient in the right amounts

consistent to an entire population is extremely

rare. Salt iodization is one example of successful

large-scale fortification in the developing world –

the primary reason being the simple and low-cost

technology and the narrow variation in salt consump-

tion within a given region or population. There exist

other opportunities for single and multiple fortifica-

tion of several commonly eaten foods such as wheat

and wheat products, corn, rice, milk and milk

products, cooking oils, sugar, and condiments. As

processed foods gain popularity in the developing

world, with an increasing market outreach, they

offer new channels for micronutrient delivery. The

decision to use a particular food or beverage must

be based on scientific data. Well-designed market

research, which includes dietary surveys and habits

and practices, should be used as a tool in identifying

the commonly consumed foods and beverages.

0020Potential food vehicles could be visualized as a

three-tiered pyramid (Figure 1). Staple foods such as

sugar, cereals, grains, fats, and oils form the base;

basic foods such as breads and biscuits, packaged

cereals and flours, and dairy products are in the

middle; and value-added foods such as condiments,

snacks, candies, convenience and ready-to-eat foods

are at the top. Fortifying less expensive staple foods at

the base of the pyramid results in broader dissemin-

ation of micronutrients throughout the population.

Also, since basic and value-added foods are processed

tbl0002 Table 2 General principles for the addition of nutrients to foods

1. The essential nutrient should be present at a level that will not result in either an excessive or an insignificant intake of the added

essential nutrient considering amounts from other sources in the diet

2. The addition of an essential nutrient to a food should not result in an adverse effect on the metabolism of any other nutrient.

3. The essential nutrient should be sufficiently stable in the food under customary conditions of packaging, storage, distribution, and

use.

4. The essential nutrient should be biologically available from the food.

5. The essential nutrient should not impart undesirable characteristics to the food (e.g., color, taste, flavor, texture, cooking

properties) and should not unduly shorten the shelf-life.

6. Technology and processing facilities should be available to permit the addition of the essential nutrient in a satisfactory manner.

7. Addition of essential nutrients to foods should not be used to mislead or deceive the consumer as to the nutritional merit of the food.

8. The additional cost should be reasonable for the intended consumer.

9. Methods of measuring, controlling and/or enforcing the levels of added essential nutrients in foods should be available.

10. When provision is made in food standards, regulations, or guidelines for the addition of essential nutrients to foods, specific

provisions should include identifying the essential nutrients to be considered or to be required and the levels at which they should

be present in the food to achieve their intended purpose

Source: Codex Alimentarius Commission (1994) Codex Alimentarius. General Principles for the Addition of Essential Nutrients to Foods, vol. 4. CAC/GL 09-

1987. Rome: Food and Agriculture Organization.

2616 FOOD FORTIFICATION

from staple commodities, fortifying foods at the base

of the pyramid results in fortifying products through-

out the food chain.

0021 In many countries, a flexible approach using a

variety of vehicles each fortified to a specified propor-

tion of recommended dietary intake (RDI) may offer

an effective option. If consumption of a particular

vehicle is consistent in some groups but only sporadic

in others, fortifying several vehicles will likely provide

complementary coverage. When considering a multi-

faceted approach, each food vehicle offers specific

opportunities and constraints:

0022 Cereals Cereal grain products such as rice, corn,

and wheat flour constitute an important calorie and

protein source for many populations. They have

proven to be good vehicles in several developed and

developing countries, but their application may be

limited where cereals foods are often eaten where

they are grown and processed at the community level.

0023 Fat and oils Cooking fats and oils may offer an

option to deliver a portion of the recommended

dietary allowance (RDA), particularly the fat-soluble

vitamins such as vitamin A. They have an advantage

in that they are often centrally refined and packed.

0024 Dairy products Milk may offer an option where

centralized dairy processing exists.

0025 Condiments Sugar, spices, starches and sauces are

attractive carriers. Some are processed centrally and

consumed in regular quantities.

0026 Value-added products In developed countries such

as the USA, fortification of snack foods has been

recommended as an appropriate public health

measure, given the increasing percentage of dietary

energy that the population derives from snack foods.

In developing countries, the most vulnerable popula-

tions consume these higher-priced products only spor-

adically. However, consumer awareness, technical

breakthroughs, and marketing innovations often

emerge from the development of fortified value-

added products.

0027When no universally consumed vehicle is available

in a country, the fortification of a number of foods

offers several key strategic advantages. When a var-

iety of food sectors are engaged, no single industry

can claim unfair treatment. When a variety of foods

are fortified, each with a lesser proportion of RDI, the

theoretical possibility of consuming dangerous levels

of a micronutrient through excess consumption of a

single food becomes more remote.

Technologies

0028Depending on the manner in which foods are pro-

cessed, different methods for addition of micronu-

trients have been developed:

0029Dry mixing for cereal flours and their products,

powder milk, powder beverages.

0030Dissolution in water for liquid milk, drinks, fruit

juices and in the water to be used for making bread

pastas cookies.

0031Spraying as in iodization of salt and cornflakes,

where the vitamins do not support the cooking or

extrusion step.

0032Dissolution in oil for the lipo-soluble vitamins for

enrichment of oily products like margarine.

0033Adhesion for sugar fortification where the vitamin

A in powder form is adhered to the crystals surface

by a vegetable oil.

0034Coating as in rice where the vitamins sprayed over

the grain must be coated in order to avoid the losses

when washing the grains before cooking.

0035Extrusion of a blend of rice flour with micro-

nutrients and stabilizers to provide a premix grains

that can be blended with rice after milling.

Research and development efforts have enhanced ef-

fectiveness of fortification technology. Better refining

procedures and packaging have significantly im-

proved the stability of iodine compounds in salt. In

the case of iron, stabilizers and absorption enhancers

are added along with the fortificant to retain it in

an absorbable form or improve absorption. The

structure of the iron or iron compounds has been

modified to improve absorption. In the case of vita-

min A, work is ongoing to retard the loss of potency

on storage through addition of antioxidants and

other stabilizers. In all these cases, there is scope for

further improvement and refinement for better

Value-added

foods

e.g. condiments, beverages

convenience foods, candies

Basic foods

e.g. breads, biscuits, packaged

cereals, dairy products

Staple foods

e.g. whole grain & milled cereals,

oils & fats, sugar, salt

fig0001 Figure 1 Food-product pyramid.

FOOD FORTIFICATION 2617