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BACKGROUND: Historically, the voluntary addition of micronutrients to foods in the United States has been regarded as an important means to lessen problems of nutrient inadequacy. With expanding voluntary food fortification and widespread supplement use, it is important to understand how voluntary food fortification has an impact on the likelihood of excessive usual intakes. Our objective was to investigate whether individuals in the United States with greater frequency of exposure to micronutrients from voluntarily fortified foods (vFF) are more likely to have usual intakes approaching or exceeding the respective tolerable upper intake levels (UL). SUBJECTS/METHODS: The National Cancer Institute method was applied to data from the 2007-2008 National Health and Nutrition Examination Survey (NHANES) to estimate the joint distribution of usual intake from both vFF and non-vFF sources for 12 nutrients and determine the probability of consuming these nutrients from vFF on a given day. For each nutrient, we estimated the distribution of usual intake from all food sources by quintile of probability of consuming vFF and compared the distributions with ULs. RESULTS: An increased probability of consuming zinc, retinol, folic acid, selenium and copper from vFF was associated with a greater risk of intakes above the UL among children. Among adults, increased probability of consuming calcium and iron from vFF was associated with a greater risk of intakes above the UL among some age/sex groups. CONCLUSION: The high nutrient exposures associated with vFF consumption in some population subgroups suggest a need for more careful weighing of the risks and benefits of uncontrolled food fortification. European Journal of Clinical Nutrition (2013) 67, 592-597; doi: 10.1038/ejcn.2013.51; published online 6 March 2013 Keywords: voluntary food fortification; NHANES; tolerable upper intake level, INTRODUCTION In the United States, fortification of any non-standardized food with a vitamin or mineral is permitted at the discretion of the manufacturer. (1) Voluntary nutrient additions are guided by [...]

Objectives: Health Canada proposes to allow manufacturers to add vitamins and minerals to a wide variety of foods at their discretion, a practice that has long been permitted in the United States and Europe. With Health Canada's proposed exclusion of staple and standardized foods from discretionary fortification, questions arise about the nutritional quality of the foods that remain eligible for fortification. To better understand the implications of this policy for healthy eating, this study examined the contribution of foods eligible to be fortified to the dietary quality of Canadians. Methods: Using 24-h dietary recall data from the 2004 Canadian Community Health Survey, the relationship between intake of fortifiable foods and indicators of dietary quality was assessed. Results: The mean percentage contribution of fortifiable foods to usual energy intake ranged from 19% among men over the age of 70 years to 36% for girls aged 14-18 years. Fortifiable food (as a percentage of total energy) was inversely associated with intake of vegetables and fruit, meat and alternatives, milk products, fiber, vitamins A, B6, B12 and D, magnesium, potassium and zinc. Fortifiable food was positively associated with dietary energy density, total energy intake and grain products. Few relationships were found for folate, vitamin C, iron, calcium, sodium and saturated fat. Conclusions: Consumption of foods slated for discretionary fortification is associated with lower nutrient intakes and suboptimal food intake patterns. Insofar as adding nutrients to these foods reinforces their consumption, discretionary fortification might function to discourage healthier eating patterns. European Journal of Clinical Nutrition (2011) 65, 31 3-320; doi: 10.1038/ejcn.2010.261; published online 1 December 2010 Keywords: food fortification; dietary quality; vitamins; minerals, Introduction Discretionary fortification, the addition of vitamins and minerals to foods at the discretion of manufacturers, has long been permitted in the United States (Food and Drug Administration, 1993) and [...]

Objective: To characterize the relationships between selected socio-demographic factors and food selection among Canadian households. Design: A secondary analysis of data from the 1996 Family Food Expenditure survey was conducted (n=10 924). Household food purchases were classified into one of the five food groups from Canada's Food Guide to Healthy Eating. Parametric and non-parametric modelling techniques were employed to analyse the effects of household size, composition, income and education on the proportion of income spent on each food group and the quantity purchased from each food group. Results: Household size, composition, income and education together explained 21-29% of the variation in food purchasing. Households with older adults spent a greater share of their income on vegetables and fruit (P [less than] 0.0001), whereas households with children purchased greater quantities of milk products (P [less than] 0.0001). Higher income was associated with purchasing more of all food groups (P [less than] 0.0001), but the associations were nonlinear, with the strongest effects at lower income levels. Households where the reference person had a university degree purchased significantly more vegetables and fruit, and less meat and alternatives and 'other' foods (P [less than] 0.0001), relative to households with the lowest education level. Conclusions: Household socio-demographic characteristics have a strong influence on food purchasing, with the purchase of vegetables and fruit being particularly sensitive. Results reinforce concerns about constraints on food purchasing among lower income households. Furthermore, the differential effects of income and education on food choice need to be considered in the design of public health interventions aimed at altering dietary behaviour. European Journal of Clinical Nutrition (2006) 60, 778-790. doi: 10.1038/sj.ejcn.1602382; published online 18 January 2006 Keywords: food, Canada, households, socio-economic factors, demographics, Author(s): L Ricciuto [1]; V Tarasuk [1]; A Yatchew [2] Introduction In order to explore the role of diet in socio-economic differentials in health and disease, relationships between socio-economic status [...]