Enriching our health?
There is a problem with the legal definition that stone-ground white flour is subject to the same rules as white industrial flour and that despite being nutrient rich small mills are required by law to fortify stone-ground white flour – which is often not possible in a mill that was built several centuries ago … LINK real bread campaign
GHGE are not only impacting global food security but also the nutritional value of our food. The evidence is already out there on how human contribution to climate change (altering temperatures and rainfall patterns) affects the growing season and reduces yields of many important staple grains, like wheat. And fewer crops mean higher rates of undernourishment (child stunting and wasting) in poorer countries where calorie consumption is reduced. At the same time, elevated CO2 levels increase photosynthesis, raising crop yields, soluble sugars and antioxidants in the plant, but diluting its nutrients. A review published on The Lancet Planetary Health website summarises the findings of three studies proving just that: higher levels of CO2 mean lower protein and mineral concentrations (e.g. iron and zinc) by 5–15 per cent, and lower B vitamins by up to 30 per cent in wheat, rice, potatoes and barley. We end up compensating for these deficits by fortifying our foods.
Since the Second World War, flour has been fortified in the UK. This was originally done as a way to improve the nation’s health during the war. Under rules laid out in the Bread and Flour Regulations 1998, all wheat flour (except wholemeal) is required to have added calcium, iron, thiamine and niacin. These have little effect on taste and cooking properties and help address malnutrition and prevent nutritional deficiencies. Folic acid must also now be included in non-wholemeal flours across the UK and in more than eighty other countries in order to reduce life-threatening spinal conditions in babies.
Although fortification of food in the US dates back to the 1920s and 1930s (with the iodisation of salt to help with goitre and vitamin D in milk to eradicate rickets), the FDA ruled in the 1940s that it would encourage rather than mandate fortification practices. Widespread participation has been achieved through market demand.
Ninety countries around the world supplement their wheat flour with one or more vitamins or minerals after considering the research and contribution to our health. See this interactive map of the countries and mandates. The Global Fortification Data Exchange claims that 90 per cent of wheat flour in the UK is fortified, 92 per cent in the US, 95 per cent in Canada, 80 per cent in Australia and only 1 per cent in China. According to 2010 data from McCance and Widdowson, wheat flour accounts for 35 per cent of the UK’s calcium intake, 31 per cent of its iron intake and 31 per cent of thiamine intake.
The Food Fortification Initiative’s (FFI) 2021 Annual Report claims that, through their efforts in providing technical assistance for grain fortification, significant progress has been made in Africa, Asia-Pacific, Europe and India to remedy micronutrient deficiencies (which can cause disorders like anaemia and spina bifida). One such programme, Smarter Futures (a partnership with the Ministry of Foreign Affairs of the Netherlands), has, the FFI says, led to the rise of mandatory fortification from seven countries in Africa to twenty-nine countries since the programme began fifteen years ago. A case study on anaemia.
When implemented at a national level, fortification benefits everyone in providing essential nutrients. However, less than half of large-scale manufacturers are consistently fortifying their products according to national standards. This is due to a lack of food-control capacity and incentive structures for the industry. Consumers are most affected, as so-called fortified products can often lack the micronutrients they claim to contain.
At the mill, the fortification process is relatively inexpensive, as it only requires the adding of a nutrient premix to the flour once milled. There’s also little noticeable impact on the price of the flour to the consumer. There are initials cost of buying the feeders, plus the on-going costs of premix (in their FAQs, the FFI provides a range of $0.85–$10 per metric ton of flour) and costs for quality control supplies and testing, but the WHO states that fortification costs only $0.05 to $0.25 per person per year (depending on the food and nutrient added).
The benefits of flour fortification offset any associated costs, especially when you look at it as a preventive healthcare intervention and consider the economic impacts (lost work productivity due to nutritional deficiencies). The FFI points to a few studies on its site showing folic acid intervention in the US from fortification practices could mean an annual net savings (from lifetime costs to care for people with spina bifida) of $603 million.
The environmental impact of commercial food fortification isn’t huge, as it uses existing food processing and delivery systems. In a study funded by GAIN, Quantis (an environmental sustainability consultancy) calculated the carbon footprint of fortified foods in kilograms of CO2-equivalents, and found that due to the relatively small amount of nutrients added to food, the carbon footprint of the fortification process is generally not more than 100 or 1,000 times less impacting than the food itself. This suggests that forty per cent of the pregnant women in Indonesia received 200 mg/day of iron sulphate through fortification and supplementation to combat anaemia, this would equal only thirty tonnes of CO2-equivalent — equal to fifteen transatlantic flights.