Talk:Food fortification

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 27 August 2019 and 6 December 2019. Further details are available on the course page. Student editor(s): Danidelponte. Peer reviewers: Carolashley, Kris2ches.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 21:36, 16 January 2022 (UTC)

"Risk factors for vitamin D deficiencies include:"

Funny wording — Preceding unsigned comment added by 120.61.87.43 (talk) 05:05, 30 August 2012 (UTC)

Iron supplementation risks

I moved a recently added paragraph to the top of the article, because it seemed somewhat out-of-place where it was. We need citations for the claims that iron fortification is considered unethical by "many doctors" (see WP:Weasel), that most males over 35 suffer from iron overload (and some clarification, e.g. in which population group?), that it is more common and serious than hypoferremia and that excess iron exacerbates many conditions, e.g. myocardial infarct. I also removed the sentence about responsible doctors first testing a patient's blood serum level, as this is not precise enough, and possibly inaccurate: If you have appreciable amounts of iron in your serum, isn't that a bit of a problem in itself? --Slashme 16:45, 9 November 2007 (UTC)

My recent addition of possible effects of iron on the gut microbiome were removed. However, I added this reference which is relevant to Western populations. [1] The concern is real and thoroughly discussed in that review. I don't know why this would be controversial. Iron supplementation is well known to cause intestinal stress. JamesPem (talk) 20:55, 20 May 2015 (UTC)

Food additives etc. ==> need merging.

At WikiProject Food and Drink I've started the thread Food additives etc. ==> need merging. in hopes that some of the pages:

• Food supplements,
• Food additive,
• Food fortification,
• Dietary supplement,
• Food processing,
• Bodybuilding supplement,
• Nutraceutical, and
• Nutrification (aka food enrichment)

can be merged/eliminated. I hope that that thread will be a central place to discuss this somewhat messy situation. I'll be adding this comment to each of the articles' Talk pages. --Hordaland (talk) 11:50, 6 October 2008 (UTC)

"As early as 1755..."

"As early as 1755, pellagra was recognized by doctors as being a niacin deficiency disease." Surely the identity of the specific molecule niacin was not know in 1755! This was a discovery of the 20th century. 107.3.80.227 (talk) 04:42, 9 July 2013 (UTC)

ad. Types: List of ways to fortify foods is problematic / incorrect

This seems factually wrong: "Synthetic biology (i.e. addition of probiotic bacteria to foods) "

: synthetic biology has to do with altering the DNA whereas probiotic bacteria can be 100% unaltered and still be beneficial. Foods can fe fortified with naturally occurring ingredients and that option is currently missing from the list. Can an expert confirm & correct?

Probiotic products are naturally found live bacteria added to foods with the idea of the bacteria reaching the large intestine and taking up residence. To my knowledge, no probiotics are genetically modified bacteria. Article changed accordingly. David notMD (talk) 22:52, 6 September 2017 (UTC)

Limited absorption section for discussion

The following was added by JamesPem in a first version in this dif and again in the version below in this dif. Each time the content has overstated what the sources say...

One factor that limits the benefits of food fortification is that isolated nutrients added back into a processed food that has had many of its nutrients removed, does not always result in the added nutrients being as bioavailable as they would be in the original, whole food. An example is skim milk that has had the fat removed, and then had vitamin A and vitamin D added back. Vitamins A and D are both fat soluble and not water soluble, so a person consuming skim milk in the absence of fats may not be able to absorb enough of these vitamins as one would be able to absorb from drinking whole milk. Phytochemicals such as polyphenols can also impact nutrient absorption.

Another example is that only a fraction of fortification iron is absorbed and most of the given dose passes into the lower small intestine and colon. Iron can affect the structural and immunological integrity of the gastrointestinal tract and its microflora, potentially promoting invasion by pathogenic enteric bacteria as well as increased gastrointestinal inflammation.

References

Issues

• the first paragraph is unsourced
• The Hurrell2002 source is from... 2002. why use such an old source at all?
• the BhuttaHurrell2012 source is about iron supplementation about poor people in malaria-prone regions. It has no place in this general discussion.
• The conclusion of the last ref PMID 25205464 is much weaker than the content. The source is very clear to say that data is contradictory, much is unknown, etc etc. That is nothing like " Iron can affect the structural and immunological integrity of the gastrointestinal tract and its microflora, potentially promoting invasion by pathogenic enteric bacteria as well as increased gastrointestinal inflammation".
• There is a very recent AHRQ review of iron supplementation in infants (PMID 25905157 and see also PMID 25825534) and it has none of this stuff about increased infection. (it says there is a lot we don't know)
• Two recent Cochrane reviews on iron supplementation also don't go into this. see PMID 25550190 and PMID 24990381.

so this needs some work before it goes into Wikipedia... Jytdog (talk) 23:28, 20 May 2015 (UTC) (struck existing content that wasn't added Jytdog (talk) 00:19, 21 May 2015 (UTC))

• • Jytdog. For the record, I did not write the first paragraph.
  • Secondly, the section is about "criticism" and the review source is very clear that iron MAY cause intestinal distress. That is literally the title and subject of the review paper. Therefore, I hardly see why it is controversial to say that "Iron can affect the structural and immunological integrity of the gastrointestinal tract and its microflora, potentially promoting invasion by pathogenic enteric bacteria as well as increased gastrointestinal inflammation." That is not overstating the source. That is literally what the source is saying. It is saying that there is a possibility that iron can do that and surely this is a valid warning. If it were not, the paper would not have been written. I'm not sure this is all that controversial. I think you need to keep in mind that the studies on GI distress on supplemented Africans only came out last year. So, the microbiome data is relatively new, as is the review paper I cited. Again. the review paper shows that concerns have been raised. I don't see the problem here. JamesPem (talk) 23:53, 20 May 2015 (UTC)
    • Thirdly, here is an opinion piece on the concern [2]. I do not think this is something that should be covered up just because it hasn't been thoroughly investigated. Researchers are concerned about it and it's a valid issue. That's why scientists are investigating it.
    • I'm not entirely sure why this is controversial. It's well known that iron can cause gastrointestinal distress. Even says so right on WebMD. [3] "Stomach or intestinal ulcers: Iron might cause irritation and make these conditions worse. Use iron with care. Intestinal inflammation, such as ulcerative colitis or Crohn’s disease: Iron might cause irritation and make these conditions worse. Use iron with care." It's common knowledge that iron can irritate the GI tract. JamesPem (talk) 00:12, 21 May 2015 (UTC)

thanks for pointing out that i included something you didn't write. fixed that by striking. twp questions:

what is this doing in an article about food fortification? (most of these GI distress sources discuss taking iron supplements, without food)

the stuff about giving supplements in developing countries in interesting and i agree important. on the one hand, iron deficiency is killing people.. on the other oral supplementation seems to increase infection in those countries (staggering indeed per the editorial. seems like great content for iron supplements. Jytdog (talk) 00:24, 21 May 2015 (UTC)

It was thought until recently that all people who were anemic needed to eat more meat or take iron pills ("anemia of iron deficiency"). However, it's now known that many forms of anemia are actually due to something called "anemia of chronic disease" (aka "anemia of inflammation" or "anemia of withholding"). What happens is that the body stops absorbing iron, and stores it in tissues, to keep iron out of the blood and away from pathogens and cancer (which thrive on iron). This is due to a hormone called hepcidin. Giving iron to someone with anemia of chronic disease is counterproductive and can even be fatal (which explains the African children getting sick from iron supplementation).

Anyhow, this is relevant to the section on "limited absorption" because food fortification of iron may be counterproductive to those with anemia of chronic disease, whose bodies intentionally aren't absorbing iron very well and all the iron just ends up causing more inflammation in the body. Researchers are still investigating it, but that's the direction the research is headed. Fortified iron isn't well absorbed to begin with (this is well known) so it's believed that iron fortification may contribute to further inflammation in people with chronic inflammation via this mechanism of poor absorption (pathogens begin fed in the GI tract from unabsorbed iron).

As an example, obesity may be a kind of anemia of chronic disease[4], so giving iron to every individual in a nation—just to treat true anemia of iron deficiency in a minority of the population—may be counterproductive.

We don't have the references to blame iron fortification directly, but I don't see why the known problems of poor iron fortification absorption on the gut flora, which contributes to intestinal inflammation, can't be highlighted.JamesPem (talk) 18:54, 21 May 2015 (UTC)

please don't use this Talk page to talk about the topic generally (see WP:NOTFORUM). The issues here are the the sources are not about fortifying food, or are about iron supplementation in the developing world in the context of malaria, or are really old. The content you want to add is not supported by MEDRS sources; it fails verification. Jytdog (talk) 19:46, 21 May 2015 (UTC)

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Assessment comment

The comment(s) below were originally left at Talk:Food fortification/Comments, and are posted here for posterity. Following several discussions in past years, these subpages are now deprecated. The comments may be irrelevant or outdated; if so, please feel free to remove this section.

The article is still a bit unstructured, and needs more information and sources on some types of fortification. It is not a stub anymore, but no better than start class.

Last edited at 10:06, 26 July 2007 (UTC). Substituted at 15:21, 29 April 2016 (UTC)

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Beta carotene is not a form of Vitamin A.

"Retinol, the active form of Vitamin A, is toxic in a much lower dose than other forms, such as beta carotene" - Beta carotene is a precursor to vitamin A - it's something your body uses to make vitamin A. It is not another form of Vitamin A, in the sense that calcium citrate and calcium carbonate can be considered two different forms of sources of calcium. 76.65.24.170 (talk) 01:25, 11 December 2017 (UTC)