Wahlqvist Mark L
Center for Health Policy Research and Development, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, Taiwan 350, RCO.
Asia Pac J Clin Nutr. 2008;17 Suppl 1:24-9.
Food fortification generally refers to the addition of micronutrients and other favourably bio-active food components to food-stuffs where there are recognised deficiencies in the target population. Each forticant has had or could have regulatory implications. It is understandable, although arguable, in the face of a limited food supply skewed, for the majority, in the direction of starchy staples of low essential nutrient density. Efforts, with plant breeding, to biofortify such foods are underway and likely to be safer, more sustainable and affordable than chemical additions. Unfortunately, with an increasingly refined and naturally tasteless food supply (salty, fatty, sugary and starchy), and where energy requirements are falling because of physical inactivity, micronutrient fortification is being used as a nutritional "fix-it' strategy. In Asia, there are several critical micro- nutrients. No one national fortification program can deal with all deficiencies is likely to be highly selective for the nutrients which have the greatest advocacy or are most recognisable. They also leave the other health promoting food properties like intactness, nutrient spectrum, and phytonutrient content un-addressed. A variety of food-stuffs, with different biological origins, is the preferred approach. Where an optimal food system is not in place, there may be justification for fortification if there is regular monitoring and surveillance of the food supply and health outcomes occurs; is a clear cost-risk-benefit advantage in such a strategy; are programs in place to improve the nutritional value of the basic food supply and is an "exit strategy' for the fortification program.
食品强化通常是指在目标人群存在公认营养素缺乏的食品中添加微量营养素和其他具有良好生物活性的食品成分。每种强化剂都有或可能有监管影响。面对有限的食物供应，且大部分食物供应倾向于低必需营养素密度的淀粉类主食，这是可以理解的，尽管存在争议。通过植物育种对这类食物进行生物强化的工作正在进行，而且可能比添加化学物质更安全、更可持续且更经济实惠。不幸的是，随着食物供应日益精细化且天然无味（高盐、高脂肪、高糖和高淀粉），以及由于身体活动不足能量需求下降，微量营养素强化正被用作一种营养“修复”策略。在亚洲，有几种关键的微量营养素。没有一个国家的强化计划能够解决所有的营养素缺乏问题，很可能会对最受关注或最易识别的营养素进行高度选择。它们也未涉及其他促进健康的食物特性，如完整性、营养谱和植物营养素含量。多种具有不同生物来源的食物是首选方法。如果没有建立起最佳的食物体系，在对食物供应进行定期监测且能观察到健康结果的情况下，强化或许有其合理性；这种策略具有明显的成本 - 风险 - 效益优势；有相应计划来提高基本食物供应的营养价值；并且有强化计划的“退出策略”。
