School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland.
Proc Nutr Soc. 2013 Nov;72(4):433-40. doi: 10.1017/S002966511300339X. Epub 2013 Sep 11.
This review aims to assess the efficacy and safety of voluntary fortification as an option to address the occurrence of inadequate micronutrient intakes in population subgroups in Europe. Although legislation is harmonised across the European Union, fortification practices and patterns of consumption of fortified foods vary considerably between countries. While the proportion of children consuming fortified foods is greater than adults, the proportion of dietary energy obtained from fortified foods is generally low (<10% in Ireland, where fortified foods are widely consumed). There are a few systematic studies on the overall nutritional impact of voluntary fortification, but there are several studies on the impact of fortified ready-to-eat breakfast cereals. The available evidence indicates that voluntary fortification can reduce the risk of sub-optimal intakes of a range of micronutrients at a population level and can also improve status for selected micronutrients (e.g. folate, vitamin D and riboflavin) in children and adults. Although concerns have been raised regarding the potential of food fortification to lead to unacceptably high micronutrient intakes, particularly for those consuming higher amounts of fortified foods, data from national surveys on total micronutrient intakes (including fortified foods) in Europe show that small proportions of the population, particularly children, may exceed the upper intake level (UL) for some micronutrients. The risk of adverse effects occurring in these individuals exceeding the UL by modest amounts is low. In conclusion, voluntary fortification practices have been shown to improve intake and status of key micronutrients in European Union population groups and do not contribute appreciably to risk of adverse effects.
本文旨在评估自愿强化作为解决欧洲人群亚组中微量营养素摄入不足问题的一种选择的功效和安全性。尽管欧盟的立法已经协调一致，但强化实践和强化食品的消费模式在各国之间存在很大差异。虽然食用强化食品的儿童比例大于成人，但从强化食品中获得的膳食能量比例通常较低（在广泛食用强化食品的爱尔兰，这一比例低于 10%）。虽然有一些关于自愿强化对整体营养影响的系统研究，但也有一些关于强化即食早餐麦片影响的研究。现有证据表明，自愿强化可以降低人群中一系列微量营养素摄入不足的风险，还可以改善儿童和成人某些微量营养素（如叶酸、维生素 D 和核黄素）的状况。虽然人们担心食品强化可能导致不可接受的高微量营养素摄入，特别是对于那些食用更多强化食品的人，但欧洲关于总微量营养素摄入量（包括强化食品）的国家调查数据表明，只有一小部分人口，特别是儿童，可能超过某些微量营养素的最高摄入量（UL）。这些个体超过 UL 的微量营养素摄入量适度增加而发生不良反应的风险较低。总之，自愿强化实践已被证明可以改善欧盟人群亚组中关键微量营养素的摄入量和状况，并且不会显著增加不良反应的风险。
