Typically takes a century for govts to fortify food with nutrients (like vitamin D)

Phases seem to typically be:

1. Detect association between nutrient and a health problem

2. Determine that the lack of the nutrient is a major cause of the health problem

3. Individuals and companies supplement with the nutrient

4. Government recommends a minimum daily amount (RDA) of the nutrient

5. Government sometimes then fortifies food (milk, salt, bread, . . ) with a bare minimum amount of the nutrient

6. Government increases the amount of fortification a half century later due to one or more of the following

   • Decreased use of the food (e.g. milk, salt) - note: Switzerland is the only country to have recently increased the amount of Iodine in salt
   • Decrease in other sources of the nutrient (less sunshine ==> less Vitamin D)
   • Decrease in cofactors needed with the nutrient (Magnesium)

Unfortunately uniform fortification ends using so little as to only partially help about 20% of the population

Often there is a concern that too much fortification will caused problems with some drugs (increase or decrease potency), or rare health problems

Very difficult to have one-size-fits all for anything: fortification, clothing, seats, shoes, eye glass intensity, size of print, calories, hearing aids, etc.

Vitamin D home fortification- don't wait 100 years for your govt

See also VitaminDWiki

• Vitamin D history back to Egyptians and fortification - Aug 2011

• Vitamin D important papers from 1645 to 2013 – Nov 2013

• Vitamin D fortification of food - review Dec 2011

• Vitamin D can fortify a variety of food and drinks – even beer – March 2012

• Vitamin D and Folate fortification of foods - April 2012

• Thoughts on improving vitamin D policies - Vieth Nov 2013 Iodine example

• Saudi have very little vitamin D fortification of food - April 2013

• Milk fortification of 1000 IU got most children above 20ng of vitamin D – March 2013

• Improved health due to vitamin D fortification in Finland

• Can fortify food with 1000 IU of vitamin D - Italy, March 2013

• A plea for vitamin D food fortification in India - May 2010

• A balanced diet is no longer enough – supplements needed - VitaminDWiki Oct 2012

• VITAMIN D: Public Shouldn’t Wait For Doctors To Usher In New “Golden Era” Of Preventive Medicine

• Overview Vitamin K and Vitamin D

• Germany does not fortify ANY food with vitamin D, is considering 1000 IU from bread – Nov 2013

• Incidence of 22 health problems related to vitamin D have doubled in a decade

• Vitamin D home fortification- don't wait 100 years for your govt

• ODIN: Europeans study vitamin D fortification and testing with some suggestions by VitaminDWiki

• 43 reasons for Vitamin D deficiency has the following graphic

• Overview Magnesium and vitamin D big decline in past 100 years

See also web

• Pellegra and Vitamin B3 (Niacin) Dr. Heaney Nov 2013 - also took a century

• Folic Acid History Wikipedia Dec 2013 - clips

  • 1920s, scientists believed folate deficiency and anemia were the same condition
  • 1930's Folate was identified as the corrective substance in brewer's yeast
  • 1948 clinical efficacy was proven by Sidney Farber
  • 1960, experts first linked folate deficiency to neural tube defects
  • 1990s (late), US scientists implemented the folate fortification program

• Vitamin C was the focus of perhaps the first Random Controlled Trial (RCT) in 1758

• Is Food Fortification Necessary? An Historical Perspective 2009

  • 1921 Clinical Trial of Iodine presented at AMA conference, 1924 Iodized salt was common

• Micronutrient Deficiency Conditions: Global Health Issues date unknown PDF at the bottom of this page

• Should Foods Be Fortified Even More? Science News Sept 2004

  • Currently, the federal government requires that manufacturers enrich cereal-grain products with five nutrients—iron and the vitamins thiamine (B1), riboflavin (B2), niacin (B3), and folate (B9). The total cost to U.S. consumers of adding calcium and vitamin D to the list should be no more than about $19 million a year, Harold L. Newmark of Rutgers University and his colleagues report in the August American Journal of Clinical Nutrition.
  • Calcium and Vitamin D would add an estimated 6 to 10 cents to the cost of food per person per year—or collectively some $19 million.
  • The team contrasts that amount with the annual savings of averting some 300,000 fractures ($2 billion) and preventing some 27,000 cases of colon cancer (more than $1 billion).
• Food fortification spurred by military purchases 2003
  • Flour fortification was greatly boosted in the US when the Army required all their bread be fortified during WWII