Food fortification

Micronutrients — vitamins and minerals needed by the body in minute amounts — are critical to optimal bodily functions and a deficiency in any of them can cause severe and even life-threatening conditions, according to the World Health Organization (WHO).

Micronutrients perform a range of functions, including enabling the body to produce enzymes, hormones, and other substances needed for normal growth and development. Deficiencies in iron, vitamin A, and iodine are the most common around the world, particularly in children and pregnant women. Low- and middle-income countries bear the disproportionate burden of micronutrient deficiencies, the WHO noted.

A lack of iron, folate, and vitamins B12 and A can lead to anemia, a condition in which there is a reduced number of red blood cells or hemoglobin concentration, causing fatigue, weakness, shortage of breath and dizziness. This can further lead to difficulties in functioning in work, education and community engagement. The WHO estimates that 42% of children under 5 years of age and 40% of pregnant women worldwide are anemic.

Severe iodine deficiency can lead to brain damage and, during pregnancy, cause a number of issues including stillbirth, spontaneous abortion and congenital anomalies. Less severe iodine deficiency may still cause mental impairment that reduces intellectual capacity. Vitamin A deficiency is the leading cause of preventable blindness in children and increases the risk of disease and death from severe infections such as diarrheal disease and measles. Vitamin A deficiency may also occur in women during the last trimester of pregnancy in high-risk areas.

Fortification is the practice of deliberately increasing the content of one or more micronutrients (i.e., vitamins and minerals) in a food or condiment to improve the nutritional quality of the food supply and provide a public health benefit with minimal risk to health. Aside from increasing the nutritional content of staple foods, the addition of micronutrients can help to restore the micronutrient content lost during processing. The WHO recommends large-scale food fortification as a powerful evidence-informed and cost-effective intervention to fight vitamin and mineral deficiencies, including iodine deficiency disorders, anemia and iron deficiency, among others.

National Food Fortification Day is observed annually in the country on Nov. 7 to highlight the persistence of micronutrient deficiencies as a public health problem affecting a significant proportion of the population. Republic Act 8172, otherwise known as “An Act Promoting Salt Iodization Nationwide (ASIN),” was signed into law in December 1995 with the purpose of eliminating micronutrient malnutrition in the country, particularly iodine deficiency disorders, through salt iodization. The law is a cost-effective and preventive measure that requires all manufacturers of salt to iodize the salt they produce, manufacture, import, trade, or distribute.

The ASIN law was supplemented by Republic Act 8976, otherwise known as the Philippine Food Fortification Act of 2000. The law has two components. With voluntary food fortification, the Department of Health (DoH) encourages manufacturers to fortify their processed foods and food products based on rules and regulations the DoH prescribes through the Food and Drug Administration (FDA). On the other hand, among the staple foods that fall under the mandatory fortification component are rice and salt (to be fortified with iron), wheat flour (to be fortified with vitamin A and iron), and refined sugar and cooking oil (both to be fortified with vitamin A). These staples were chosen because these are regularly consumed by the population, especially those at risk to micronutrient deficiencies regardless of socioeconomic status.

The Sangkap Pinoy Seal Program (SPSP) strategy encourages food manufacturers to fortify processed foods or food products with essential nutrients at levels approved by the DoH. The DoH seal of acceptance is used by manufacturers after their products have passed a set of criteria for food fortification. This seal serves as a guide for consumers in selecting nutritious foods. The Sangkap Pinoy Seal is granted to manufacturers who fortify their processed food products with iron, vitamin A, and iodine. The Saktong Iodine sa Asin Quality Seal can be seen on salt products with the recommended amount of iodine. The Diamond Sangkap Pinoy Seal is for staples covered by mandatory food fortification.

There are a number of factors that affect an individual’s health. Eating right is a step into the right direction.

TEODORO B. PADILLA is the executive director of the Pharmaceutical and Healthcare Association of the Philippines (PHAP), which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are at the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.