Dietary supplements and food fortification
Fortifications of foods with micronutrients should raise average nutrient intakes, and if an almost universally consumed food is fortified, it should also raise median intakes and reduce the numbers of people consuming inadequate amounts of the nutrients concerned. In addition to any mandatory fortification, manufacturers may add micronutrients to a food to improve its nutritional value or marketability. When folic acid supplement advice proved to be so ineffective in practice, the USA and Canada introduced mandatory fortification of flour with folic acid in 1998. Fortification of a core food should raise median intakes and raise the intakes of those with low intakes as well as simply increasing average intakes. The United Kingdom (UK) food fortification policy is essentially a legacy of 1940s wartime regulations and an update is long overdue. The case for adding folic acid, vitamin D, iodine and possibly B12 to flour is stronger than that for existing additions.