Fortification of Ultra-Processed Foods: When More Becomes Harmful

Fortification of Ultra-Processed Foods: When More Becomes Harmful
By Bukola Olukemi-Odele

Throughout history, human survival has greatly depended on sourcing, preparing, and consuming different kinds of food. Food is the third basic need of man after air and water. It supplies our bodies with nutrients for growth, tissue repair, maintenance, and the regulation of vital processes.

Food is not just for nourishment; it is also an integral part of our cultural heritage and national identity. It is a social lubricant that promotes bonding amongst people regardless of diversity, fostering interpersonal relationships, and contributing to community and nation-building. Considering the pivotal role food plays across the globe, issues pertaining to it must be addressed with care.

Traditionally, food was largely produced by local farmers, prepared from scratch, and freshly consumed at home. However, with the advent of technology and the proliferation of industries, came the urbanization of diets, accompanied by an increased burden of diet-related non-communicable diseases.

In recent times, food production has gradually been hijacked by the food industry, a complex, global network of diverse businesses that supplies most of the food consumed by the world’s population. This has led to increased production and sales of ultra-processed foods and the introduction of genetically modified foods. Consequently, there is now a corresponding shift in dietary patterns from traditional grains, dairy, fish, meat, vegetables, and fruits towards foreign, ultra-processed, and convenience foods characterized by low nutritive value, often high in salt, sugar, and fats.

The majority of these highly processed foods are relatively cheap, readily available, and marketed by big food companies, the private sector, and small and medium enterprises to influence the dietary preferences of a critical segment of the population—children, adolescents, and young adults.

A major pathway through which some food industries increase demand for their products is ‘fortification’. Fortification involves the enhancement of widely consumed staples with vitamins and minerals to deliver nutritional benefits with minimal or no health risks and address micronutrient deficiencies within a target population. As much as this public health initiative is intended for the public good, evidence abounds that the adoption of fortification by food industries, especially in Nigeria, is done to increase demand, drive sales, and enhance profit accumulation.

In Nigeria, one of the most pressing issues surrounding the practice of fortification and its promotion is the misleading marketing strategies frequently deployed to promote these products. Manufacturers tend to exaggerate and embellish the purported advantages of fortified foods, consequently leading unsuspecting consumers to harbour the misguided belief that these items are significantly healthier than they truly are. Sometimes, they amplify the presence of a micronutrient as a halo effect to cover the health risks associated with other ingredients added to increase the shelf life or palatability of the heavily processed product. This health halo effect has been deployed in the advertisement of products like bouillon cubes (commonly called stock or seasoning cubes) and breakfast beverages to sway consumers towards unhealthy choices, showcasing these products as nutritious and fortified with one or more micronutrients and, in the same vein, concealing the dangerous amounts of salts, sugars, or chemical additives that could trigger the risks of non-communicable diseases such as hypertension and diabetes, amongst others.

Most of these fortified foods frequently claim to be miracle workers for health or remedies for nutritional gaps. These advertisement gimmicks can be curbed by the enforcement of warning labels on processed and prepackaged foods.

Furthermore, it is noteworthy that overconsumption of fortified foods can lead to serious repercussions for public health. When consumers ingest quantities of a specific nutrient through different channels, such as government-led supplementation programs and industry-led fortification exercises, that exceed their body’s requirements, the consequences can manifest in a variety of adverse health effects. For instance, an excessive intake of iron can lead to stomach upset, constipation, nausea, abdominal pain, vomiting, ulcers, and diarrhoea. Similarly, an overabundance of vitamin A can trigger hypervitaminosis A, a condition known to cause liver damage and a range of other significant health issues that could further complicate the present health and nutrition crisis in the country.

To safeguard public health and curb the rise of non-communicable diseases (NCDs), the Federal Ministry of Health and Social Welfare (FMOHSW) should discourage the use of unhealthy ultra-processed food products such as bouillon as vehicles for fortification, as this has the potential to increase the intake of sodium and the burden of high blood pressure. The National Agency for Food and Drug Administration Control (NAFDAC), Standard Organization of Nigeria (SON), and other relevant Ministries, Departments, and Agencies (MDAs) must collaborate to implement nutrient profile models and enforce front-of-pack warning labels, marketing, and advertisement regulations that align with global best practices to protect citizens from straying towards unhealthy dietary choices as well as curb the potential effects of misleading nutrition and health claims made by industries.

The enforcement of mandatory salt targets alongside the aforementioned public health strategies should be implemented before considering industry-led nutrition initiatives such as the fortification of bouillon cubes and other ultra-processed foods. All relevant MDAs responsible for safeguarding health, improving nutrition outcomes, and protecting consumers must improve collaboration, coordinate efforts, and align all policy decisions and interventions with the country’s public health and social development goals.

More importantly, there should be close communication and intra-collaboration within the various units of these MDAs, as working in silos could lead one department to approve and implement interventions that inadvertently undermine the goals and efforts of another department within the same government body.

Bukola, a food scientist, is the Programme Officer, Sodium Reduction at Corporate Accountability and Public Participation Africa (CAPPA).