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Potential nutrient intake as a result of fortification

A GFDx analysis of the additional nutrient amount a population receives by consuming the fortified food.

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Interpretation

It is useful to estimate the additional nutrients that food fortification contributes to the diet to inform program actions such as, modifying nutrient levels in standards, adding or removing foods under a mandatory fortification program, changing legislation for a food from voluntary to mandatory, or evaluating the contribution of food fortification to micronutrient intake in relation to other programs that deliver micronutrients.

GFDx calculates the potential nutrient contribution from fortified foods (in milligrams per capita per day, mg/c/d) using the following information:

  • Food intake (e.g., from a dietary survey in grams per capita per day, g/c/d) or availability (the amount of food available for human consumption per FAO Food Balance Sheets, g/c/d)
  • Nutrient addition levels (in milligrams per kilogram, mg/kg) in that country’s fortification standard.

This provides the amount of additional nutrients that food fortification contributes to the diet if nutrient addition levels specified in the fortification standards are added at point of production. GFDx then compares this estimated nutrient contribution from food fortification to:

  • Estimated Average Requirement (EAR) for women of childbearing age, and
  • Tolerable Upper Intake Level (UL) for women of childbearing age.

However, the following factors can lower potential nutrient intake:

  • Food is not industrially processed: In many countries, small-scale production of foods (for example, at-home or village milling) is still practiced to some degree. With the exception of salt, GFDx assumes that foods that are not industrially processed will not be fortified and will not contribute to potential nutrient intake through fortification.
  • Poor compliance/quality to fortification requirements: If food producers are not following fortification legislation and standards (such as by adding non-recommended compounds or nutrient levels, or not fortifying at all), then the potential nutrient contribution of fortification will be lower than expected.

Considering all of these factors together, GFDx presents potential nutrient contribution before and after industrial processing and compliance/quality data are taken into account.

  • Before adjustment: Makes the assumption that 100% of the food is industrially processed and 100% of the food is fortified (full compliance) – this represents the highest possible nutrient contribution achievable through that country’s fortification standards.
  • After adjustment: Applies the country’s most recently available data on industrial processing and compliance/quality—this estimates current or actual nutrient contribution, based on fortification implementation.

The difference in nutrient contribution between before and after adjustment indicates additional nutrient amounts that food fortification could contribute to the diet if  improvements in compliance or industrial processing could be achieved.

Indicator and term descriptions

Potential nutrient intake: Daily amount of nutrient (expressed in milligrams) that a person could ingest if the food is fortified according to national fortification standards.

Percentage of recommended intake: Percentage of a woman’s daily nutrient requirements that a person could meet if the food is fortified according to national fortification standards.

Percentage of Tolerable Upper Intake Level (UL): Percentage of a woman’s upper intake level that person could meet if the food is fortified according to national fortification standards.

Before adjustment: For potential nutrient intake, percentage of recommended intake, and percentage of UL, the calculation was done assuming 100% of the food is industrially processed and 100% of the food is fortified according to national fortification standards (i.e., is fully compliant).

After adjustment: For potential nutrient intake, percentage of recommended intake and percentage of UL, the calculation includes country data the percentage of the food that is industrially processed and that is compliant.

Daily food intake: The average amount of the food that is eaten expressed in grams, per capita, per day (g/c/d).

Daily food available: This indicator is used if food intake data are not available. It is the average amount of the food that is available for consumption expressed in grams, per capita, per day (g/c/d).

Fortification standard: Legal or official documentation indicating the micronutrients and the forms and levels of these micronutrients that must be added to fortification vehicles at the production level. Fortification standards are generally indicated in national food fortification legislation or regulations and/or food standards for the food vehicle.

Percent fortified: The percentage of industrially processed food that is required by legislation to be fortified that is fortified at levels that meet relevant standards (i.e., the compliance/quality percent).

Compliance: An adherence to an order, regulation, or law. In the case of food fortification, foods that are fortified and included within any order, regulation, or law on food fortification (mandatory or voluntary) must adhere to the micronutrient specifications detailed in the nationally adopted fortification standards and/or other food quality, safety, packaging, and labeling requirements. To be deemed “compliant,” food producers or importers must “pass” a pre-determined and objectively defined set of requirements during a site audit/inspection by the government entity responsible for food control.

Quality: The degree to which a product meets stated requirements. Unlike compliance, which must be measured at the point of production or import by authorized government entities, data on quality may be generated by public, private (non-government) or civil society stakeholders. Additionally, quality may be collected from places of production, import or markets and may rely on qualitative or quantitative tests.

Percent industrially processed: The proportion of the total food available that is processed by an industrial processor. Ideally this quantity is required to be fortified according to relevant legislation (if mandatory legislation exists).

Estimated Average Requirement (EAR): The nutrient intake level that is considered adequate for half of healthy individuals in a group. In other words, even if fortification provides 100% of the diet’s EAR, approximately half of healthy individuals will need additional nutrients through other sources in their diets.

Tolerable Upper Intake Level (UL): The highest daily intake of a nutrient considered safe for most people. Taking more than the UL is not recommended and may be harmful. For safety reasons, the UL is calculated to provide a buffer range of safe intake; at intakes above the UL, the risk of adverse effects increases.

Additional information about this indicator
How to download data

Follow these steps to download data from the visualization as an Excel or CSV file:

  • Click on the “Data” tab at the bottom of the visualization window.
  • Hover over the header row of the table until an ellipses (three dots […]) appears.
  • Click on “more options” and a drop-down menu will appear. Select “Export data.”
  • In the new window, select the export format that best supports your needs and click the “Export” button.
Considerations
  • GFDx has calculated nutrient contribution according to levels specified in a food standard (before and after adjustment). GFDx recognizes that the actual nutrient intake may differ depending on the following factors:
    • Actual addition levels may differ from the standard. In particular, overages of certain nutrients may be added to the fortificant to account for potential losses during storage or cooking.
    • Losses between food production and consumption, e.g. during storage or cooking. Depending on the nutrient’s stability and food processing/cooking methods utilized (which have varying effects on nutrient losses), actual nutrient intake may be lower for some nutrients (and in some instances considerably lower) than these calculations imply.
  • Estimates of the contribution of food fortification at production have been compared with EAR and UL for intake. It is recommended that this comparison be made when the distribution of intakes is known for hundreds of individuals; not when intake for a group is based on one number (with no variability). This comparison is therefore not strictly accurate but has been undertaken to provide some measure of the adequacy of the fortification contribution.
  • Where data were missing, elements of the analysis could not be conducted:
    • Potential nutrient contribution could not be calculated if there are no data for that country on food intake or availability.
    • Proportion of UL achieved through fortification could not be calculated for a specific nutrient if there is no defined UL.
    • The after adjustment analysis could not be completed if a country did not have data on the proportion of food industrially processed or the proportion of food fortified (compliance/quality).
  • GFDx uses availability data from FAO for maize flour, oil, rice, and wheat flour. Food availability is not the same as food intake and may overestimate food intake (and thus nutrient contribution) if there is significant waste or loss of that food.
  • GFDx uses salt intake from Powles, et al. 2017. In some countries where actual intake is not available, intake was estimated through statistical modeling.
  • All availability/intake data is a per person national average. In reality, food consumption patterns for a food may differ by population subgroup and/or geographic region.
  • The proportion of food industrially processed ideally refers to the food that falls under the scope of the fortification legislation. E.g., if 100% of the flour in a country is industrially processed, but only cake flour is required under fortification legislation, which is 30% of the total flour supply, then this analysis should be adjusted for only 30% of the flour that is industrially processed and required to be fortified under legislation scope. However, because the data available to apply the legislation scope corrections are often not available, the GFDx estimate of industrially processed food may be an over-estimate.
Methodology

Step 1: Calculate Nutrient Contribution Before Adjusting for Industrial Processing and Compliance/Quality

  • Nutrient Contribution (mg/c/d) = Nutrient Addition Level in standard (mg/kg) ÷ 1000 g × Food Intake or Availability (g/c/d)

Step 2: Calculate Nutrient Contribution After Adjusting for Industrial Processing and Compliance/Quality

  • Nutrient Contribution × Percent Industrially Processed × Percent Compliance

Step 3: Calculate Percent EAR and Percent UL Before Adjusting for Industrial Processing and Compliance/Quality

  • Percent EAR = Nutrient Contribution (from Step 1) ÷ Nutrient-Specific EAR Value for women ≥19 years
    Percent UL = Nutrient Contribution (from Step 1) ÷ Nutrient-Specific UL Value for women ≥19 years

Step 4: Calculate Percent EAR and Percent UL After Adjusting for Industrial Processing and Compliance/Quality

  • Percent EAR = Nutrient Contribution (from Step 2) ÷ Nutrient-Specific EAR Value for women ≥19 years
  • Percent UL = Nutrient Contribution (from Step 2) ÷ Nutrient-Specific UL Value for women ≥19 years

For further details, please refer to Pachón et al 2021.

Data sources
Other resources
Suggested citation

Global Fortification Data Exchange. Map: Potential nutrient intake as a result of fortification. Accessed dd/month/yyyy. [http://www.fortificationdata.org.]