Are we ready for mandatory fortification with vitamin B-12?

摘要

Fortification of food with micronutrients has played an important role in reducing common nutrient deficiencies worldwide, including the use of iodide to prevent goiter, vitamin D to prevent rickets, thiamine to prevent beri-beri, niacin to prevent pellagra, and iron to prevent anemia. These fortification policies have been great successes for public health. Today, when most of the population in developed countries is well-nourished, the authorities face different problems when they consider fortification because 1) the nutritional deficiency is often limited to a subset of the population, and 2) we have to find the right dose of forti-ficant so that it is effective but not toxic. Indeed, some nutrients are not without harm if taken in large doses, eg, several of the minerals, vitamin A, and perhaps folic acid.