The history of food fortification in the United States: Its relevance for current fortification efforts in developing countries

This essay is an attempt to examine the American experiences with food fortification in the context of current food fortification efforts in developing countries. We also attempt to describe the past roles of the food industry, the government, and the professional health organizations in U.S. food fortification programs. This article examines the several major waves of food fortification in the United States: iodization of salt in the 1920s, fortification of milk with vitamin D in the 1930s, enrichment of flour and bread in the 1940s, and the widespread addition of calcium to a variety of products beginning in the 1980s. Throughout the article our focus will be on the social, economic, and political aspects of food fortification, rather than on technical issues. This article does not review fortification experiences globally. The experiences of other developed countries are likely to be different from those in the United States and may offer more or different lessons than what is summarized here, which is based on the U.S. experience.