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Am J Public Health. 2000 May;90(5):727-38.

Effectiveness of food fortification in the United States: the case of pellagra.

Author information

  • 1Food and Drug Administration, Office of Nutritional Products, Labeling, and Dietary Supplements, Washington, DC 20204, USA. ypark@cfsan.fda.gov

Abstract

OBJECTIVES:

We evaluated the possible role of niacin fortification of the US food supply and other concurrent influences in eliminating the nutritional deficiency disease pellagra.

METHODS:

We traced chronological changes in pellagra mortality and morbidity and compared them with the development of federal regulations, state laws, and other national activities pertaining to the fortification of cereal-grain products with niacin and other B vitamins. We also compared these changes with other concurrent changes that would have affected pellagra mortality or morbidity.

RESULTS:

The results show the difficulty of evaluating the effectiveness of a single public health initiative such as food fortification without controlled experimental trials. Nonetheless, the results provide support for the belief that food fortification played a significant role in the elimination of pellagra in the United States.

CONCLUSIONS:

Food fortification that is designed to restore amounts of nutrients lost through grain milling was an effective tool in preventing pellagra, a classical nutritional deficiency disease, during the 1930s and 1940s, when food availability and variety were considerably less than are currently found in the United States.

PMID:
10800421
[PubMed - indexed for MEDLINE]
PMCID:
PMC1446222
Free PMC Article
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