At the early part of the 20th century, rickets remained one of the most devastating health consequences of the Industrial Revolution. As early as 1822 Sniadecki recommended that children from the inner cities should be exposed to sunlight and encouraged sunbathing as a preventive and treatment strategy.
Milk fortification began in the first half of this century. Vitamin D fortification of milk in the United Kingdom is reported to have begun in 1923; currently, milk fortification with vitamins A and D is practiced on a voluntary basis.
Food fortification programs in the United States started as a means of correcting serious nutritional deficiencies in some portions of the population. Addition of iodine to salt to help prevent goiter, vitamin D to milk to help prevent rickets, and niacin to bread to help prevent pellagra are the best-known examples.
In 1933 the Council on Foods and Nutrition of the AMA (American Medical Association) began to recommend the fortification of milk with vitamin D in an effort to eradicate rickets. The disease — caused by vitamin D deficiency that softens and weakens the bones — was rampant at the time among poor children, particularly in northern U.S. cities. This recommendation was heavily supported by the medical community because of the prevalence of rickets in children.
In 1939, the Food and Nutrition Council of the American Medical Association pronounced the addition of no more than 400 IU of vitamin D per quart of milk, in the interest of public health.
Within a few years after this process of fortifying milk with vitamin D was implemented, rickets was eradicated as a health problem.
Chile introduced iron-fortified milk powder for children over 20 years ago. Today, complementary feeding programs provide powdered milk fortified with vitamin C, iron, copper, and zinc.
Argentina has successfully fortified liquid milk with iron using ferrous sulfate microencapsulated with phospholipids with no deleterious effects on the shelf life or sensory properties of milk.
In the early 1950s, in Great Britain, an outbreak of hypercalcemia in infants were thought to be due to the over fortification of milk with vitamin D. This prompted many countries in Europe forbid fortification of dairy and food products except breakfast cereals and margarine because of an outbreak of vitamin D intoxication in neonates.
History of milk fortification
