The value of food fortification as a public health intervention

Carol Bower, Fiona J Stanley and Mike Daube
Med J Aust 2018; 208 (11): . || doi: 10.5694/mja18.00248
Published online: 18 June 2018

The Editorial by Harvey and Diug1 on the value of food fortification as a public health intervention was prompted by demonstration of the effectiveness of mandatory iodine fortification in reducing iodine deficiency.2 Mandatory fortification of wheat flour for bread making was introduced in Australia at the same time to prevent neural tube defects. Harvey and Diug state that the two are conceptually different, as the former addresses a population iodine deficiency, whereas folic acid fortification is to compensate a presumed genetic defect that cannot be individually recognised, thus raising ethical questions about exposing the many for the benefit of the few. However, this is the case in almost all public health interventions. Using an example of Harvey and Diug, we expose the whole population to the mandatory fortification of flour with thiamine to prevent Wernicke–Korsakoff syndrome, a condition largely confined to people with a chronic alcohol problem.

  • Carol Bower1
  • Fiona J Stanley1,2
  • Mike Daube3

  • 1 Telethon Kids Institute, Perth, WA
  • 2 University of Western Australia, Perth, WA
  • 3 Curtin University, Perth, WA

Competing interests:

No relevant disclosures.


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