Would the removal of voluntary iron fortification put vulnerable populations at risk? Modelling the risk of inadequate and excess iron intakes in children in Ireland

Purpose Iron is an essential element for human health with natural sources and fortified foods being the main contributors to intakes. In the context of setting safe maximum levels (SML) in food supplements and fortified foods in the EU, it is necessary to understand the current role of fortified foods in the diet and the potential impact of any regulatory changes. This study used three modelling scenarios to investigate the impact of removing voluntary iron fortification of current iron fortified foods on iron intakes in children. Methods Data were based on the Irish National Children’s Food Survey II. The modelling scenarios included 1. Removal of iron from all fortified foods, 2. Removal of iron from fortified foods excluding ready-to-eat cereals (RTEC) and 3. Removal of iron from fortified RTEC only. Usual intakes of iron, the prevalence of inadequate intakes and risk of excess intakes were examined at baseline and for each scenario for the total population and consumers only. Results Removing the iron fortified component from all iron fortified foods/RTEC only significantly increased the prevalence of inadequate intakes of iron from 20% to 50% with significantly higher proportions of females (55–61%) having inadequate intakes compared to males (37–44%). There was negligible risk of excess iron intake at baseline and no further impact from any of the three scenarios. Conclusion This study showed that removing voluntary iron fortification could carry a significant nutritional risk and should be carefully evaluated to ensure the iron status of vulnerable population groups are not adversely affected.