Maybe I got it all this morning
Last week, I heard an advertisement for a nutritional supplement on a national radio station.
What caught my attention was the claim that food is not as nutritional as it used to be decades ago.
I doubted this was the case and decided to investigate. Despite technological advances in modern agriculture, are were producing less nutritious food or could it be that we are doing this because of these advances?
When I had a bowl of my favourite cereal this morning, I looked at the nutritional content of the portion, including the added milk.
This simple breakfast served me with 60% of the recommended daily allowance (RDA) of vitamins A, B2, B12 and 30% of vitamins B1, B3, B5, B6 and D.
It also gave me 60% RDA of iron and zinc and 20% calcium and phosphorus.
Legislation on food labelling introduced in SA has made it relatively easy for the consumer to assess the content of nutrients in their food.
Fortification is the act of adding essential micronutrients (vitamins and elements) to food to increase its nutritional content in an attempt to improve public health.
It is estimated that two-billion people worldwide suffer from micronutrient deficiencies, of which most are asymptomatic and undetected.
Several studies in the 1990s showed significant deficiencies in children under the age of six and this culminated in the publication of SA legislation in 2003.
This made fortification of maize and wheat products with eight different micronutrients mandatory.
Because maize and bread is a staple to most low-income households, it was a cost-effective method to improve the health of the most vulnerable. Globally, 85 countries have legislated food fortification.
Folic acid is one of the vitamins included in the fortification programme. It also the one gynaecologists like myself are most interested in.
The link between folic acid deficiency and neural tube defects (NTDs) had been suspected since the 1960s but was only proved in 1991.
These defects are a range of developmental abnormalities of the foetal brain and spine and carry great morbidity and mortality risk. The most commonly known is spina bifida.
The spine fails to fuse properly, leaving the spinal cord exposed to toxins. The child may be born paraplegic with abnormal bladder and bowel function. It is one of the more common indications for foetal (intrauterine) surgery.
The first SA case of this complex surgery was performed in 2019.
Folic acid supplementation decreases the risk of development of NTDs by up to 75%. This research paved the way for the US being the first country to legislate folic acid fortification in cereal in 1998.
But what about fresh produce? Is the carrot my grandfather ate in 1950 more, or less nutritious than the one I buy at the local store today?
A relevant concern is that crops have been selected to achieve the highest yield in the shortest time so that quality may be compromised for quantity.
There is some evidence of a slow decline in nutritional value over the decades but climate change may accelerate this process.
I asked dietician Solandi van Zyl to give her opinion on this topic.
She says there is significant growth in the trend towards organic foods.
Though there is no evidence to show it being more nutritious than conventional produce, it may contain less harmful chemicals and has the ethical advantage of being environmentally friendly.
There is often limited availability of organic foods in the market and reverting to its import or storage can be counterproductive because this decreases its nutritional value.
Solandi advises the focus to be on freshness and variety. She says SA-sourced fresh produce is the way to assure this.
There is no need to be afraid of buying at large retailers as long as they can assure good packaging and the cold chain.
For the public, the price will a always remain a factor.
In the end, it is the diet that has significantly changed over the decades, more so than the food that is available for consumption. In the past, labelling was minimal with little legislation involved.
Standards of safety and quality control have also improved. You can now actively take control of your nutritional intake.
Read the labels, eat fresh and eat a variety of foods. This holistic approach will ensure a better and healthier diet than your ancestors.
Maybe we just need a fresh, local and organic apple to keep the doctor away.
• Dr T is a registered medical practitioner in Nelson Mandela Bay
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