Nutritional quality of voluntarily fortified foods with micronutrients versus non-fortified foods consumed by the Portuguese population

Abstract

Voluntary food fortification is a common strategy to improve micronutrient intake, yet concerns remain regarding its application to foods with poor overall nutritional quality. This study evaluated the nutritional quality of micronutrient-fortified foods (Mn-FF) versus non-fortified foods consumed by the Portuguese population, using data from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016) and the updated Nutri-Score algorithm. A total of 2074 food items were analysed across six categories: cereal bars (n = 103), breakfast cereals (n = 394), cookies and biscuits (n = 485), dairy substitutes (n = 97), plain and flavoured milks (n = 101), and yoghurts (n = 894). Of these, 30.3 % (n = 629) were Mn-FF. Nutri-Score ratings (A to E) were grouped into three classes: [A, B], [C], and [D, E]. Significant associations were found between fortification status and Nutri-Score classification for breakfast cereals (chi(2)=30.02; p < 0.001), cookies and biscuits (chi(2)=99.5; p < 0.001), and yoghurts (chi(2)=17.27; p < 0.001). Fortified breakfast cereals and yoghurts were more frequently classified in less favourable Nutri-Score classes, while fortified cookies and biscuits showed slightly better profiles. No significant differences were observed in other categories. This is the first study in Portugal to evaluate Mn-FF using the updated Nutri-Score. Findings support the need to align fortification practices with public health goals through nutrient profiling regulation.