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Arguments against enriched flour from physicians, nutritionists, and health workers have evolved since the practice began, focusing on the loss of nutrients during refinement and potential negative health impacts.
Early Concerns (1940s-1970s)
1940s: Debate Over Effectiveness: When enrichment was introduced to combat diseases like pellagra and beriberi, some health professionals debated its long-term necessity versus a focus on whole foods. A 1945 New York Times article reported nutritionists debating the value of enrichment of bread, with some arguing against state legislation mandating it.
1960s: Over-Fortification Fears: In the 1960s, as fortification became more widespread, the FDA and some health professionals raised concerns about potential over-consumption of added nutrients. The FDA proposed regulations to limit fortification to only essential nutrients.
1970s: The Ultra-Processed Food Movement: Concerns over highly processed, refined foods (including enriched flour products) were part of the holistic and environmental health movements of the 1970s–80s. Nutrition advocates raising these concerns were often labeled as "food faddists". 
Modern Arguments (1990s-Present)
Modern health arguments against enriched flour focus less on deficiency diseases and more on chronic health conditions:
Nutrient Stripping: The primary argument is that processing removes valuable components like fiber, antioxidants, and phytonutrients (such as zinc, magnesium, and selenium) that are not added back in the enrichment process.
High Glycemic Index: Physicians and nutritionists argue that enriched white flour, which is mostly starch, is rapidly digested and absorbed, causing spikes in blood sugar and insulin levels. Over time, these spikes are linked to an increased risk of obesity, type 2 diabetes, and cardiovascular disease.
Synthetic vs. Natural Nutrients: Some health professionals contend that the synthetic forms of vitamins and minerals added during enrichment do not absorb as well or act the same way in the body as naturally occurring nutrients in whole grains. For example, the type of iron added is often metallic iron, which is less bioavailable.
Potential Harm from Additives/Levels: Concerns have been raised about potential by-products from bleaching processes (like alloxan) and the high levels of some added nutrients. For instance, high levels of added iron have been linked to increased risk of diabetes and heart problems in certain individuals. 
In summary, the health argument has shifted from "enriched flour is not as good as whole flour" to "enriched flour is a refined carbohydrate that actively contributes to modern chronic health issues."