The 'Clean' Label Trap

On most packages of all-purpose flour in the United States, you'll see vitamins and minerals listed among the ingredients. We call that "enriched," since these nutrients were lost when the wheat was processed into white flour and then added back in again.

[Read: 5 Food Labels Items You Need to Start Reading.]

But apparently, that process isn't a give-in anymore. During my recent visit to Natural Products Expo West in Anaheim, California, I learned about a new trend -- white wheat flour that is unenriched. What's that all about, I wondered, and is it a good thing?

From Fortification to Enrichment: a Brief History

Back in the early 1800s, many Americans suffered from nutrient deficiencies. But in the 1900s, food manufacturers began fortifying foods using a new technology in order to help prevent these gaps in Americans' diets. (Fortification, as opposed to enrichment, is when vitamins or minerals are added to a food that never contained those nutrients to begin with.) For example, in the early 1920s, salt was fortified with iodine to prevent goiter, a swelling of the neck resulting from a thyroid gland enlargement (remember that Seinfeld episode?). Subsequently, vitamin D was fortified into milk to prevent rickets, which is when children's bones soften and cause bowed legs and knocked knees. Bread and flour, meanwhile, started getting boosts of B vitamins (including thiamin and niacin) and iron in the early 1940s, due to the prevalence of deficiencies of these nutrients that had led to about 7,000 deaths in 1928.

Fast-forward to the 1980s and 1990s, during which fortified and enriched products were all the rage. Take calcium-fortified orange juice, for example. Consumers were literally eating up fortified products because they felt they were getting a better-for-you product filled with more nutrition. In many cases, they were right.

[See: 7 Ways to Get Calcium Beyond Milk.]

The 'Clean Eating' Revolution

Today, consumers want "clean" labels -- or those with "non-science-sounding ingredients they recognize" because they feel such products are more healthful, Francine Rivera, senior brand manager at Arrowhead Mills, an organic baking company that now makes products with unenriched flour in addition to its enriched products, told me. "We also recognize that natural and non-GMO claims appeal to many millennial shoppers, who are seeking more wholesome ingredients," she said.

But Cynthia Harriman, director of food and nutrition strategies at Oldways, a food and nutrition education nonprofit, says that words like "organic," "unbleached" and "unenriched" can mislead consumers, who may think the product is healthier than it actually is. Any flour that is refined rather than whole, as white flour -- whether or not it's enriched -- is, is made without its original bran and germ, she points out. In other words, it's missing half to two-thirds of its original nutrients.

"If you care about your own health enough to eat organic -- or any other 'clean' label issues -- why not choose whole grains?" Harriman asks. "And, if you care enough about the health of the planet to eat organic, why choose products whose manufacture requires discarding 30 percent of the original grain kernel?"

What's more, there's concern that the trend of eating unenriched flour and bread might lead to a repeat of deficiencies, as seen in the early 1900s. That worry is why, in 1998, the U.S. mandated folic acid be added to enriched grains or flours. A folate deficiency in a pregnant woman can lead to neural tube disorders like spina bifida in babies, which results in brain and spinal cord malformation.

What's a Flour Lover to Do?

The U.S. Food and Drug Administration requires manufacturers to label enriched foods as such, so you'll know whether your flour, for example, is enriched. But while "unenriched" flour may be labeled as such to appeal to consumers looking for a clean label, it may also appear as simply "flour." Whether you agree with Harriman or Rivera -- who says Arrowhead Mills, which also makes products rich in whole grains, doesn't advocate only eating unenriched flour, but feels you can make it part of a well-balanced and nutritious diet -- don't assume unenriched flour is your healthiest option just because the vitamins and minerals aren't listed.

[Read: Are Processed Foods Getting a Bad Rap?]

Further, if you are pregnant or planning on becoming pregnant, choosing unenriched flour can be detrimental if you don't get folic acid from other sources. If you do choose to eat unenriched flour, still try to make at least half your grains whole -- what the 2015 Dietary Guidelines for Americans recommends.

Toby Amidor, MS, RD, CDN, is the owner of Toby Amidor Nutrition and author of the cookbook, "The Greek Yogurt Kitchen: More Than 130 Delicious, Healthy Recipes for Every Meal of the Day" (Grand Central Publishing 2014). She consults and writes for various organizations, including FoodNetwork.com's "Healthy Eats" blog and "Today's Dietitian" magazine.