The Hard Facts
by Laurie Gorton
“Food fortification should support dietary improvement strategies and not be seen as an alternative,” stated Kantha Shelke, PhD, principal, Corvus Blue, Chicago, IL. Fortifying popular snacks, in her opinion, does not necessarily fulfill the nutritional needs of American consumers and may only result in irresponsible food choices.
She further cautioned, “The reductionist approach of characterizing the relationships of single nutrients and disease appears to be a gross oversimplification of the complex relationship between diet and disease and does not account for food synergies.
“There is a hidden hunger in our society today because of the way we grow our foods and the type of foods we choose to eat,” Dr. Shelke said. “Our bodies yearn for minerals and other nutrients that our current dietary practices do not adequately provide. Fortification of cereal grains may change the quality of our foods but not necessarily how we eat and in the long run may actually further exacerbate our poor diet and lifestyle choices and related health issues.”
The 2010 Dietary Guidelines Advisory Committee considered issues affecting the American diet. Of the 10 shortfall nutrients recognized as “probably tenuous,” only vitamin D, potassium, calcium and fiber were considered to be of public health concern, particularly in light of the emergence of complex health conditions such as atherosclerosis, diabetes, cancer and obesity, each with multiple causes. “These are not deficiency diseases,” Dr. Shelke said, “but ailments growing because of poor food and lifestyle choices in a relatively well-nourished society.”
With master’s degrees in food science and organic chemistry and a doctorate in cereal chemistry, Dr. Shelke founded Corvus Blue LLC, a science and research firm, in 2000. Her previous experience includes senior positions at ACNielsen, Continental Baking Corp. and Grand Metropolitan Food Sector. Her current projects include expediting new product and technology development in food and nutrition. She is a “food science communicator” for the Institute of Food Technologists.
What minerals are most lacking in the American diet?
According to the US Department of Agriculture (USDA) in a January 2009 report, Americans lack iron, calcium, magnesium and potassium in their diet. But the USDA’s Center for Nutrition Policy and Promotion compilation of its Healthy Eating Index for Americans showed that Americans also lack molybdenum, selenium, phosphorus, zinc and chromium — trace minerals that are not provided by highly refined foods.
Americans are seriously lacking in these microminerals, which are only now being understood.
How can whole-grain products help Americans achieve a better profile of mineral consumption?
Grains, appropriately hailed as the “staff of life” for their historical significance in human nutrition and survival, are essential. Period. Grains, in all shapes and sizes and from all parts of the world, are rich in complex carbohydrates, various vitamins and minerals, and are naturally low in fat. When not refined, cereals — popularly known as whole grains — are even better for you. Whole grains are rich in fiber and other important nutrients including selenium, phytosterols, flavonoids and lignans.
Should the enrichment standards for cereal grain products be altered to move calcium from its current status as optional to mandatory inclusion? What’s holding back this change?
Logically, it would seem that if manufacturers are going to continue to ply the marketplace with foods made from refined ingredients, then mandatory fortification of cereal products appears a responsible thing to do.
Federal law already permits calcium and vitamin D fortification of food. Harold L. Newmark of Rutgers University and his colleagues, writing in the August issue of the American Journal of Clinical Nutrition, stated that mandating these nutrients in certain food categories could significantly lower the incidence of colon cancer and of osteoporosis-related fractures — conditions associated in numerous studies with chronically low consumption of calcium and vitamin D, which helps the body use calcium efficiently, in the population that relies on manufactured foods. The researchers estimated an investment of approximately $19 million a year for adding calcium and vitamin D would reportedly spare Americans some $3 billion in direct medical costs from illnesses and injuries resulting from inadequate consumption of calcium and vitamin D.
But our understanding of nutrition is still not where it should be. While we know calcium from our diet is more bioavailable in certain forms and when certain nutrients are present alongside, we also have evidence that adding calcium to our staple foods might do more damage than good. Have our regulators kept up with the exponential increase in our scientific knowledge regarding micronutrients and monitored the effects of the supplement industry pace of calcium influx in our diets?
A longer term and more sensible solution would be educate consumers and the food industry about the benefits of replacing refined ingredients with more wholesome ingredients that are inherently richer in calcium. Such an approach would require considerable investment of efforts and resources, the cost of which may not be affordable, especially with regulators who do not appear as focused on prevention as on cure and an industry focused on margins.
What’s the most difficult aspect of formulating baked foods to include more calcium and/or phosphorus?
The ability to add more calcium was once not easy for bakers, especially as it related to the calcium-to-phosphorus balance that favors bone mineralization. What has changed is the availability today of calcium phosphate and tricalcium phosphate — salts that are excellent sources of calcium and which also maintain a calcium-to-phosphorus ratio ideal for bone mineralization. An added bonus is that ingredient technology has helped create calcium phosphates that are flavorless and not chalky or gritty as they used to be and that do not affect texture or appearance negatively.
What about magnesium? Why is it important?
Magnesium is a calcium enabler for building strong bones and teeth and is essential for physical health and well-being. Magnesium is the fourth most abundant mineral in the body. Half of it is found in bones and the other half is distributed throughout the cells to help maintain numerous metabolic pathways. Having enough body stores of magnesium protects against disorders such as cardiovascular disease and immune dysfunction. Absence or insufficient stores of magnesium can cause, contribute to or aggravate high blood pressure, cardiovascular problems and type 2 diabetes, among other health conditions
What other mineral nutrients might be of concern in the future?
Minerals are needed in small amounts to regulate body functions, aid in growth and maintenance of body tissue and help release energy. There are about 17 essential minerals. If consumed in quantities too small or too large for good health, they cause characteristic signs and symptoms to develop. Minerals go hand in hand with vitamins. So taking just a mineral or vitamin supplement without the other simply defeats the purpose.
The body is nourished by two kinds of minerals: macrominerals and trace minerals. The body needs macrominerals such as calcium, phosphorus, magnesium, sodium, potassium, chloride and sulfur in larger amounts, while it needs just trace amounts of iron, manganese, copper, iodine, zinc, cobalt, fluoride and selenium.
There are several factors to consider:
• Today’s food supply is more mineral deficient than ever before.
• Our continued avoidance of fruits and vegetables, whole grains and milk further exacerbates our risk of inadequate mineral nutrition.
• Formulators do not replenish both macro- and microminerals in our staples, and consumers continue to get inadequate amounts of both in their diets.
Minerals of top concern are:
• Chromium is an essential trace mineral required for normal insulin function.
• Magnesium and zinc are even more crucial to the diabetes and cardiovascular issues affecting so many today. Health organizations are seriously exploring mandatory fortification with magnesium to help prevent deaths related to heart attacks.
• Selenium is becoming increasing relevant with its proven “first in the line of defense” mechanism in the prevention of cancer.
• Strontium is forecasted by many as the next “hot” mineral to gain recognition for its therapeutic benefits and especially for its positive effects in bone health.
What directions will fortification efforts take?
While it is evident that nutritional fortification of cereal foods has been very effective in the past in eliminating widespread nutritional deficiencies, there is a need to re-evaluate FDA’s 1980 Fortification Policy (21 CFR 104.20). It is a different world than it was 25 years ago.
In the end, it will be all about the science and commercial viability. The only minerals and nutrients that will sustain their position in the marketplace and in the realm of what consumers choose to support health will be those with strong roots in medical literature.