Fortified foods: Too much of a good thing?

Remember when your morning OJ was just a simple glass of juice? Today it could be a nutritional cocktail, with added antioxidants, calcium, folic acid -- even fish oil to help you get your omega 3s. The same goes for dairy products, eggs, breads, cereals and most other packaged foods. All this fortifying must provide health benefits, right? While that might be true for some people, for others, fortified foods may offer too much of a good thing.

Fortifying food isn't new -- in the 1930s we added vitamin D to milk to prevent rickets, the bone-softening disease, and since the 1920s, salt has been fortified with the mineral iodine, which prevents the development of goitres. But whether or not you choose foods with specific added ingredients should depend on your personal nutritional needs.

Women need more calcium
For women of all ages, especially postmenopausal women concerned about calcium, opting for cow's milk with added calcium can be a smart move. Do you prefer rice milk beverages? Those fortified with calcium, zinc, vitamins A and D, and some B vitamins including B12 offer nutrient levels comparable to those of cow's milk.

Iron, another nutrient often used in fortified food, can be beneficial in many ways. An iron-fortified cereal can assist in meeting your increased iron needs if you're pregnant, nursing or have heavy periods. However, high iron stores could be harmful in the case of postmenopausal women. The iron may act as pro-oxidants, substances that may speed up oxidation, which can damage tissues, including your arteries, and boost your risk of developing heart disease and certain cancers.

More folic acid for pregnant women
Folic acid, a B vitamin, is another critical nutrient for pregnant women. Research shows that consuming adequate amounts prior to becoming pregnant significantly decreases the risk of having a baby with neural tube defects such as spina bifida. Consequently, the federal government requires that all white flour products be fortified with folic acid.

Click to continue for details on how traditionally non-nutritional foods are being pumped up...

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The program seems to be working -- the incidence of these types of birth defects is dropping. But scientists at Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University have uncovered a potential dark side to folic acid fortification -- there's been a slight increase in the risk of colon cancer since the fortification of flour began. This is even more of a concern since some food companies are now going beyond white flour and fortifying whole grain breads and pastas with folic acid.

"Healthy" cola drinks and meal replacements
Lately, companies have begun adding nutrients to low-nutritional-value foods and beverages; for example, a new diet cola contains added zinc and B vitamins, including niacin and B6. While it isn't much zinc, if you sip it with a few servings of other zinc-fortified foods, and then take a multivitamin and mineral supplement, you could be getting an excess of zinc. And while too little can lead to poor immune system function, too much zinc can do the same. Why not get it from foods naturally offering a bounty of other nutrients, such as legumes, whole grains, dairy products or nuts?

Be careful if you regularly consume food products labelled "meal replacements." They can be fortified at much higher levels, again possibly boosting certain nutrients to undesirable levels. One meal replacement cereal, for instance, contains almost 40 per cent of the daily value (DV) of folate and almost 50 per cent of the DV for zinc in just one serving. Pour yourself a heaping bowl and you could be beyond your daily quota of these nutrients.

A better calcium
It turns out that not all forms of added calcium are equally well absorbed. A study published in the Journal of the American Dietetic Association showed that calcium citrate malate was better absorbed than added tricalcium phosphate/calcium lactate.

Check the ingredients list to see which form your juice contains. Does
drinking a lot of fortified orange juice boost your risk of developing kidney stones? Before these juices hit store shelves, scientific research found that they do not.

Click to continue to learn how folic acid can offer a defence against cancer...

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You say folic acid, I say folate
Folic acid is the synthetic form of the B vitamin folate, which is naturally found in foods such as dark leafy greens, citrus fruits, legumes and nuts, such as peanuts. In its natural form, folate can be lost through cooking and exposure to heat, while folic acid is the more stable form used for fortifying foods or in supplements.

Both forms seem to offer a defence against some cancers, including colon cancer and breast cancer, especially in women who consume alcohol. A shortfall of folate or folic acid is linked to a higher risk of colon cancer, but too much of the latter, the synthetic form, may also boost the risk. It's possible that large amounts of folic acid may be a growth factor in precancerous or cancerous cells. It's also possible that the excess may enhance the transformation of benign growths into cancers, or of small cancers into larger ones. Too much folic acid can also mask a deficiency of vitamin B12.

Folic acid will be on the ingredients list if the synthetic form is used to fortify foods. Note that the daily recommended intake of folic acid is 400 mcg (0.4 milligrams), the amount found in some multivitamins. The maximum safe amount from fortified foods and supplements is 1,000 mcg (1 milligram) per day.

Rosie Schwartz, RD, is a Toronto-based consulting dietitian.

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This article was first printed in the October 2008 issue of Homemakers Magazine. Click to subscribe online and never miss an issue.

Find more of Rosie's health advice in our Health & Fitness section.

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