To Your Health

Why is calcium added to so many foods while other nutrients (like magnesium) aren't?

Q. Why is calcium added to so many foods while other nutrients (like magnesium) aren't? Does the food industry push certain nutrients based on science or on sales?

A. For decades, the Food and Drug Administration has regulated foods and food supplements to ensure that they are safe and wholesome. In 1994 Congress passed the Dietary Supplements Health and Education Act with several provisions that made significant changes in labeling regulations of foods and food supplements.

Although labels still may not claim that the use of a dietary supplement will cure a specific disease, for certain nutrients the manufacturer can now describe the effects of a nutrient on the structure of the body. The first – and for a short time, the only – such claim to be allowed was that increased calcium intake reduces the risk of osteoporosis. With such a head start, the addition of calcium to a great many foods, from orange juice to waffles, was inevitable.

As a result, calcium consumption in the U.S. is higher than it has been in decades, yet we still rank among populations with the highest incidence of osteoporosis. If the politics of nutrition were more sophisticated, health care providers would be encouraged to evaluate the magnesium status of their patients who are at risk for developing osteoporosis before recommending extremely high supplements of calcium alone. The new wisdom now emerging is that magnesium is the key to the body's proper use of calcium, and that calcium supplements above about 1,500 milligrams/day without an awareness of its effect on magnesium can be a problem.

The cost of the added nutrient does not seem to be the determining factor in choosing which to supplement. While there are differences in the cost of various nutrients, fortifying a serving of food with 1,000 milligrams of calcium costs less than one cent. The cost of adding significant amounts of most nutrients is even less. Considering the consumer appeal of fortified food products and the increase in sales that results, adding nutrients to food is a bargain.

Likewise, science is not the greatest influence on choosing which nutrients to add to a food. If it were, folic acid would surely have been the first nutrient to be allowed to make a claim under the DSHEA rules. Folic acid is most easily obtained from fresh fruits and vegetables, and if it were not for fortification of breakfast cereals with folic acid Americans would still be having a tough time getting the recommended amount of folic acid. A label claim linking folic acid deficiency to a reduced risk of neural tube birth defects is now allowed, and, like the addition of calcium, the addition of folic acid to foods is on the rise. Thankfully there seems to be no drawback to adding folic acid as there is with calcium.

There are now 16 authorized label claims associating specific foods and nutrients with health conditions, ranging from soy protein and coronary heart disease to potassium and high blood pressure and stroke. In the future these will also tend to affect the addition of nutrients to foods. The Food and Drug Administration has denied authorization for five other claims, including the connection of omega-3 fatty acids to heart disease.

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