Let’s Stop Judging Food Choices and Start Measuring Status to Find Nutritious Solutions
Fortification of foods is an important source of nutrients for many. There are two approaches to food fortification: 1) mandatory fortification of staples such as folic acid addition to flour, vitamin D addition to milk, and iodization of salt, and 2) voluntary fortification, e.g. ready-to-eat cereals, bars, and beverages.
Dachner and associates examined changes in voluntary fortification of beverages in Canada during two periods of differing federal regulations. Front-of-package labels of 20,520 unique products found in 3 large supermarkets in downtown Toronto were identified between July 2010 and August 2011. Eighty beverage products met their criteria. The most common fortificants were vitamins B6, B12, C and niacin. The lead author is quoted saying, “While our findings suggest that consumers stand to reap little or no benefit from the nutrient additions in novel beverages”. This is an opinion on beverage consumption.
The reality is that all enriched, fortified foods and beverages can contribute to vitamin and mineral intake. To do so in a meaningful manner, they must contain minimal amounts (defined by federal regulatory agencies) of vitamins and minerals per serving. According to Table 2, these beverages meet the criteria. It is subjective to denigrate the relative contribution of different foods and beverages to total nutrient intake. The relative contribution depends upon dietary patterns. Where is the humanity in denying fortified products from many more people who are not consuming the Estimated Average Requirment (EAR) than the minority (<5%) with dietary patterns exceeding the EAR ?
Maybe epidemiology requires populations to be evaluated by the EAR. However, do you want to be the person consuming enough for the average individual (EAR) or the Recommended Daily Allowance (RDA) established to meet the needs of 97.5% of the population? Do you even know your vitamin status?
Finally, the Dachner et al paper demonstrates the challenges of maintaining accurate food databases. The investigators identified 80 beverage products in August 2011. When they returned to purchase products, only 66 were still being sold. Fourteen (17.5%) were no longer available. Three years later, less than half of the original 80 products (or 39 of the 66 examined) were found in store. Only 7 of the 20 products from the original sample were still in supermarkets as of July 2014. In other words, two-thirds of the products were no longer available to consumers. The percentage of original products still available would be lower today.
Products disappear from the marketplace when consumers don’t buy them. Supermarkets, box stores, and other retailers do not stock products which aren’t selling. Manufacturers constantly innovate products to keep them in the market.
Nutrition status cannot be determined from food or beverage choices. People shouldn’t be judged by what they eat. It is time to rely upon biological measures of nutritional status as a criterion of adequacy rather than dietary recall and inaccurate food databases.
Dachner N, Mendelson R, Sacco J, Tarasuk V. An examination of the nutrient content and on-package marketing of novel beverages. 2015 Appl Physiol Nutr Metab doi: 10.1139/apnm-2014-0252
Eicher-Miller HA, Fulgoni VL, Keast DR. Energy and nutrient intakes from processed foods differ by sex, income status, and race/ethnicity of US adults. 2015 JADA doi: 10.1016/.j.jand.2014.11.004
Weaver CM, Dwyer J, Fulgoni III VL, King JC, Leveille GA, MacDonald RS, Ordovas J, Schnakenber D. Processed foods: contributions to nutrition. 2014 AJCN doi: 10.3945/ajcn.114.089284