In our tough economy, my patients frequently ask me how they can keep their nutrition up and their food costs down especially when it seems that the healthiest foods are the most expensive. They ask me about including fortified foods in their diet as a way of getting the most nutritional bang for their dwindling food bucks. Like my patients, you may wonder about the value of adding fortified foods to your diet. Allow me to explain and give you some recommendations and cautions about adding fortified foods to your diet.
What Are Fortified Foods?
When food is manufactured, many of their natural nutrients are stripped in the process. At the end of the refining process, these lost nutrients are added back in and the food is then labeled as enriched.
Fortified foods, on the other hand, are foods that have vitamins, minerals, fiber, and antioxidants, added to them that they don’t naturally contain. For example, most orange juice manufacturers now fortify their product with calcium. Calcium does not naturally occur in oranges or orange juice. Buying calcium fortified orange juice allows you to not only get Vitamin C but extra calcium. This can be beneficial for people who cannot, or do not wish to, drink milk.
Here are some other examples of fortified foods that are available:
- Cow’s Milk – fortified with Vitamins A and D and folic acid. Vitamin D helps your body absorb the calcium in milk, vitamin A helps keep eyesight and hearing healthy, while folic acid keeps homocysteine levels normal to prevent heart attacks as well as birth defects.
- Sterols and stanols – these are plant substances that help lower cholesterol. They are now added to many foods such as yogurt, chocolate, cheese, margarine, orange juice, to up the capacity of these foods to lower cholesterol.
- Cereals – many cereals, hot and cold varieties, are now fortified with an array of vitamins including vitamin D, B12, foliate and zinc. Many of these cereals tout the minimum daily requirement of all vitamins in one serving. Combine a bowl of one of these cereals with fortified milk and a cup of fortified orange juice and you’ve already consumed a good amount of vitamins and minerals. Choose the lowest sugar varieties however, such as no sugar added bran and whole grain cereals.
- Plant Milks – soy, rice, and almond milks are often fortified with calcium and B12. Soy milk has up to 50% the minimum daily requirement of B12 while rice and almond milks are about 25%.
- Vegetarian “Meat” – these include veggie burgers and sausages. They are often fortified with vitamin B12 which usually is sorely lacking in the vegetarian diet.
- Meal replacement shakes – these are typically milk shake–like products that contain protein, vitamins, minerals and antioxidants. These can be helpful for both busy people who might otherwise skip breakfast or lunch, or to ensure nutrition when someone’s regular food intake is decreased from illness or dental problems.
A Few Warnings About Fortified Foods
Most Americans don’t get enough vitamin B12, folate, calcium, vitamin D and antioxidants in their diets. Although some cereals claim to have the full minimum daily requirement of vitamins in one serving, most fortified foods have only a small percentage of other vitamins added to them. We also don’t know how much manufacturers’ claims of nutrients contained in these products is accurate. With the exception of iron and vitamin K, there is not real danger of getting too much of other vitamins and minerals, even if you take a daily multivitamin as well. That said, here are some things to consider:
Iron: Be sure that you are not getting too much iron from the fortified foods you eat. Adults only need about 15-18 mg of iron a day, menstruating women slightly more. Once in menopause, a woman’s need for iron falls back to about 15 mg. Too much iron in your blood can result in high homocysteine levels and risk for heart problems. Too high iron can also cause depression. If you regularly eat fortified cereals that have the MDR of iron in them, be sure the multivitamin you take does not contain iron and not to consume a lot of other iron-rich foods.
Vitamin K: If you take Coumadin, or other blood thinners, you will want to check the label of the fortified foods for vitamin K. If they contain vitamin K, check with your doctor, or your pharmacist, about what percentage of the vitamin is safe for you to consume, if any, as it could cancel out the effect of your medication.
Calcium: If you take thyroid replacement for hypothyroidism (low thyroid), be sure not to eat any calcium-fortified foods within 3-4 hours of taking your medication as the calcium prevents the absorption of thyroid medication.
Antibiotics: The effectiveness of the quinolone family of antibiotics are also decreased sometimes up to 90% by the minerals, calcium, magnesium, zinc, and aluminum. If you have to take these types of antibiotics, be sure to take them separate from any fortified foods containing these minerals. Ask your pharmacist or doctor how far apart you should separate the two.
With any medication, be sure to read the pharmacy insert that should list food and drug interactions with your medication. If in doubt about any possible drug/vitamin/mineral interactions with the fortified foods that you eat, please consult your pharmacist or doctor.
In general, though, I see no harm in adding a fortified cereal and orange juice to your breakfast, or meal replacement throughout your day. Just be sure to make your fortified food choices wisely to both benefit your nutrition and keep you healthy!