Originally, the intention behind adding vitamins and minerals to everyday foods - such as breakfast cereals - was to protect children's health. But has the pendulum swung too far the other way? Are we now in danger of harming children? A new report from the Environmental Working Group in the US says we should be concerned that American children may be consuming too many vitamins and minerals.
One reason the report gives is that the explosion in fortified foods, paired with inadequate government policies, means that many children in the US are now consuming too many vitamins and minerals.
Vitamins and minerals are essential for good health, and for many children, exceeding the required amount is unlikely to cause harm. But for some, there is a narrow band between an optimum level that benefits health and an excessive level that can cause harm. Unlike adults, whose bodies are much larger, children are more vulnerable to overdosing.
Too much vitamin A, zinc and niacin
Citing several government and academic sources, the Environmental Working Group (EWG) report summarizes how millions of American children under the age of 8 are getting too much vitamin A, zinc and niacin from fortified foods and supplements.
Too much vitamin A can result in short-term health problems, such as brittle nails and hair loss, and long-term problems including liver damage and skeletal abnormalities. In pregnant women, it can cause developmental abnormalities in the fetus, and in older adults it can lead to hip fractures.
An excess of zinc can stop the body absorbing copper properly and result in anemia, changes in red and white blood cells and impaired immune function, while too much niacin or vitamin B3 can cause rashes and other skin reactions, nausea and liver toxicity.
The EWG report shows that two types of processed foods - breakfast cereals and snack bars - are often fortified with vitamin A, zinc and niacin in amounts that exceed children's daily needs. In some cases, the amounts exceed the limit that the Institute of Medicine (IOM) - a branch of the National Academy of Sciences - considers safe for children.
The EWG report concludes that an important reason American children are ingesting too many of these vitamins in their food is because the Food and Drug Administration (FDA) guidelines on what food companies should show on the nutrition facts label - the percent Daily Values - are inadequate.
Food labels 'should be updated to reflect children's Daily Values'
The FDA's percent Daily Values shown on food nutrition labels are for adults and are higher than the maximum levels the IOM deem safe for children. Even products made for children only show percent Daily Values calculated for adults.
The EWG report states that: "Fortified breakfast cereals are the number one source of added vitamin A, zinc and niacin in children's diets." In the report there is a table listing 23 cereals with the highest added doses, where a "child age 8 or younger eating a single serving of any them would exceed IOM's safe level."
While the vast majority of the cereals in the Top 23 list are not specifically aimed at children, they do contain popular and well-known national brands, such as Kellogg's and General Mills and store brands, such as Food Lion, Safeway and Stop & Shop.
The EWG report also lists 27 snack bars containing more than 50% of the IOM's recommended daily value of a vitamin or mineral and over 100 cereals containing 33% or more.
The report suggests three other reasons for why children in the US are consuming levels of vitamins and minerals that exceed a safe maximum:
- Food companies are using high fortification levels to market their goods to consumers who - impressed by the high vitamin content - believe they are doing the right thing buying these foods for their families.
- Food serving sizes listed on breakfast cereals and other products are much smaller than people are likely to give to their kids, who end up consuming more added sugars, vitamins and minerals than the label suggests.
- The FDA guidelines on voluntary food supplementation do not take into account current scientific evidence - the last update was 34 years ago.
The EWG report recommends that until the FDA makes the Daily Values on food labels reflect up-to-date science and show values for children, parents should limit their children's intake of fortified food to no more than 20-25% of the adult Daily Value for vitamin A, zinc and niacin.
Consumers 'should educate themselves about vitamins and minerals'
Another recommendation is that consumers should educate themselves about nutrients, and vitamin A in particular.
For example, there are several forms of vitamin A and the danger of exposure applies to what is known as "preformed" vitamin A and not vitamin A precursors - such as carotenoids - that occur in naturally high levels in certain foods including carrots and pumpkins.
Preformed vitamin A is sometimes listed on nutrition labels as retinyl palmitate, retinyl acetate, vitamin A palmitate, vitamin A acetate or retinol.
The report also suggests older adults and pregnant women monitor their intake of foods fortified with vitamin A, especially if they are also taking a daily vitamin tablet.
In December 2013, Medical News Today reported how medical experts concluded that 'multivitamins are a waste of money.' They said routine use of vitamin and mineral supplements was not justified and should be avoided, noting that this was especially true for the general population with no clear evidence of micronutrient deficiencies.