Pumped-Up Products : More Foods Are Touting Health Benefits; How Do Their Claims Stack Up?

Right there on the box, Quaker claims its oatmeal can help reduce cholesterol. But can one bowl a day do the trick?

Citrus Hill Plus Calcium says its fortified orange juice has a “special delivery system” to increase absorption of calcium. But is such a system necessary?

General Mills says its Total cereal provides 100% of the U.S. Recommended Daily Allowance of iron. But is extra iron really healthy for everyone?

Sorting Myth From Reality

The more companies tout the health benefits of their products, the harder it gets to sort dietary myth from reality. Three of the hottest commodities in today’s packaged food market are water-soluble fiber (such as oat bran), calcium and iron. Some manufacturers are pushing one or more of these nutrients in their advertising, suggesting their products may be the easy route to improved health.

The claims are based on research studies that suggest pumping up the intake of certain nutrients--and minimizing others--may prevent or delay certain diseases. But there are conflicting conclusions and experts don’t always agree on the practical implications. In its guidelines, the Food and Drug Administration calls for the “rational addition of nutrients to foods” but has no mandatory requirements.

Here is a guide to some of the claims on grocery shelves right now and some of the research that supports or undercuts them.

Soluble Fiber

Not long after researchers began finding that oat bran could reduce blood cholesterol in some cases, cereal advertising changed dramatically.

An “excellent source of oat bran,” reads the Cheerios box. Quaker Oats is even more specific: “Recent medical studies show that eating 2 ounces of Quaker Oats every day as part of a diet low in cholesterol and fat can lower an average adult’s level of blood cholesterol, and reducing cholesterol is one way to reduce their risk of heart disease.”

Meanwhile, Cracklin’ Oat Bran is described as “more than just a great-tasting cereal.” The oat bran and wheat bran, reminds the box, “might be important to you tomorrow.”

Somewhat more subtle is the label on Oatmeal Goodness Bread, made by Continental Baking Co., which poses the question “Do You Want to Reduce Cholesterol?” and claims three slices contain the same amount of oat bran as an ounce of oatmeal.

Experts generally agree that whether oat bran and other water-soluble fibers actually lower cholesterol depends on a number of factors: how much you eat, the nutritional value of other ingredients in the product and what you eat the rest of the day.

The seeds of today’s “oat bran mania” were planted more than a decade ago when Dr. James Anderson of the University of Kentucky College of Medicine noticed among diabetics on high-fiber, low-fat diets, blood cholesterol levels fell dramatically, sometimes by 30%. Suspecting fiber was the key, he studied oat bran intake in non-diabetics and again found dramatic reductions in cholesterol levels.

Reporting on another study published earlier this year in the Archives of Internal Medicine, Anderson wrote that fiber supplements can be as effective as some cholesterol-lowering drugs.

In an eight-week study of 28 subjects, he found a fiber supplement reduced blood cholesterol by 15% while a placebo had no effect. Fiber delivers a “double whammy” by increasing cholesterol loss from the body as well as slowing down its manufacture, concluded Anderson, a professor of medicine and clinical nutrition.

Contradictory Research

But in research that is somewhat contradictory, Linda Van Horn, assistant professor of community health and preventive medicine at Northwestern University Medical School in Chicago, found that the average person needs to eat 35 grams, or about 2/3 of a cup, of oat bran or oatmeal every day to lower cholesterol by 3%.

For consumers tired of oats, there’s other promising news about fiber. Citrus pectin, like that found in grapefruit, as well as certain other foods can lower cholesterol, too, according to Dr. James J. Cerda, professor and associate chairman of the department of medicine at the University of Florida, Gainesville.

In a study of 27 subjects, Cerda found that 15 grams of grapefruit pectin, taken daily in the form of 27 capsules, lowered total blood cholesterol an average of 7.6% and low-density lipoproteins, so-called “bad” cholesterol, by 10.8%.

“I have no idea how many grapefruit that is,” said Cerda, who published his findings earlier this year in the journal Clinical Cardiology. “But the next step is to figure out a way to add more pectin to the diet.” One possibility, he notes, might be to “spray” pectin on oat bran flakes or other foods before packaging.

Carrots may be yet another cholesterol-lowering option, says Peter Hoagland, a research chemist at the Eastern Regional Research Center of the U.S. Department of Agriculture in Philadelphia. Isolating fiber from carrots in the lab, he found it binds with bile acids and may help remove cholesterol from the body as researchers believe the soluble fiber in oat bran does.

Practical Implications

As for the practical implications of fiber research: Anderson recommends 50 grams (about 3/4 cup) of dry oat bran every day to produce a 20% drop in low-density lipoproteins, so-called “bad” cholesterol, and a 15% drop in total cholesterol. The same amount of oatmeal will produce a smaller drop, he believes. Those with moderately high cholesterol levels will have the greatest drops, he predicts. (A cholesterol level of 200 milligrams per deciliter or less is generally considered desirable.)

However, Van Horn says those with near-normal cholesterol levels should not expect dramatic drops from eating oat bran. Rather than recommending a specific oat bran intake, she advises a “total diet” approach to cholesterol reduction. “Evaluate your entire eating pattern,” she says, noting the importance of cutting down on saturated fats to reduce cholesterol.

“Just because something has oat bran in it does not mean it’s going to lower cholesterol dramatically,” concurs Molly Gee, chief dietitian at Houston’s Institute for Preventive Medicine at the Methodist Hospital and a spokeswoman for the American Dietetic Assn.

Weigh the bad ingredients along with the good, says Bonnie Liebman, director of nutrition for the Center for Science in the Public Interest in Washington. A case in point: Kellogg’s Cracklin’ Oat Bran Cereal, which also contains coconut oil, a highly saturated fat. “That could cancel out the cholesterol decrease you get from the bran,” she says, acknowledging it’s difficult to determine if that is the case.

Says Anderson: “I’m not alarmed about the amount of saturated oil in Cracklin’ Oat Bran.”

Kellogg spokeswoman Marie Kitlas points out the company is now studying ways to omit coconut oil from Cracklin’ Oat Bran, which currently has 3.7 grams of saturated fat per 1/2 cup serving.

‘Not an Exact Science’

Predicting how much oat bran it takes to lower cholesterol is “not an exact science,” Liebman adds. To take in 35 grams of oat bran per day, which some experts recommend, consumers must eat about 1/2 cup of oat bran cereal, eight oat bran cookies or 10 oat bran animal crackers, according to the center’s Nutrition Action Healthletter.

Dried beans and peas--including pinto, kidney, navy, and black beans, chick-peas, split peas and lentils--are also rich in soluble fiber, Liebman adds. “We estimate that a half-cup of cooked beans or peas will lower cholesterol the same 3% as a bowl of oat bran.”

Even after adding soluble fiber to your diet, don’t “assume you’ve taken care of the cholesterol problem,” she warns.

One other caveat from the experts: All fiber is not created equal when it comes to lowering cholesterol. While soluble fibers, like oats, may lower cholesterol, wheat fiber is mostly insoluble and valuable primarily as a source of bulk to promote regularity.

Calcium

Ounce for ounce, Minute Maid’s calcium-fortified orange juice claims to have “as much calcium as milk.”

Citrus Hill Plus Calcium orange juice mixes citric and malic acids with its calcium, increasing its absorption, company researcher Thomas Gougeon says.

Total Cereal is promoted as an “excellent source of calcium . “

And one cup of Gold Medal flour with calcium provides 20% of the daily total U.S. Recommended Daily Allowance (RDA) of 1,000 milligrams.

Scientists have long known that calcium is important for bone growth, blood coagulation and proper functioning of muscles, nerves and the heart. Recent studies have focused on its importance in warding off osteoporosis, the “brittle bone” disease of old age, and in reducing the risk of colon cancer.

A study of 957 men and women, conducted by UC San Diego researchers, found that increased dietary calcium intake seemed to protect the subjects against hip fracture.

Another study, published this month in the Journal of the American Medical Assn., concluded that women with high levels of the hormone estrone and high calcium levels had greater bone density than women with less calcium and/or estrone. The researchers, from the University of Pittsburgh, Wayne State University and East Carolina School of Medicine, suggest that a lifetime of adequate calcium intake plus sufficient estrone levels are vital for maximizing bone density after menopause. Consistent intake from birth may also be one key to preventing osteoporosis, they added.

Calcium may reduce the risk of colon cancer as well, says Michael J. Wargovich, professor of cell biology at the University of Texas M.D. Anderson Cancer Center in Houston, who published a paper on the subject earlier this year in the Journal of the American College of Nutrition. “Calcium could be an antidote to combating fat in the diet (believed a risk factor for colon cancer),” he wrote, and might also help prevent the conversion of normal cells to cancer cells.

Research Too Sketchy

Meanwhile, others say research is still too sketchy to warrant raising the RDA of 1,000 milligrams, about the amount found in three cups of milk.

On the other hand, Liebman of the Center for Science in the Public Interest, for one, has “no major concerns” about calcium-fortified products. “Getting (calcium) from fortified food is probably as good as getting it from a supplement,” she says.

But Wayne R. Bidlack, assistant professor of pharmacology and nutrition at the USC School of Medicine, worries that “calcium-fortified” products may be be seen as panaceas. While mixing calcium with acids “probably does increase absorption by making the calcium more membrane-permeable,” Bidlack adds, he “would rather see kids drinking milk instead of (only) calcium-fortified orange juice.” Milk, he points out, has other important substances such as riboflavin, essential for tissue repair, and Vitamin D, important for normal skeleton growth.

“Probably up to 1,500 milligrams a day (of calcium) has no health risk,” he adds, noting “you have to work pretty hard to take in that much via food.”

Those at risk for kidney stones should also be wary of too much calcium, doctors caution.

Iron

Total says it provides “100% of the U.S. RDA of iron.”

Kellogg’s Bran Flakes promises the same. The manufacturer claims half the U.S. population doesn’t get enough.

Iron is an essential nutrient, vital to biological processes such as the transport of oxygen in the body. Women especially have been advised to consume sufficient iron, especially during childbearing years.

But excess iron stores in the body may increase the risk of certain cancers, at least in men, new research suggests.

And other scientists say such stores may also increase the likelihood of bacterial infections.

The higher the iron stores, the higher the incidence of certain cancers, found a study published earlier this year in the New England Journal of Medicine. “Iron may increase the risk of some cancer sites and not others,” wrote Richard G. Stevens, a researcher at Battelle, Pacific Northwest Laboratories, a government-funded private laboratory which conducted the study with the National Cancer Institute.

“Cancers of the colon, bladder, and esophagus appeared to be strongly related, and cancer of the lung also appeared to be related to iron status,” Stevens and his co-researchers found. Cancer of the stomach did not.

A Word of Caution

“It’s only one study and it doesn’t mean it’s true,” cautioned Stevens, pointing out the study examined the effects of high natural iron stores, not those resulting from iron-fortified foods.

Exactly how the high iron stores may increase the chances of cancer isn’t known, but researchers speculate the excess iron may catalyze production of “oxygen radicals,” substances which may lead to cancer, or that excess iron may increase the chance that cancer cells will survive and flourish.

High iron stores may also increase the chances of bacterial infections, said Stevens and Kenneth Lee, an associate professor of food science at the University of Wisconsin, Madison. Bacteria may use iron as “food,” Lee explained.

At Fox Chase Cancer Center in Philadelphia, epidemiologist Katherine McGlynn is studying 10,000 male blood donors to determine if those who have routinely given blood (and therefore tend to have lower body iron stores) have a lower-than-normal incidence of cancer. Results are expected by mid-1989.

The current RDA for iron is 18 milligrams a day--about that in two servings of some bran flakes. A half-cup of canned spinach provides 10% of the recommended iron; a 4-ounce serving of raw spinach 15%.

“Don’t assume you need (supplemental) iron,” Liebman advises. “Too much iron may be dangerous for some people.”

Several nutritionists recommend discussing with your doctor the feasibility of having iron levels tested.

In general, they agree, men don’t need extra iron. “Iron-fortified cereal might be fine for mom and the kids but not for dad, “ says Gretchen Newmark, a Santa Monica registered dietitian.

“Iron supplementation for those who are not anemic may be unwise,” Stevens adds. “If elevated iron stores increase the long-term risk of cancer, and if iron intake affects iron stores, then the policy of iron fortification of food should be reconsidered.”

The Products Oat Bran Advertising Claims “Recent medical studies show that eating 2 ounces of Quaker Oats every day as part of a diet low in cholesterol and fat can lower an average adult’s level of blood cholesterol, and reducing cholesterol is one way to reduce their risk of heart diseasse.”

Cracklin’ Oat Bran calls itself “more than just a great-tasting cereal” and explains that the oat bran and wheat bran in the cereal “might be important to you tomorrow.”

The Cheerios label now says the cereal is an “excellent source of oat bran.”

Experts Say Whether oat bran and other soluble fibers actually lower cholesterol depends on a number of factors, including what you eat the rest of the day. Studies have shwon that oat bran can reduce total blood cholesterol and low-density lipoproteins, so-called “bad” cholesterol, and thus reduce the risk of heart disease. But one study found that the average person needs to eat two-thirds of a cup of oat bran or oatmeal every day to lower cholesterol by just 3%. One pitfall of some oat-bran products is that they include undesirable ingredients such as saturated oils. Iron Advertising Claims Kellogg’s Bran Flakes notes on its box that half the population doesn’t get enough iron. A 1-ounce serving of Total cereal promises 100% of the recommended daily allowance of iron. Experts Say Iron is an essential nutrient, and women have been advised to consume sufficient amounts of it, especially during child-bearing years. But don’t assume you need extra iron, particularly if you are male. Stores of high body iron in men were associated in one study with increased cancer risks. And excess iron may also increase the chances of bacterial infections. Two servings of some bran flakes--and one of Total--provide the current recommended daily allowance for iron. Raw spinach, by comparison, provides only 15% Calcium Advertising Claims Minute Maid says its calcium-fortified orange juice has as much calcium as milk. Citrus Hill Plus Calcium orange juice promotes a “special-delivery system” for calcium. Gold Medal claims one cup of its calcium-fortified flour supplies 20% of the recommended daily allowance of calcium. Experts Say A steady lifetime intake of calcium seems important. It may help ward off osteoporosis, the “brittle bone” disease of old age, according to several studies. It may also help reduce the risk of colon cancer. The federal recommended daily allowance of calcium is 1,000 milligrams or about the amount found in 3 cups of milk. One cup of Gold Medal flour delivers about 20% of the total, and Minute Maid’s orange juice matches milk’s calcium, ounce for ounce.