Calcium craze, Take 2. On the heels of a booming calcium-supplement business comes another marketing trend aimed at capturing the calcium-conscious. Only this time Mother Nature isn't ending up in a pill. This time it's food that's getting the calcium boost.
It's still a trickle, but if marketers keep up the competitive pace, we might someday have as many foods enriched with calcium as we do with iron or vitamins A and D.
Government statistics have repeatedly indicated that the majority of Americans -- particularly women -- do not get enough calcium. Setting the wheels in motion was a 1984 National Institutes of Health Consensus Development Conference on Osteoporosis at which it was recommended that certain segments of the population should get more calcium -- even more than the current 800-milligrams-a-day recommended daily allowance -- in light of impressive evidence that it may protect the bones against osteoporosis.
Couple this increasing awareness of the need for more calcium with the general interest in self-help health care and the market for calcium supplements -- whether in pill form or food form -- becomes obvious. As with many other marketing trends, however, when health advice is applied to product development, the motivations and implications get complicated.
Nutritionists have long advised that food is more beneficial than pills because you get a lot of other naturally occurring nutrients in a single food that you don't get in a single pill.
Yet increasing concerns over high-fat foods (with which high-calcium dairy products are often associated), the distaste for milk or yogurt among a portion of the population and the how-many-sardines-can-you-eat syndrome have sent many shoppers to the drugstore instead of the supermarket for their calcium fix. According to Advertising Age, sales of supplements mushroomed from $18 million in retail sales six years ago to $125 million in 1985, with projections of $200 million a year by 1988.
As a result, food companies may have tough competition. Although Martin Friedman, editor of the newsletter "New Product News," said he expects to see "more and more" calcium-fortified foods on the market soon, he has heard from at least one food company source that the company's market research indicated that calcium-concerned consumers prefer the convenience of taking a pill.
In addition, according to Dr. William Peck, cochairman of the Department of Medicine at the Washington University School of Medicine and chairman of the 1984 NIH Consensus Development Conference on Osteoporosis, "at the present time, the best guess is that calcium from food and supplements has the same net effect on the skeleton." Peck said that some evidence suggests that the calcium in milk may be more beneficial to bones than other types, but that the data that support it are minimal.
Dr. Richard Rivlin, chief of nutrition services at Memorial Sloan-Kettering Cancer Center and the New York Hospital-Cornell Medical Center, said that the bio-availability of calcium in food versus supplements is a "debated issue" and that many factors may influence absorption in the body, such as what time of day the supplement is taken, what other ingredients the calcium is bound to in the food or what drugs the individual is taking.
Nevertheless, there are those who have trouble taking pills, don't like taking pills or don't get enough calcium and don't know it. For this segment of the population, food marketers have an edge.
Patricia Hausman, a local nutritionist and author of "The Calcium Bible" (Rawson Associates, $13.95), believes that calcium-fortified foods are a good idea for some people. But, Hausman cautioned, "how far do we carry it before we get too much of a good thing?"
This is a question that concerns Peck, too. While Peck is supportive of recommendations to increase calcium intake to 1,000 or 1,500 milligrams daily (the latter for pregnant or postmenopausal women not taking estrogen), he is concerned that with the addition of calcium to food, people may not be aware of how much calcium they are actually getting. Furthermore, Peck is wary of the proclivity to think that if some calcium is good, more is better.
At 1,000 or 1,500 milligrams per day, "you're okay," said Peck. At 3,000 to 4,000, "you could be in trouble." There are no long-term studies on the effects of high calcium supplementation, Peck said.
What we do know, Peck said, is that large doses of calcium can lead to kidney stones in susceptible individuals or increase blood calcium, which might lead to complications in other diseases.
But, said Hausman, you have to weigh the odds. Inadequate calcium intake is a lot more common than overadequate intake. "We're not trying to push calcium down people's throats," said Alan Kligerman, president of Lactaid, the company marketing a high-calcium milk called CalciMilk. "We're trying to get people to get enough."
Between supplements and food, then, how do you get enough calcium without getting too much?
Peck agreed that if you are already eating hearty portions of calcium-containing foods, then you obviously don't need supplements. And if you take supplements, you probably don't need to stock up on calcium-enriched foods.
Marcia McLean, product manager for DairyCrisp, Pet Incorporated's calcium-fortified cereal, said that consumers have been using the product in conjunction with supplements: one day they may have the cereal for breakfast, the next day, a supplement.
The types of food that calcium is being added to run the gamut. Some, like CalciMilk, are naturally high sources of calcium to begin with. Others, such as Gold Medal flour, are not. The advantages and disadvantages of each approach depend on how much calcium you normally consume.
On the one hand, said Hausman, if you're already getting calcium from dairy products and you start getting additional calcium from sources where you don't expect to find it, you may be on your way to an overload. And if you already drink milk regularly and eat other high-calcium foods, then adding more calcium to them may be unnecessary for some individuals.
On the other hand, if you're not a milk drinker or a yogurt lover, then increasing calcium broadly across the food supply, in products such as flour, may be a wiser idea, a contention supported by Rivlin and Dr. Robert Heaney, vice president of health sciences at Creighton University.
"Not everybody is going to eat everything," said Heaney, who added that he would like to see beverages such as soft drinks and even meat fortified with calcium.
What marketers have in the wings remains to be seen, but in the meantime, here are the details of some of the calcium-fortified foods already on the market.
Lactaid's CalciMilk: If you're not a milk drinker, milk with added calcium is probably not going to get you to drink it anyway. If you do drink milk, now you just won't have to drink as much of it.
CalciMilk, fortified with tribasic calcium phosphate, has 66 percent more calcium than regular low-fat milk. Regular low-fat milk has about 300 milligrams per cup, CalciMilk has 500. That means that you have to drink two cups of it to satisfy NIH's newly advised requirement.
CalciMilk is being marketed by the makers of Lactaid, the lactose-reduced milk for those who have trouble digesting regular milk. Like Lactaid's regular product, CalciMilk is formulated for the lactose intolerant, although Lactaid president Kligerman said the product is geared for "anyone" looking for more calcium.
Nonetheless, Kligerman said the company has plans to introduce a regular low-fat milk with added calcium -- an idea that other members of the dairy industry are considering as well, according to Ted Heck, vice president of marketing for Lehigh Valley Farms, the dairy that owns the franchise for Lactaid in the Washington area.
The calcium phosphate is added to CalciMilk before the milk is pasteurized. Kligerman said that calcium phosphate is the type found in the human bones, as well what is found naturally in milk.
Like Lactaid's regular lactose-reduced milk, CalciMilk has a slightly sweet taste because the lactose has been broken into simple sugars, said Kligerman. Also, CalciMilk has a somewhat cooked taste, due to the ultrapasteurization of the product. It is heated to 281 degrees for five seconds, instead of standard pasteurization, which heats milk to 115 degrees for 15 seconds. Kligerman said the higher temperatures give the milk a shelf life of four to five weeks, a necessity for a specialty product that doesn't have a massive turnover.
For questions about Lactaid's CalciMilk, the company has a toll-free number. Call 800-257-8650 for more information.
DairyCrisp: Pet Inc. took the first plunge with a calcium-fortified cereal when the company introduced DairyCrisp in September in test markets. A middle-aged woman who looks too young to have gray hair stares out from the front of the box. Surely you can have strong bones and be as well-preserved as she if you eat DairyCrisp, the box cries out.
You might, if you can down it. While those with a sweet tooth may like it, DairyCrisp -- which appears to be a sugar-coated version of the company's Heartland granola cereal -- tastes like a product that would appeal more to the Froot Loops set, not the mature woman. In fact, according to McLean, "many people" have complained to the company that the product is too sweet, even though initial premarket taste panels preferred the current formulation.
McLean said that the tart, nonfat, dried fresh yogurt in the cereal is "bringing the sweetness level out." Although DairyCrisp may taste sweeter, McLean noted that the cereal actually contains less sucrose and other related sugars than other less sweet-tasting cereals. DairyCrisp contains four grams of sucrose and other related sugars per serving; Kellogg's Bran Flakes and All Bran contain five grams both.
As for the matter at hand -- the calcium content -- DairyCrisp contains 680 milligrams of calcium per ounce, or 800 milligrams with 1/2 cup of milk -- 100 percent of the RDA for calcium.
The source of calcium is tricalcium phosphate and there is vitamin D added, to aid absorption. It comes in strawberry, blueberry and plain. So far, strawberry is leading sales, McLean said.
McLean said the company made the decision to provide 100 percent of the RDA because 60 percent of all women get less than 800 milligrams per day and that since most doctors are recommending no more than 2,000, consumption of DairyCrisp fits within a safe range.
Gold Medal Flour (Self rising and all-purpose): No, bread is not a high source of calcium and it still isn't with Gold Medal's new calcium-fortified flour. But that's not the point, according to General Mills' spokesperson Kim Dickey.
While the company manufactures a variety of food products, it chose to fortify flour, according to Dickey, because it goes into a wide variety of foods and is eaten by a wide variety of consumers.
Every little bit helps might best describe the philosphy behind it: Two slices of bread made with Gold Medal's regular flour now satisfies 10 percent of the RDA. (One cup contains 20 percent of the RDA for calcium, or 160 milligrams. It used to contain only 2 percent, or 16 milligrams.)
The new self-rising flour contains more -- 35 percent of the RDA per cup, or 280 milligrams. (Self-rising flour contains more calcium phosphate because phosphate is used to trigger leavening action with the baking soda.)
According to Dickey, Gold Medal's new flours are not a new line, but a replacement for the company's old flour. As soon as markets run out of the old flours, they should start replacing it with the new calcium-fortified ones, Dickey said.
Consumer taste panels showed no discernable difference in taste or baking properties between the new calcium-containing flour and the old line, Dickey said.
Hollywood Special Formula Bread (Light and Dark): A slice of most breads satisfies between 2 and 4 percent of the RDA for calcium. Hollywood's new bread, enriched with calcium sulfate, beefs it up to 15 percent per slice. "Three slices provide more than one third of the U.S. RDA requirement for calcium" boasts the label.
The difference in calcium content is substantial, said nutritionist Hausman, although it won't give someone who eats no other source of calcium the recommended amount. For strict vegetarians who eat no dairy products, fortified bread is a good vehicle for calcium, too, she said.
Hollywood's Special Formula bread, which regularly contains nine vegetable flours and a list of other ingredients practically as long as a baguette, has added wheat bran as well. (The company gets two recent trends in one product. Furthermore, its thin slices add up to only 45 calories each.)
LaCal: Call it the Superman of nonfat dry milk. Made by a Columbia, Md., company called IGI Biotechnology Inc., LaCal, a calcium enricher similar in appearance and cooking applications to nonfat dry milk, contains 950 milligrams of calcium per tablespoon. (Nonfat dry milk contains about 55 milligrams of calcium per tablespoon.)
It also contains only 25 calories per tablespoon, virtually no fat, only 40 milligrams of sodium and the company claims the calcium is 100 percent available to the body. What is it?
According to William Hall, executive vice president of IGI, the source of LaCal is grade A milk whey, which has been modified through a "physical-chemical process" and then spray dried.
The process concentrates the calcium in the whey, said Hall. Extra calcium is not added, although the fat is removed.
Powdery LaCal can be mixed into yogurt, casseroles or mashed potatoes. And because it acts as an emulsifier, it should improve the consistency of such products as homemade creamy salad dressings. It is not easily soluble in liquids -- forget about putting it into your morning coffee if you don't go for little pools forming on the surface. Plus, in coffee at least, it has a waxy taste similar to nondairy coffee creamers.
Hall said several large food companies -- specifically those that make cereal -- are testing LaCal as an ingredient in some of their new product formulations.
Although IGI Biotechnology does not sell LaCal retail, it is available via mail order, through a Columbia health care company called Retech Inc., which calls the product FEMCAL.
Information brochures are available by calling 1-800-243-2638 (outside of Maryland) or 301-730-1144 for callers within Maryland. The product can also be ordered by phone. Cost is $7.95 for a bottle with 30 servings.