Sampler Platter: fortification, carotenemia, nitrates in food

Your Nutrition Profs answer nutrition questions for curious eaters, and on this episode your burning questions take center stage. We answer not just one, not just two, but three listener questions. We’re cleaning out the closet so to speak. Join us!

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Transcript

Get ready for a nutrition feast on our latest episode we’re calling a 'sampler platter'. We’re serving up bite-sized answers to a variety of your burning nutrition questions, from carotenemia to nitrates in our food.

M: I’m Professor Megan 

S: and I’m Professor Susan, and we’re

Both: Your Nutrition Profs!

M: We are registered dietitians and college professors who have taught more than 10,000 students about health and nutrition. We have answered a LOT of questions about nutrition over the years – 

S: Some questions we get asked every year and some are rarely asked but very interesting.

M: We’re here to share our answers to these common (and uncommon) nutrition questions with you.

S: So bring your curiosity and let’s get started. 

Both: Welcome to our class!

M: Welcome everyone to our first “Sampler Platter” episode. Not all of the nutrition questions we get asked require a full-length episode to answer. So we thought we would address a few of these questions on this episode. 

S: Yes, we’ve got several great questions sent in by listeners that we’re going to answer today. So let’s get started.

M: Oh and one more thing. If you want us to do a full episode on any of these topics, please let us know! Believe me, we could deep dive anything! 

S: Oh for sure. Our first question is from Anne who’s a listener in Pennsylvania. She asked “why did my toddler develop orange palms and soles of his feet after eating certain vegetables?”

M: What an interesting question! This is one that I’ve only been asked about by maybe one or two students, although I do mention this phenomenon in class when discussing micronutrients.

S: Right, me too. The answer to this question lies in the solubility of vitamins. The 8 B vitamins and vitamin C are water-soluble. This means that they dissolve in the body’s water. And the human body doesn’t store water or most of these water-soluble vitamins. That’s why we need to consume water and water-soluble vitamins frequently. They circulate through the body and when we urinate, we lose water, and excess water-soluble vitamins can be lost here too. 

M: But some vitamins instead dissolve in the body’s fat. The 4 fat-soluble vitamins are vitamins A, D, E, and K. Because we don’t lose fat from the body very quickly…

S: Unfortunately!

M: …these vitamins hang around longer and because they’re stored, it can take some time before you might notice any signs of deficiency.

S: So to answer Anne’s question we need to discuss vitamin A. It has several very important body functions. It helps maintain your vision, it promotes a healthy immune system, it maintains healthy skin and the linings of your tissues. It regulates growth and development, particularly in fetal stages and it has antioxidant properties. 

M: It’s found in a wide variety of foods, both animal and plant sources, and it comes in several forms. Vitamin A found in animal foods like liver or tuna and this is called preformed vitamin A,  and it’s pretty much ready to be used “as is” in the body. But in plant foods the vitamin A is not yet ready to be used, it’s called provitamin A.

S: Well, provitamin A is found in the phytochemicals called carotenoids. These are pigments that are synthesized by plants to give them their yellow, orange, and red color. Think carotenoids, CARROTenoids, like carrots! But they’re not only found in veggies those colors, dark green veggies like spinach also contain quite a few carotenoids 

M: Right. There’s over 600 carotenoids that have been identified so far, and beta-carotene is probably the most well-known. About 10% of carotenoids like beta carotene can be converted into usable vitamin A in the body. 

S: So vitamin A and the carotenoids get stored in the body, primarily in the liver, but also in body fat including the layer of fat that lies just below the skin, called the subcutaneous layer. As the body requires vitamin A for those functions we just mentioned, the liver releases it from storage and it travels through the blood to the tissue that needs it. 

M: So when Anne’s son was consuming large amounts of yellow, orange, or red veggies like carrots, pumpkin, squash, or sweet potatoes, or even spinach, that extra beta-carotene got stored in subcutaneous fat and it turned his palms and the soles of his feet a little bit orange. The sciencey term for this condition is carotenemia 

S: Toddlers often go on what is called a food jag and this means they like to eat one or two foods or food groups repeatedly while refusing other foods. This is a fairly typical phase that kids go through. In Anne’s case, the focus of her son’s jag was orange veggies. 

M: And that explains it! But it doesn’t just happen to toddlers. Anyone who consumes a large amount of these yellow, orange, or red veggies over time can also turn orange. The lighter your skin the more likely you are to see the color change. 

S: My parents had a friend who drank several glasses of carrot juice daily and he thought it was going to cure all of his ills. And…he was orange and not just the palms of his hands! His face and his arms were also orange-tinted. 

M: Wow!

S: Yeah.

M: Well the good news for those of you who love carrot juice and all of those foods- this is not dangerous. Eventually, especially once the food jag is over in the case of a toddler-

S: Or the adults stops drinking all that carrot juice!

M: Then the beta-carotene will eventually get converted to vitamin A and used by the body. 

S: Now you might be wondering how much beta-carotene we’re talking about, how much results in this color change? According to one dermatologist who has been cited repeatedly, you would need to consume 20 and 50 mg of beta-carotenes every day. A medium carrot has about 4 mg of beta-carotene, so that would be like eating 10 carrots a day for several weeks!

M: Wow…

S: That’s a lot of carrots! 

M: Alright, well thanks Anne, for the question.

S: The next question we have is a very common one we get about fortified foods and enriched foods. Every semester students ask about this, do they mean the same thing? Is one better than the other? Are they different and if so, how are they different?

M: Yes, you’ve probably seen a cereal box with the words “fortified with, you know, x number of essential vitamins and minerals” or a bag of flour that says in large letters “enriched”. Both terms refer to the addition of nutrients to a processed food, but they are not quite the same. 

S: Right, the term “fortified” means that nutrients have been deliberately ADDED to a food item to improve its nutritional quality. The original ingredients don’t contain these nutrients, or if they do, they contain them in very small amounts, so the product manufacturer will add some of these nutrients back in. There are several ways that fortification is done, but today we’re just going to look at industrial or manufacturing fortification. 

M: Let’s look at calcium-fortified orange juice as an example.

S: Really common.

M: Yeah.  A typical medium-sized orange contains about 50mg of calcium or about 6% of one’s total calcium needs in a day, so not very much. But oranges are great for you, they’re excellent sources of vitamin C and potassium and fiber, but they are not a good source of calcium. 

S: But most Americans do not consume adequate calcium in their diets. So orange juice manufacturers saw an opportunity to improve the nutritional content of their juice, so they “fortify” it by adding 300mg or even more of calcium, equating the calcium in calcium-fortified OJ with the same amount of calcium in dairy milk. 

M: And the same is true for some ready-to-eat prepackaged cereals especially those with flakes. In this case nutrients, usually the vitamins and minerals, are added at several points during processing. Some are added by powder or liquid before the dough is cooked, some are added after cooking but before toasting, and some are added after toasting by spray. 

S: So that’s a look at industrial fortification. It’s common for juices, milk-alternatives like soy and nut milks, and highly processed breakfast cereals and processed “health” foods. We also fortify dairy milk with vitamins A & D. It’s done in these common popular products to make these nutrients more accessible or to enhance the image of the food as “healthy”. So that’s a look at fortification. Let’s talk enrichment.

M: Alright, enrichment is a specific type of fortification. When foods are processed they are changed from their fresh, original form into a food product. Grains are processed into flour and used in hundreds of thousands of food products. Fruits are processed into juices. And with most food processing, there is nutrient loss. Enrichment attempts to REPLACE some of those lost nutrients. 

S: Let’s use wheat flour as an example. Wheat plants produce a seed grain that contains three parts: the germ which is where most of the vitamins and minerals are found, the endosperm which surrounds the germ and contains starch, and the outer coating or bran which contains fiber. When the entire seed grain is ground into flour, all three parts contribute to the nutritional value and 100% whole wheat flour is created. 

M: But if you’ve ever used this flour, you’ve seen that the grind is coarser, it’s not as white in color and the holes in things like bread are larger and less uniform. It’s great for many things, but it doesn’t provide the smooth, soft texture that we often look for in things like baked goods and desserts. 

S: Right! In the early 20th century manufacturers started making flour just from the endosperm of the seed grain. They called it refined flour. The result was a very fine grind that’s whiter and creates soft textures in our white bread, cookies, pie crusts, and pizza dough. And without the germ, shelf life increased. And Americans loved it! We prefer products made with white flour to those made with whole grain. And some viewed white flour as more “pure”. By the 1930s and 1940s white flour was the standard in most U.S. households for baking breads, cakes, pies, and even used for breading on fried foods. 

M: Also during the early 20th century, vitamin deficiency diseases like pellagra caused by deficiency of niacin- we have a whole episode on it!

S: We do. Check it out!

M: Yeah. Beriberi which is caused by deficiency of thiamin and riboflavin deficiency or the sciencey term ariboflavinosis were widespread. One of the reasons was the consumption of refined white flours. As Susan just mentioned, the bran and germ of the grain and seed are not used. Subsequently, most of the nutrient content including thiamin, riboflavin, and niacin was missing. 

S: So as they refined the flour, they lost nutrients. To address these missing nutrients, bakers began to add high-vitamin yeasts to breads. These were synthetic versions of B vitamins and they became increasingly available and cheaper. By 1943, 75% of white bread was fortified with thiamin, riboflavin, niacin and iron. This was called “enrichment” and officially it’s the replacement of nutrients that were lost during processing when they pulled out the germ and the bran. At the same time the U.S. Army agreed to only purchase enriched flours for its soldiers to improve the health of recruits. And this increased the demand for enriched white bread nationwide. 

M: That’s the quick story of fortification and enrichment. Neither are mandated by the U.S. government, but the practice has been and continues to be very common. So just remember, fortified means ADDED and enriched means REPLACED.  

S: The next question to tackle on our sampler platter comes from Teri who listens in Minnesota. She asked “What are nitrates and nitrites, and should I be worried about them in my food?”

M: This is such a confusing topic. 

S: It is.

M: And I think it’s the terminology. So, nitrates and nitrites are both made of nitrogen and oxygen, but nitrates contain 3 oxygen atoms and nitrites only contain 2. Nitrates can be transformed into nitrites during digestion by bacteria in the mouth and enzymes in the intestines. Nitrites can then transform into nitric oxide or nitrosamines. And we’ll talk more about those in just a minute. 

S: A little bit of chemistry but don’t freak out. So let’s talk about where these come from. Nitrates and nitrites are chemical compounds and they naturally occur in some of our foods. They’re found in the soil, plants, and water and they’re part of the earth’s nitrogen cycle. And because we eat foods that contain them, we also have them in our bodies. 

M: Both nitrates and nitrites are naturally present in fruits and veggies and these aren’t concerning. They’re normal and healthy. But they can also be used as food additives, usually in the form of sodium and potassium salts. These added ones may be a little bit more problematic.

S: Vegetables with the most naturally occurring nitrates and nitrites include leafy greens like spinach, kale, and romaine, and root veggies like beets, celery, and carrots. And again they’re no problem.

M: As a food additive, they’re often used to cure and preserve meats like sausage, bacon, hot dogs, deli meats, even some cheeses. They’re used to prolong shelf life, prevent growth of pathogens that can cause foodborne illness and they can boost the color and flavor of some foods- punching up the umami!

S: In our bodies though these nitrates and nitrites have the potential to be converted into compounds as we discussed earlier called nitrosamines. And these are considered carcinogenic, they can increase your risk of developing various cancers and may contribute to high blood pressure. 

M: So does that mean we should avoid consuming all nitrates and nitrites?

S: Well here’s where it gets interesting. Research has shown that source matters. Eating plants that have naturally occurring nitrites and nitrates is NOT associated with an increase in cancer risk, in fact, it’s exactly the opposite! Diets high in whole plants can actually decrease your risk of developing cancer. 

M: But diets high in processed meats that contain ADDED nitrates and nitrites IS associated with increased cancer risk, especially colon cancer. 

S: We mentioned this before in our aspartame episode from last season, the possible link between processed meats and cancer. If you haven’t listened, check it out! But the big question here is, why the difference in source?

M: Of course, like a lot of things we talk about in this podcast, it’s complicated. 

S: Of course it is. 

M: One issue may be how the food is prepared. When meat is cooked at high heat, like frying or grilling, nitrates and nitrites can react with the amino acids in the meat protein to make nitrosamines. 

S: So should we avoid frying or grilling meats? Maybe…but wait there’s more!

M: Of course. 

S: Vitamin C can stop nitrates from turning into nitrosamines which may explain why we don’t see increased cancer risk with the fruits and veggies we mentioned. They contain nitrates and nitrites but also vitamin C. In fact, sometimes vitamin C is actually added to some processed meats to try to prevent this cancer-causing compound from being formed.

M: And to make things even more complicated, product labeling that says “preservative-free”, “organic”, or “natural” implies that they wouldn’t contain nitrates or nitrites as food additives. However, they could contain some that occur naturally in plants which have been processed into powders or liquids and then added back to the food as a preservative.

S: Talk about confusing and misleading! So these that are added back in even though they originally came from plants, they could still be converted into the harmful nitrosamines, so they are not necessarily healthier. 

M: Exactly. But here’s another wrinkle….As we mentioned earlier some of these naturally occurring nitrates and nitrites are transformed into a beneficial chemical compound called nitric oxide. These have been shown to help lower blood pressure and reduce the risk of cardiovascular disease. So think nitroglycerin as a treatment for chest pain! 

S: Right.

M: Nitro…

S: Nitrites as medication can relax and widen blood vessels, prevent blood clot formation, prevent inflammation, and promote the creation of new blood vessels.

M: Some studies have shown that nitric oxide can improve sports performance and even recovery after exercise. Have you ever seen those beetroot juice supplements advertised on TV?

S: I have and like, Super Beets, is another- another common supplement they sell. 

M: Yeah, I’ve seen those. 

S: So that may explain why consuming nitrates and nitrites in fruits and veggies is beneficial. 

M: So don’t be scared of nitrates and nitrites. Just focus on getting most of yours from fruits and veggies instead of bacon or hot dogs.

S: Right. An occasional grilled hot dog, salami sandwich, or slice of bacon is OK. But limit your intake of processed meats to once in a while and increase your daily intake of whole fruits and veggies as the benefits of those are enormous!

M: Absolutely. Well those are all the questions we have for today’s sampler platter but here is one more thing... 

S: Yes, we want to give an update on what’s happening in California with their food additives bill. We discussed this bill in our food dyes episode from a couple of months ago. At the time of the episode the California state legislature was considering a bill, AB 418, that proposed a ban on the sale of foods containing five food additives. That bill passed in October of 2023. 

M: One of the now-banned additives is red dye #3, also called erythrosine. It’s a synthetic dye made from petroleum that’s been used in food products for over 100 years. 

S: It’s really not used much anymore, but you can still find it in candy like Peeps or Candy Corn, and it’s also in some unusual places like vegetarian bacon made by Morningstar Farms. 

M: I did not know that! That is so Interesting! 

S: I know, right?

M: Unexpected. 

S: Yeah, I was like- wow, really? Its use has been linked to cancer in lab rats and it had already been banned by FDA for its use in cosmetics, but it was still legal to add it to food products. 

M: But it’s no longer legal in California or at least it won't be after January 1, 2025.

S: But we’ll see what happens. Our prediction is that most of the products that still contain red dye #3 will find an alternative, and of course it’s going to have to go through the courts because it’s really unclear whether a food additive that’s approved by the federal government can be banned by an individual state. 

M: So stay tuned! We’ll keep you posted if we hear anything more. 

S: We definitely will. Alright, so that’s it for our first Sampler Platter episode,  we hope you liked it!

M: Join us next time for a snackisode about mangosteen.

Both: Class dismissed.

S: We hope you enjoyed this episode. You can find the show notes and a list of sources on our website, yournutritionprofs.com. 

M: Your homework is to follow us at your nutrition profs on Instagram and to listen to our next episode. You can listen on Amazon Prime, Apple Podcasts, Spotify, YouTube, or anywhere podcasts are found. We’d appreciate it if you’d “like” us, write a review, subscribe, and invite your family and friends to join us too. 

S: If you have a nutrition or health question you’d like answered, let us know! We may even do a show about it! Send an email to yournutritionprofs@gmail.com or click on the “Contact Us” page on our website.

M: Thanks to Brian Pittman for creating our artwork. You can find him on instagram @BrianPittman77

Both: See you next time!