Fortified Cereals May Pose Health Risks

When life gets hectic with too many activities to juggle and not enough time, many of us reach for cereal, assuming it’s a reasonably healthy meal. After all, cereal is packed with vitamins, right? Add milk and a piece of fruit and you’re good to go. But according to a report published this year by the Environmental Working Group (EWG), children might be getting too many nutrients if they are having a large serving of cereal, or multiple servings, in a given day – and especially if that cereal is fortified with vitamins and minerals, and if the kids are also taking a multivitamin or mineral supplements.


Should parents and caregivers be concerned? First we worry about whether our kids are getting enough nutrients and now we’re fretting about them getting too many! Local nutrition experts say that yes, there is cause for concern, but as with everything, it’s best to strive for moderation.


Vitamin Overdose


The EWG, a nonprofit organization that focuses on human health and the environment, warns that consuming too much zinc, vitamin A and niacin is toxic and can, over time, be potentially harmful. This is especially true for kids under the age of 8, pregnant women and older adults. The EWG cites recent studies that indicate kids are being overexposed to these nutrients and, in fact, going above the Tolerable Upper Intake Level recommended by the Institute of Medicine.


Too much vitamin A (which is fat-soluble so a person doesn’t pee out the excess) can lead to liver damage over time, as can excessive niacin. Too much zinc can result in impaired immune function. Short-term effects of too many nutrients may include symptoms like nausea, vomiting and rashes.


The EWG took a look at the labels of 1,500 breakfast cereals and found that 114 of the cereals – about 7 percent of them – contained a large percentage of the recommended Daily Values of vitamin A, zinc and/or niacin per serving. Those values are based on what’s good for adults, not young children, and many of the values are outdated since they were set back in 1968. That means that if kids eat more than one serving, they can meet or exceed their Daily Value.


Ann Manzi, a registered dietician at the North Shore Medical Center in Salem, says it’s true kids may be consuming more cereal than they should. “They might have cereal for breakfast and then come home from school and have another big bowl of cereal. It tastes good and it’s easy and they grab it,” she says. “Sometimes the parents aren’t even aware of this if they aren’t home after school. Kids with limited variety in their diets might be eating many bowls per day every day.”


Variety Is Best


Parents and caregivers should keep an eye out and make sure that kids aren’t having a lot of the same food – or the same cereal – day after day, says Manzi. Instead, encourage kids to eat a variety of different foods.


However, to put vitamin overdosing in perspective, Manzi conducted her own study by looking at the labels of eight boxes of cereal she had in her home. She observes, “Most of the ‘healthy’ ones had about 25 percent of the Daily Value for most nutrients. Only the iron was higher in many (50 percent), which shouldn’t be a problem in kids, especially older kids.”


Younger children eat less and tend to “self-regulate” their food intake, which shields them somewhat from going over the limit, she explains. “If kids eat one large serving of cereal every day with fruit and milk, that’s fine,” she reasons, but again stresses that they do need variety. “It is up to the parents to work on planning meals and snacks with their kids to be sure the goals of good nutrition are met most of the time,” she says.


The EWG advises using caution when feeding children foods with more than 25 percent of the adult Daily Value and monitoring their intake of all foods to make sure they’re not getting excessive nutrients, especially if the child is also taking a multivitamin or supplements.


Julienne Seed, a registered dietician who practices at Harvard Vanguard Medical Associates’ Somerville, Copley and Watertown practices, agrees with the EWG’s advice. “Twenty-five percent of the adult recommended Daily Value provides an adequate safety measure for children who may consume the product, but I would not recommend going over this,” she says.


Other Foods to Watch


“Not only are cereals fortified with vitamins and minerals, but so are many other foods and beverages commonly consumed by children, such as fruit juices, instant breakfast drinks and ‘fruit snacks’ gummy candies,” says Seed. “That means that when all of these are added up, kids will easily surpass their nutrient needs.” Snack bars fortified with vitamins and minerals are another leading culprit, according to the EWG.


The bottom line is that while companies use the term vitamin-fortified in their advertising campaigns to boost a product’s appeal and make it sound healthy, in actuality, it is just another example of a case where “too much of a good thing” is not good for us.


Seed cautions parents and caregivers to read Nutrition Facts panels carefully because she says the labels can confuse consumers who may not realize that the Daily Values are based on what’s good for a 25-year-old male. “They may not realize that the product is providing possibly as much as three times of that recommended for a child,” she notes. “Children consuming a single serving of the 100-percent-fortified breakfast cereal will reach their UL [Tolerable Upper Intake Level] and having other foods and vegetables puts them over their limit.”


Are Multivitamins Necessary?


“Kids can get their needed vitamins and minerals if they eat a variety of foods from each of the five food groups daily: fruits, vegetables, proteins, dairy and grains,” says Seed. “The multivitamin or mineral supplement can be used as an ‘insurance policy,’ but is not generally needed if a healthy diet is consumed.”


Manzi recommends that parents and caregivers don’t give kids a multivitamin “unless they have very limited intakes due to medication, psychological issues, or food allergies or intolerances.” Of course, check with your child’s pediatrician on this and all other matters relating to your child’s health.


Good Cereal vs. Bad Cereal


A good rule of thumb in choosing a cereal, according to Manzi, is to aim for (in one serving) “one cup or more in volume, not more than a teaspoon (4 grams) of sugar, at least 3 grams of fiber and the first ingredient should be whole grain.” To cut down on the amount of sugar kids consume, she says it’s helpful to mix a sweetened cereal with a plain cereal (such as Cheerios). Plain or multigrain Cheerios, Kix, most Chex cereals and oatmeal are good choices.


“Try adding fresh fruit like blueberries or raspberries to the whole grain cereal for natural sweetness,” says Seed. Bad cereal choices, in her opinion, include those high in sugar, those made from refined grains, such as rice or corn, and especially those fortified with 100 percent of the Daily Value for vitamins and minerals.


To take a break from always reaching for the cereal, the two dieticians suggest:


• natural peanut butter on 100 percent whole grain bread or toast with all-natural fruit spread (without added sugar) or with shredded vegetables;


• a boiled egg, or a scrambled egg made in a stick-free pan a couple of times per week (omelets will get the veggies in); and


• lowfat or nonfat plain yogurt with fresh fruit.



Mary Alice Cookson is associate editor of Boston Parents Paper.

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24 Nov 2014

By Mary Alice Cookson