Even the class dunce knows that calcium is good for your bones, but in a society where convenience and health are still battling it out for the top spot, there is a mass deficiency of this crucial mineral.
Bone mass increases up to the age of 30 and if you don't have enough calcium when you're young, you'll run into problems in later life, warns Gillian Berry, marketing manager at ingredient supplier S Black. An inadequate calcium intake is associated with osteoporosis, and recent studies also link it to oral bone loss, colon cancer and hypertension, she says.
However, calcium is not only used by the body for bones. It is also an essential mineral for blood coagulation, nerve function and skeletal muscle formation. "In fact, skeletal formation is the lowest priority use by the body for calcium, so perversely this is why bone mass is the first to decrease over the other functions," she says.
Osteoporosis in the UK has risen from10.4-11.4M people over the last 10 years and, as calcium loss accelerates in the elderly, an ageing population means the problem is growing, she says. Nevertheless, there is hope that the situation can improve. "If teenagers increase their bone mass by 5-10%, that should substantially reduce the risk of developing osteoporosis later in life," claims Berry.
Calcium absorption varies from person to person depending on a number of mitigating factors, but studies suggest that, on average, people absorb 20-50% of the calcium they consume, she says. "To get your recommended intake through products that naturally contain calcium, you have to consume the equivalent of three yoghurts and three glasses of milk a day," she claims. "People aren't going to do that every day, so calcium must be added to food in order to fulfil the body's daily requirements."
Theoretically, you could put calcium in anything, but absorption rates can be affected by different foods, she explains. In foods such as spinach and pulses, calcium can bind and form mineral complexes with parts of non-fermentable fibre in the digestive transit, she says. "So a high fibre product with calcium would not be a good idea as this would result in reduced absorption."
Darren Spiby, business development manager for health and nutrition at ingredients distributor Cornelius, says that processors must also take the bioavailability of specific calcium sources into consideration. "From a manufacturing point of view, calcium isn't expensive," he says. "The problem is that the bioavailability can vary in different calcium sources." Non-gritty calcium, such as calcium gluconate and calcium lactate is more favourable, but doesn't necessarily have as high bioavailability as chalkier calcium carbonate. "It's swings and roundabouts," he says.
Marcus Smet, head of marketing strategy at ingredients firm Naturis, believes that there is plenty of mileage for functional foods in the bone health sector. "Bone benefit foods are growing at 4% per annum and there is definitely a case for more products in this area," he says.
Diets have changed significantly in recent years, providing ample opportunity for product enrichment, says the firm's new product development manager Phil Berry. "People are eating more processed foods, but we're not quite there yet with a balanced diet," he says. "Although calcium is inherent within milk, people are skipping breakfast and there is a greater awareness of dairy allergies." Dairy-free products such as soya and lactose free milks, both of which can be enriched with calcium, are growing in popularity, notes Smet.
Phil Berry advises manufacturers to be cautious about what they fortify, though. He claims that consumers are more accepting of enriched dairy products, because they already contain calcium naturally. "Consumers want to pick up products they're familiar with. Would people accept calcium in a sandwich?" he questions. However, Gillian Berry believes there could be an opportunity for manufacturers to elevate even an unhealthy product to premium status by adding calcium. "As a parent, if there's a choice of sweets, you would pick the one with added benefits," she says.
Attitudes to functional food vary across the globe, and different countries have different calcium requirements. "Some people are comfortable to pop a pill, but not everybody is like that," says Smet. He notes that many UK consumers are "driven by a quick fix"
Asian consumers are also fans of food fortified with calcium, but not because of its convenience. "Traditionally, our target market has been Asia because there is this socio-economic reasoning that if you are tall, you will be successful," he says.
Meanwhile, other countries are proving harder to crack. "The German market is slow to move and very conservative," says David O'Leary, commercial manager at ingredients manufacturer Marigot. "They are keen to have the facts before they decide to enrich products." The amount of press coverage on bone health is growing and people's awareness is increasing, he claims. "Look at recent changes - Kellogg in Ireland is telling people about the need for taking calcium in their diet," he says.
Age considerations will also play a key role in calcium enrichment going forward, says O'Leary. "We need to look at targeted food solutions for specific ages - food that consumers like to eat that is good for them."
Spiby agrees: "The biggest thing will be increased market segmentation around life stage - it's a marketer's dream," he says. "It's a bit of a see-saw - you can't do much about genetics, but women don't achieve the same levels of bone mass as men because teenage girls are quite faddy in terms of diet and many cut out milk."
"At the age of 25-30, the see-saw tips," he says. "You reach your peak bone mass and start to lose a small amount year-on-year." In addition, women end up sacrificing calcium for the sake of their children during breastfeeding, and menopause is a further drain on calcium levels.
All of the above reasons mean that women have a far higher fracture risk than men. In the UK, one in three women and one in 12 men over the age of 50 will have osteoporosis, states the Medical Research Council's scientific research body Human Nutrition Research.
"Osteoporosis is referred to as the silent killer - you can't see the instant effects of calcium deficiency; then when you reach 50 or 60, you fall over and break a bone," says Spiby. "But it's not about scaremongering," he is quick to add.
Calcium is relatively easy to talk about on packaging, because it has been on people's radar for some time, he claims. Products need to contain a minimum of 15% of the calcium reference nutrient intake (700mg) to make a claim on pack.
While Spiby is supportive of the current regulatory regime surrounding health claims in the UK ("it tidies thing up in my mind and stops companies ripping consumers off"), he is concerned about forthcoming European legislation. "Big multi-nationals will probably squeeze some of the smaller companies out of the market regarding tests to make claims. There's an issue with exclusivity because if, say, Unilever does a trial, it's Unilever's intellectual property - why should it do it for everyone else to jump on the bandwagon?"
Ingredients manufacturer Orafti is eager to prove to the public that its Beneo Synergy1 can increase the body's absorption of the calcium it consumes. In the US,100 adolescents were given either 8g of Orafti's ingredient or an equivalent amount of placebo every day for a year. After six weeks, the ingredient had increased calcium absorption by 25%. This level was maintained throughout the year and the adolescents' bone mineral density had significantly increased by the end of the study.
"We know the science behind our studies, but we're not cowboys shooting around. We will wait for the EU regulations and see what kinds of claims can be made," says the firm's marketing co-ordinator Davy Lyton. "Calcium is probably the most important missing vitamin in the world," he adds.
Douwina Bosscher, manager of nutrition research at Orafti is keen to make clear that Beneo Synergy1 is in no way meant as a substitute for calcium fortification, but rather to complement it. "It would be interesting if we could combine all these strategies," she says. "The situation is too dramatic to exclude any methods."
While it is impossible to cure osteoporosis, it seems that calcium enriched foods could be critical in preventing bone-related health problems. Even the National Osteoporosis Society (NOS) is warming to the idea. This is certainly a ray of hope for food manufacturers, who are often used as scapegoats for health problems."Naturally occurring calcium is the way the NOS urges people to go, but if this is difficult, then calcium-enriched products may be the way to go," says a spokesman.