For long, vitamins and minerals have been added to certain staple foods-such as milk and cereal-either to replenish nutrients lost during processing or to address specific health-related nutrient deficiencies, particularly in children. Today, with an improved understanding of the role vitamins and minerals play in overall health and wellness, and more specifically in the areas of bone health, energy replenishment and muscle rejuvenation, vitamins and minerals are taking center stage in specialty foods and beverages, many of which are dairy based.

In 2009, expect to see a broader range of dairy foods fortified with vitamin D, also known as the sunshine vitamin. Vitamin D was originally added to milk in the 1930s to prevent infantile rickets, which is a softening of bones in children that can lead to fractures and deformity. This practice virtually eradicated the disease in the United States.

Federal Standards of Identity for milk and flavored milk state that vitamin D fortification of milk is optional. However, due to the importance of vitamin D’s role in conjunction with other nutrients in milk that help build strong bones, milk processors are strongly encouraged to fortify all fluid milks with vitamin D.

According to federal regulations, all fortified milk sold in the United States should contain 400 International Units (IU) of vitamin D per quart. Further, the food additive provisions for direct addition of vitamin D permit its use in other milk-based products including cultured dairy foods, cheese and cheese products, as well as calcium-fortified fruit juice, soy beverages, infant formula, margarine, meal replacement bars, breakfast cereals, pasta and grain products. However, at this time vitamin D is not permitted to be added to ice cream, sherbet, water ice or frozen desserts.

There is concern regarding rickets’ return to America, as many Americans do not drink enough milk to consume sufficient levels of vitamin D. This is compounded by the fact that increased use of sunscreen prevents the body from naturally making vitamin D via a reaction of ultraviolet light with compounds in the skin.

How much vitamin D a person needs daily is under discussion. At the annual meeting of the American Medical Association (AMA), the nation’s largest physician organization, this past June, members adopted a policy asking that recommended levels for vitamin D intake set in 1997 be re-evaluated.

Current research suggests that the Upper Limits for adults is likely overly conservative. “The health benefits of vitamin D are plentiful, such as strong bones and a reduced risk of breast cancer and cardiovascular disease,” said AMA Board Member Steven Stack. “It’s time to take a good look at the current daily recommended level of Vitamin D and ensure that Americans know the appropriate levels so they can reap the full health benefits.”

According to AMA Board Member Steven Stack, “It’s time to take a good look at the current daily recommended level of vitamin D, and ensure that Americans know the appropriate levels so they can reap the full health benefits,” including reduced risk of breast cancer and heart disease. For more, see

In early October, FDA amended its osteoporosis risk reduction health claim to reflect the importance of vitamin D in combination with calcium in promoting long-term bone health. The amended labeling provides for simplified model claim language that eliminates requirements to reference the mechanism or sex, race and age that were part of the existing calcium and osteoporosis health claim. The rule allows reduced-fat, low-fat and fat-free milk and other eligible dairy products to display a health claim that states, “Adequate calcium and vitamin D throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis” or “may build and maintain good bone health.”

Dairy processors were immediately able to use the claim and many are in the process of revising labels to include this important information. However, FDA set the effective date for this regulation as Jan. 1, 2010, to allow processors currently using the existing calcium and osteoporosis health claim ample time to changes labels and deplete product and packaging inventory.

Foods that supply at least 200 mg of calcium and 80 IU of vitamin D per the FDA defined reference amount commonly consumed per eating occasion serving size qualify to use the new health claim. The required amounts of vitamin D and calcium may be from either a level of nutrients naturally occurring in the food or by fortification. Under FDA’s general requirement for health claims, products containing high levels of fat, saturated fat, sodium or cholesterol are still not allowed to use the health claim.

In addition to vitamin D’s newfound notoriety, another vitamin-vitamin K-will likely start showing up in more dairy foods in 2009. This is because vitamin K has been shown to play a key role in proper absorption and regulation of calcium and vitamin D by the body. And though vitamin K is found in common edible oils and green leafy vegetables, having it delivered to the body in the same vehicle containing calcium and vitamin D is an attractive marketing position.

Rather recent research indicates that vitamin K regulates calcium in the body. It helps keep calcium in bones and out of arteries. In so doing, vitamin K can reduce the risk of heart attack and osteoporosis at the same time.

Vitamin K works through gamma-carboxyglutamic acid, or Gla, which is part of a certain kind of protein that controls calcium. It is believed that vitamin K is the only vitamin that exerts this function, which is chemically referred to as carboxylation. Carboxylation enables certain proteins to attach to calcium, keeping calcium in bones where it is needed. Proteins that do not get enough vitamin K are under-carboxylated and can not control the mineral. Without a functioning protein to control calcium, the mineral drifts out of bone and into arteries and other soft tissue.

The most famous Gla protein is osteocalcin. Under-carboxylated osteocalcin (osteocalcin without vitamin K) cannot regulate calcium. When this happens, calcium leaves bones and teeth. Those with under-carboxylated osteocalcin excrete calcium and bones become porous and teeth weaken. Vitamin K reverses this trend.

Vitamin D fits into this whole bone-building chain reaction, too. Vitamin D provokes the osteocalcin gene into action. Once synthesized, however, osteocalcin needs vitamin K to function properly.

Vitamin D has dominated discussion on bone because it is a hormone that acts swiftly and dramatically. But the slower-acting vitamin K is just as important. And although it does not act as quickly on bone as vitamin D, new research indicates that vitamin K may actually be more of a bone-building regulator than previously recognized.

Without a doubt, the bone building message in 2009 will be a three-prong approach: consume calcium, vitamin D and vitamin K. And what better delivery vehicle is there than dairy foods?