In survey after survey, we say we want to eat healthful foods, but then what do we do?
We eat whatever we want, hoping to somehow avoid the consequences of excess calories, sugar and fat in our favorite treats.
Always eager to give American consumers what they want, the food industry thought, why not make all unhealthful foods "healthy" by adding assorted herbs and nutrients?
If you buy into that thinking, you can still have that Dove bar ... as long as you sip coffee fortified with herbal supplements that "improve joint health," "promote natural weight loss" or "strengthen the immune system." And you can still eat Doritos today ... but snack on cheese with probiotics to aid digestion tomorrow.
But should you?
Ever since iodine was added to Morton salt in 1924 to eradicate the thyroid condition goiter, food companies have been exploring ways to add other medically beneficial ingredients to their products. Milk was fortified with vitamin D and grains with folate. Some cereals and margarines make heart-healthy claims, and calcium-fortified orange juice is standard fare.
"Since World War II, a lot of fortification has led to improvement in overall nutrient intake," said Eileen Kennedy, dean of the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University in Boston, the only graduate and professional school of nutrition in North America.
Fortification isn't a magic pill, though, just as nutritional supplements are only that - supplements, Kennedy said.
"I am a strong believer in food being the cornerstone of nutrition rather than non-traditional sources or pills," she said.
"There's a tendency to think, let's take a product which is not a core part of the diet - like carbonated beverages, which used to be an occasional treat - and fortify it. Now milk is being replaced with soda, which is a disturbing development."
Perusing new products that carry assorted health claims can be confusing.
"The problem with fortified foods is, if you eat them you don't know if (the health claims) work or not," said Harry Balzer, vice president of The NPD Group market research company. Balzer has followed Americans' eating and drinking patterns for 25 years and has seen consumers both latch onto fads and become skeptical of health claims.
Health claims are just that - claims, he said.
None of the low-fat, low-cholesterol foods introduced in the past has taken over its particular category, except for dairy, Balzer said.
One thing is certain: Diet is implicated in four of the six leading causes of death in America: heart disease, certain cancers, stroke and Type 2 diabetes, according to the Centers for Disease Control and Prevention. A report by Mintel International Group Ltd., another market research giant, notes that as many as three out of four deaths annually are attributed to diseases linked to diet and lifestyle.
So clearly, consuming the right nutrients is important. Whether you can accomplish that by consuming fortified foods is a matter for more research, and to some degree, common sense, the experts say.
"What are naturally good sources of a nutrient from the food supply, we can get there. If we can't, try fortification," she suggested. "Talk about information overload, though. You almost have to be a nutritional scientist to make sure what combination of food and nutrients makes sense."
"Health" and "wellness" are buzz words with staying power. But the message of how we may achieve those goals shifts over time, Balzer said.
"In the mid-'90s, health was about what foods we should avoid - sugar, caffeine, sodium, cholesterol," the market researcher said. "Then there were foods to eat because they're good for you, such as fortified cereal and orange juice.
"Health and wellness is not a fad, but how it's defined tends to be."
Last year, cereals with heart-healthy claims and/or cholesterol-reduction claims were the most-often purchased "functional" foods, according to a Mintel survey. Cereals with added vitamins and/or minerals ranked second, followed by margarine/spreads with heart-healthy claims.
Fortified orange juice and bottled waters topped the functional beverages category in the 2006 survey.
But in recent years, food companies have pushed the envelope. Now you can buy diet cola with vitamins and minerals added, or diet cola with ginseng to help you get through the day. Then there's water with, of all things, fiber.
Probiotics and prebiotics are among the newest wave of additives. Prebiotics are substances intended to promote the growth of certain bacteria in the intestines, while probiotics are bacterial cultures that assist the digestive system, possibly helping those with lactose intolerance or other digestive issues.
At the Food Marketing Institute's trade show in Chicago this month, about 20,000 food industry people perused thousands of new food items produced by American companies.
For every traditional sugar-laden dessert, at least one "health and wellness" product presented another option.
But while Americans generally are eager to try new things, they aren't rushing en masse to grab the newest generation of fortified foods from the shelves.
In the 2006 Mintel survey, of the two-thirds who had not bought a functional food or drink in the previous three months, 35 percent agreed with the statement: "I don't believe the claims they make."