+Waldbott Fluoride in Food AmJrlClinNutr 1963

8/3/2019 +Waldbott Fluoride in Food AmJrlClinNutr 1963

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From th e D epa rtm ent of M edic ine , H arper H osp ital,I )etro it , M ichig an.A m e rica n Jo urn a l o f C lin ic a l N u tri tion 45 5 V ol . 12 , June 1963

P ersp ectiv es in Nutr i t i on

F luor id e in F oodGEORGE L . W ALDBOTT, M .D .

I T Is hop ed tha t P erspe ctive s in N utrition w ill review th e literature selectively , in -te rpret it m odera tely and p resent a spectrum o f id ea s that w ill se rve a s a contin ua l

st imalatiomi to nutritiona l research applied to m edical pro blem s .

T lIE e lem en t flu orin e, aale green ish ye llowgas, conden ses to liqu id a t 120# {176}c . and

freezes a t m inus 2 50#{176}c . it is very ac tiveand , because o f its strong ten dency to com binew ith o ther e lem en ts , ra re ly occu rs in pu regaseous fo rm .

F luoride ion is w idespread in na tu re ; it ises tim ated to be th irteen th in abundance am ongthe e lem ents o f the earth .23 Pharm aco log i-ca lly sign ifican t is its s trong affin ity fo r ca lc iumand o th er m eta ls w ith w hich it fo rm s h igh lycom p lex com pounds . S om e of its ac tion hasbeen ascribed to its ca lcip r iv e effec t.4 Itsc lin ical sign if icance is p red ica ted upon its h ighreac tiv ity , its ub iqu ity and its p resence innearly every hum an tissue . In add ition tobon es and tee th , m any soft tis su es m ay , und ercerta in cond itions , s to re fluoride ion .

M ost food s, w h ether derived from plan t o ran im al life , con ta in fluoride ion a t least inm inu te am ounts. Som e foods con cen tra teadd itiona l f lu oride io n from boiling , p rocess ingor con tam ina tio n . F luorid e ion leve ls varyw id ely , even be tw een sam ples o f th e sam e kindof food .

FLUOR IDE ION IN FOOD FROM VEGETAT IONF luoride ion in p lan ts is d eriv ed from con-

tam in ated a ir and from so il. A ir becom escon tam ina ted by em ission o f fluo ride ion fromfac to ries, vo lcan ic erup tion s, com bus tion o fco al, evapo ra tion o f sea w ate r and from spray -

in g .7 F luo ride ion in the a ir en te rs th e p lan tth ro ugh the leaves , in so il th ro ugh th e roo ts.

There a re m any in co nsis tenc ie s in the f luo rideion co n ten t o f fo od derived from plan ts. T heya re a ttr ibu tab le to the loca lity in w h ich theya re g row n ; th e typ e of so il ; the d istance froman a ir-con tam ina ting source ; the d irectio n andin tens ity of p reva iling w inds ; the season ,especia lly whether d ry or w et ; w ea ther co nd i-tion s at the tim e of sam p ling ; w he ther theed ib le po rtion o f th e p lan t is lea f , roo t o rruit;w he the r th e p lan t w as fe rtiliz ed o r sp rayed ;how th e fo od w as pro cessed ; and how it w asp repa red fo r ea ting .

In the a ir f luo ride ion is p re sen t a s fum es o rm is t, m a in ly as h ydrog en fluo rid e and s ilico nte tra f luo ride and in p a rticu la te fo rm as sod iumfluo ride . W hen fluo rid e ion se ttle s o n leav es,it is abso rbed and tend s to m ig ra te to th eirtip s and m arg ins .8 W hen fluor id e ion is ab -so rb ed th ro ugh roo ts , it is depos ited m a in ly inthe roo ts an d stem s.7 V ery little tran sloca tiono ccu rs in to o the r p arts .

A tm ospheric cond ition s an d season affec tf luo ride ion sto rage b y p lan ts . T h ere is re la -tive ly little f luo rid e ion in legum es early in theg row ing season , bu t in a lfa lfa, flu o rid e ionleve ls2 a re h igh in M ay , d ec line to a m in im umin Jun e, and then rise to the m ax im um . T heh ighest fluo rid e io n u p take from the air occu rsd u rin g d ry pe rio ds, the low est af te r ra in . Insp ray in g exp erim en ts ,8 leaves co n ta in m o refluo rid e io n than stem s, stem s m o re thanruit;th ere is very little flu o ride ion inruit an d seed .


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SC When dried foods are analyz ed, f luo ride ion lev elsper w eight unit are four to ten tim es higher than im ithe fre sh material.

45 6 Waldbott

Intake o f fluoride ion into roo ts is large lydependent on the concentratio n of fluoride ionin the so il and on the type of so il.9 ,b0 Wheatgerm grown in an area of N o rth A frica w ith anunusually high fluoride ion content (7 ,470ppm.) in so il contained tw elve times morefluoride ion than w heat grow n in France .1

In acid so il f luo ride ion is more so luble7 -9and its intake by plants is increased. Lim ingthe so il w ith calc ium oxid&3 and the additio nof phosphates 4 reduces fluo ride ion intake byplants. A plant grow n in c lay loam takes upless f luoride ion than one grow n in sand.7N ommick2 found four to five times morefluoride ion in po tato skins than in the remain-der of the potato .

External s tructures of fruits and v eg etablescontain more f luoride ion than internal parts .D ry skin of bananas5 contained 51 ppm.,w hereas the fruit contained only 3 .8 ppm .Leaves in the center o f a head of spray ed cab-bage 6 had 3 .0 ppm ., w hereas the outsideleaves contained 34 ppm. The suture side o fpeaches in an air-contam inated area (TheD alle s , Ore .) contained substantially morefluoride ion than the opposite 7 partic-ularly during the ripening season.

With so many factors entering into thedepo sition of fluoride ion in plants, erraticvariations in content w ould be expected. A d-ditio nal discrepancie s in the available data82 #{ 1 76}are due to variatio ns in methods of analys is .

Tea leaves hav e the highest f luoride ioncontent2 and seem to have an unusual affinityfo r fluoride ion ; green leaves more than blackones ,22 o lder ones more than young er ones ,23reg ardle ss o f w hether fluoride ion is derivedfrom the atmosphere or from the so il. Incommerc ial teas, f luoride ion lev els vary from9 to 40 0 ppm. in dried samples .2 3 In some tealeaves, as much as 1 ,758 p.p.m . has been found(fat-free , dry* w eight), or 1 .7 mg. o f fluoride ionper gm23 A ccording to Jackson and Weid-mann , 24 the average brew of tea in Englandcontains about 1 ppm. of fluo ride ion ; 6 cupsw ould supply about 1 mg .

There is re lative ly little fluoride ion in grain,

roughly about 1 p.p.m . ; corn, w heat and buck-w heat tend to contain more , oats and rice less .Wheat germ , bran, corn germ and other ex -ternal s tructures of grain have show n fluorideion leve ls as high as 1 1 ppm. in tw enty-oneplants o f a sing le brand of w inter w heat, grow nin Sw eden in the same location under the sameconditions , the fluoride ion content v aried be-tw een 0 .38 and 1 .35 ppm.; in nine differentkinds of w inter w heat from different areas inSw eden fluoride ion leve ls rang ed from 0.92 to3 .69 ppm.2 Fluo ride ion in dust and so il w asbe liev ed to account for the high values .

Leafy veg etables are particularly susceptibleto air-borne fluoride ion and this accounts fo rw ide variatio ns in the contents o f vegetablesgrow n in dif ferent areas. A cco rding to M c-

Is the av erage fluoride ion content o fvegetables ranges betw een 0 . 10 and 0 .30 ppm.on a fresh w eight bas is. Conspicuous are therang es of fluoride ion in spinach (0 . 1 to 28 .3p.p.m .) and parsley (8 .7 to 11 .3 ppm.). Inpo tatoes (0 .4 to 5 .2 (1 ppm.) fluoride ion con-tent seem s to be re lated to the fluoride ioncontent o f

In recent reports from an area near Madras ,India, high in natural f luoride , analyses o f thefluo ride ion content o f eggplant show ed valuesof 2 .6 to 2 0 .0 ppm. and of okra, 4 (1 to6. 0ppm.2 In areas w ith industrial air contain-ination the fluoride ion content o f vegetablesdiffers appreciably from that in noncontam i-nated areas26 (Table i).

Fruit contains little fluoride ion : In c itrusfruits , leve ls range from 0 .( )7 to 3 .36 ppm.;in nonc itrus fruit, betw een 0 .35 and 2 . 1 ppm.-bananas, currants and gooseberries show ingthe highest lev els . Pineapple, according to

19 contains about 0 .9 ppm . In mostfruits , particularly c itrus , the protec tive rindexc ludes fluoride ion. How ever, apples spray edw ith fluo ride ion-containing insec tic ides containfrom 2 16 to 5 .6 ppm .29

Fluoride ion contents o f nuts v ary betw een0 .3 and 1 .4 5 ppm. Truhaut9 reported asmuch as 7 .8 ppm . in w alnuts .

Ex tensive studies o f the fluo ride ion contentin w ine have been made in w ine-rich Sw itzer-land and France. The usual concentrationranges from 0.05 to 0 .3 ppm . In w ine made


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F luoride in Food 457

TABLE IEffect o f A ir C on tam ina tio n on Fluor ide Ion Lev els in Food

Area Source FoodF luorid e Io n

Contamina t ion(p .p .m.*)

Norma l(ppm.)

Th e 1 )alles, O re .7M olil in , Sw itzerland27Tampa , Fla.28

S tray ed food item ns6

A lum inum n PlantA lum inum P lan tPhosphateFertiliz er P la n t

PeachCarro tsO rang e ju iceSp i na chMilkCelery leav esApp l e s

3.2 -21 .95. 0

0 . 05-3 . 1216 .0

3. 277.0-135

2.0-4 .5

0 .210.22-2 .00 . 07-0 . 17

0.1-0 .30 .7-5 .7

0 .04-1 .3

SC Va lue s vary accord ing to p ro xim ity of fac tor ies .

from g rapes grow ing near ac tive vo lcano es inI ta ly , m agnitudes of fluo ride io n as g reat asIS . 1 ppm . have been fo und .3#{176}

F lu oride io n contents of hop s and m alt areh igh (0 .9 and 12 .2 ppm .).3 In bee r T ruhau tnoted from 0.2 to 0 .8 ppm . of f lu oride ion .Sev era l b rew eries located in c ities in wh ichw ate r is f luo rida ted use n onfluo rid ated w a te rfo r brew in g .3 2 B eers brew ed w ith fluo rida tedw ate rcon ta in up to l.2p .p .m .33

FLUORIDE ION IN FOOD FROM AN IM ALSIn an im als , m ost f luo ride ion accum u late s in

th e ske leto n . Th ere fo re , b ones, b one m ea l an dbone sa lts, and calc ium -phosp ha te prep aration sm ade from bones a re m najo r so u rces o f f luo rideion in our d aily d ie t. T h e an im als age , thelen g th o f tim e it h a s been consum in g fluo rideion and the m agnitude of fluor id e io n in itsfo rage , its d rink ing w ate r and in supp lem enta ryd iet m ix tu re s de term in e the ex ten t o f f luo rideion accum ula tion . Am ong the w ide ly vary ingf igu re s o n fluo ride ion co n ten t o f bon es , tho seo f Roho lm 4 are cons idered re liab le ; he fou ndfrom 12(1 to 38(1 ppm . in young , apparen tlyhea lthy an im als and from SO to $10 ppm . ino ld er ones.

C erta in baby foods m ade from bone m eal,such as P ab lum , co n tain ed as m uch as 1 3 .7P-P 3 4 By sub stitu ting b one m eal fromyoung an im als , th is leve l has been redu cedconsiderab ly . T he resu lts o f ou r ana lyses ofthe f lu oride ion con ten t o f Pab lum rang ed from1 1 to iS ppm .33

U nder certa in cond itions no t ye t un derstoo d ,accum ula tion o f flu o ride ion tak es p lace inm u sc les , sk in and o th er o rg an s.6 -3 5 T hus , m ea tproduc ts , w hich usua lly con ta in re lative ly littleflu o ride ion occasio na lly con stitu te a sou rce o fh igh fluo ride ion in tak e . In m ost m eats f luo -rid e io n con ten t rang es from 0 .2 to 2 .0 p .p .m .,bu t in sa lt p o rk lev els a s h igh as 3 .3 p .p .m .have been repo rted ; and in k idneys an d liv er ,as h igh as 10 .8

M arine pro duc ts con ta in la rge am ounts offlu orid e ion , m ain ly b ecause wa ter is relativ elyh igh in flu o ride io n (1 to 8 .7 2 p pm .) . S om eseafoo ds, esp ecia lly C ru stacea th roug h th eirh igh ca lc ium con ten t, tend to accum ula te m orefluo rid e ion . As in p lan ts , th e ex te rna l po r-tio ns expo sed to f luo ride io n co n ta in la rg eram ounts than the in te rna l parts; the sk in ofsard in esM has fiv e tim es m ore fluo rid e ionth an th e w ho le fish ; the sk in o f cod fish tw en tytim es m o re than tha t o f its m ea t (32 .9 and1 .5 ppm . , re spectively). O ur da ta on f ishcaug h t n ea r the p hospha te -r ich sea coast o fF lo rida show ed 50 ppm . fluo ride io n in a redsnapper an d 54 p .p .m . in a sheepsh ead .33 L eeand N ilson37 repo rted as m uch as 8 4 .47 p .p .m .in d ry m acke re l.G e la tin is p repa red from an im al sk ins tow hich fluo ride ion -con tain ing com pound s hav ebeen app lied in cu ring and p ro cessin g .38 Lev elsas h ig h as 130 and 160 p .p .m . have been re-ported in ge la tin .39

M ilk con tain s from (1 .09 to 0 .3 2 ppm .4#{176 }T he re is no con sis ten t co rre latio n o f the flu o ride


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45 8 Waldbo t t

in T exa s, A riz ona , T enne ssee , A r -

ion con ten t o f m ilk and fluo rid e ion inhedrink ing w ate r o f ca ttle o r in the so il.4 F luo -ride ion lev e ls in m ilk in c rea se as the in take o ff luo ride io n in c rea ses .4 2 In m ilk from cow sgrazin g in a con tam in ated a rea , f luo ride iondid no t exceed 0 .5 p .p .m .4 3 F luo ride ion m ayen te r m ilk from c leans ing 12 bo th a tthe p lace o f p rod uc tion and in th e d airy . T h is ,in com bin atio n w ith a ir-bo rn e fluo rid e io n incon tam ina ted areas, m ay accoun t fo r suchex tremely h ig h fluo ride ion lev els a s the 3 .2p .p .m . encoun te red in a sam p le26 ob ta inedf rom cow s grazin g nea r a pho sph ate fe rtiliz e rp lan t in T am pa , F lo r ida . A ccord ing to E vansan d Ph illip s ,4 4 m o st f luo ride ion in m ilk isfound in the w ate r frac tion (0 .014 ppm .) andin case in (0 .005 ppm .) ; less is p resen t in fatand prec ip ita ted heat co agu lab le p ro te in(0 .00 12 ppm .).

Cheese co n ta ins ap prox im ate ly 60 pe r cen td ry sub stance. T he re fo re, it is co rre spo nd-ing ly riche r in f luo rid e ion than m ilk va luesrange be tw een 0 .16 and 1 .31 ppm .2 Som ef luor ide ion no doub t is lo st w ith the w hey inthe p ro duc tion of cheese. In com m erc ial ca -sein used in an im al experim enta tio n , fluorideion leve ls as h ig h as 3 59 p .p .m . w ere foun d .45

E ggs con ta in be tw een 0 .2 an d 0 .4 ppm . o ff luo ride ion . P h illip s e t a l.46 fou nd 3 .2 ppm .w hen ch icken s w ere fed ro ck pho sph ate con-tam ing 3 pe r cen t f luo ride ion fo r tw en ty -e igh tm on ths. In eg g yo lk fluo rid e io n is p re sen tas its lipo id frac tion .46

Thus, the m a jo r sou rces o f flu o rid e ion in a

TA BLE IIF lu oride Ion in W ater

Source .Location Fluor ide(ppm.)

Seawat&Sea w a ter6Ra in w ater4Wel l wa te rR iv er w ate rM axim um allow -

ab le lim it6

P ers ian G ulfGe rmanyU . S . A .

In w arm clim ateIn coo l clim a te

1 .( ) -1 .48 .72Up to 3 .4Less th an 0 5S C0 . 0-25 and

mnore1 .42 4

SC H igher lev elskan sas and South D ako ta .

d iet a re tea , s ea food , ge la tin , sp inach and bon em ea l; the food s w ith the leas t fluo rid e io ncon ten t are fru its and v eg e tab les . H ow ev e r,the re is n o w ay of p red ic ting the am oun t o ff luo ride ion in a ce rta in m ea l becau se o f th ew ide varia tion s o f fluo ride ion in d iffe ren t sam -p ies of the sam e food .

DA ILY INTAKE O F FLUOR ID E IONTo d e term ine the d aily fluo rid e io n in take o f

a person , th ree fac to rs m ust be con sidered :(1 ) the re la tion of food-b orne fluo ride ion toflu o ride ion from othe r sou rces; (2 ) p rep ara tionan d processing of fo od ; an d (3 ) foo d hab its o fthe ind iv idua l.Food-Borne Fluoride ion Related toFluoride Ion from O ther Sources

Food and w ate r are the p rinc ipa l sou rces o ffluo ride ion in tak e ; abso rp tio n of f lu oride ionfrom air and in tak e from drugs are lesse rsources . M cC lure4 7 estim ated the da ily aver-age in take o f f luo ride io n from fo od by ch ild renunder tw elv e y ears o f ag e toe b etw een 0 .25to 0 .5 5 m g. M ach ie e t al.48 consid ered 0 .5 to1 .0 m g . th e ave rag e in take fo r adu lts . A na lyse sby A rm strong and Know lton 49 o f th ree m ealsse rv ed to th e hou se sta ff o f M inneso ta G ene ra lH o sp ita l, be fo re th e w a te r w as fluo rid ated ,show ed an ind iv idu als in take to b e be tw een0 .27 and 0 .32 m g. of fluor id e ion per day .G abov ich ,5# {176} in a low fluo ride a rea o f theU .S .S .R . fo und fluo ride ion in take to b e be-tw een 0 .54 to 1 .2 m g . p er d ay .

Fluoride Ion in W aler (ThbIe II). T he fluo -r ide io n con ten t o f w ate r d ep en ds large ly up onits sou rce . Sea w ate r con ta in s b e tw een I .0and 1 .4 p pm .5 Th is is h igh com pared w ithleve ls o f iod ine , p hosp ho rus an d a rsena te .F luo rid e ion con ten t in th e w a te r o f th e P ersianG ulf has been repo rted to be as m uch as 8 .72ppm .52 Surface w ater is genera lly low inf luo ride io n , in con tra st to sub so il w a ter w h ichis in c lo ser, m ore pro trac ted con tac t w ithfluoride ion-bearing m inera ls. F luoride io nco n ten t in lakes in vo lcan ic areas is kn ow n tob e as m uch as 2 ,8 00 ppm .53 k Iost w e lls inthe U . S . A . con tain traces o f fluo rid e io n , lessthan 0 .5 ppm . H ig her leve ls a re fou nd ina rea s o f fluo rid e ion -bea rin g ro ck su ch as


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SC Iii the w ate r of t h e P eace R iv e r , F lor id a , 47 ppm.w a s n o ted r e cen t ly ( Tam pa Tribune, S eptember 15 ,1961) .

Fluo ride in Food 45 9

Western Texas, A rizona, Tennessee, A rkansasand South D ako ta. A nalysis o f rainw ater inan air po lluted area in Germany show ed asmuch as 3. 4 ppm. ; in Tennessee , from 0.01 toi.o: ppm.4 Our data revealed 2 .1 p.p.m .near a phosphate fertiliz er plant in Florida.River w ater contam inated by facto ry w aste hasshow n as much as 25 p.p.m .SS*

One part per m illio n in w ater supplies is be ingrecommended for the preventio n of too th de-cay . W ith concentratio n in w ater at this leve l,daily intake of 1 ,000 or 1 ,500 ml. o f w aterw ould supply be tw een I and 1 .5 mg. o f f luo rideion .47 This amount is contained in four tosix g lasse s o f w ater a day , or its equivalent insoups , co f fee, e tc . Eating and drinking habits,atmospheric conditions , temperature andhumidity changes , state o f health (diabetes,febrile diseases , e tc .) account for w ide dev ia-tions of fluoride ion intake from such averages.A s maximum allow able lim its o f fluo ride ion inwater, health authorities hav e se t 2 .4 p.p.m .in coo l climates and 1 .4 p.p.m . in w armclimates.56

F luoride Jon in ir. Relative ly little in-formation is available about the daily absorp-tion of fluoride ion from air in metropo litan andrural areas . Combustion of w ood and coal andemanations from factories contribute to anormal c ity atmo sphere w ith a f luo ride ioncontent o f 0 .025 p.p.m .5 7 This w ould prov ide adaily intake through the air passag es o f 0 .1 6mg . In c lose prox im ity to certain facto ries ,espec ially tho se producing stee l, alum inum,magnesium , beryllium , phosphate fertilizer,g lass and bricks, these v alues are greatly ex -ceeded .

Fluoride Ion from D rugs. Some persons takeinto the ir sy stem substantial amounts off luoride ion from drug s. Certain tranquilizersand stero ids , for instance , taken habituallythree times a day , furnish a daily intake offrom 0.8 to 1 .0 mg. N ot known at present ishow tightly the fluoride ion remains bound tothe molecule o f the drug once it has reachedthe extrace llular and intrace llular fluids .

F luoride ion in Processed and C ooked F oods(Table III)A dditional f luc tuations o f fluoride ion intake

from meals are attributable to processing andfood preparatio n. W hen food is bo iled influo ride ion-containing w ater, its f luoride ionconcentration increases .M Caulif low er andcabbage cooked in w ater containing fluoride ionabso rb more fluoride ion than beets andcarrots , w hich are les s penetrable . V eg etable scooked in a saucepan abso rb more f luoride ionthan tho se co oked in a pressure cooker.MD ried foods, such as oatmeal, absorb w aterduring co oking59 and thus acquire additio nalamounts of fluoride ion.

In canned, strained spinach, Ham andSm ith34 reported the fluoride ion content to bebe tw een 6 .8 and 8 .2 p.p.m . (dry) as comparedto unprocessed spinach inhich the contentranged from 11 1 to 7 .97 ppm . Pow deredspinach contained 70 p.p.m . S e lf-ris ing flo ur

T A B L E I I IFluoride I o n L ev els (p p m .) in M a jo r F lu or id e I on -

Containing Foods

Fluoride IonFood ( p p m . )

F rom V egetable K ingdom

Te aG r a i n\egetablesPotatoesSpinachCitrus fruitN oncitrus fruitN u t s

Wine

Beer

3 .2 -4 . ( )A l x u t 1 .00 . 10-0 .300 .4-5 .200 . 1 -20 .30 .07-0 .360 . 35-2 . 10 .3 -1 .45(max i -

mum 7.8)0.05-0.3(maxi-

mum 18.1 )0.2-1.2

F rom Anim al K ingdom

Bone mealMeatDriedmeatFishMilkCheeseEgg

246-7700 .2-2 .03 .3 -7 .71 .0 -8 .0 (maxi-

mum 84.5 )0 .09-0 .320 . 1 6-1 .310 .2-0 .4


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460 W ald bo tt

had a fluorid e ion con ten t ran g ing from 4.9 to7.4 ppm .6#{176 } In on e sam p le o f sh redd ed w heatthe flu o ride ion con ten t w as 9 .4 ppm . in an-o ther sam ple it w as on ly 0 .86 p .p .m .33

T he U . S . F o od and D rug A dm in istra tion smax imum allow ab le lim it o f flu o ride ion insp ray res idue on fru it and vege tab les w as 1 .43ppm . in 1943 ; in 1944 it w as increased from2.8 to 7 p .p .m .6m Celery leaves6 spray ed ex-pe rim en ta lly w ith a f luo ride ion -con ta in in gin sectic ide con ta ined as m uch as 1 35 ppm .;app les a s m uch as 5 .6 ppm .29 A la rg e app lethu s treated w ou ld p rov ide 1 .0 m g . o f f luo rideio n or as m uch as fou r g la ss o f w a te r f luo ri-d ated a t 1 .0 ppm .29

Fe w reliab le da ta a re ava ilab le o n flu o ride ionin fo od add itives . In N ew found lan d , flourcon ta in s a ca lc ium supp lem en t of 0 . 5 per cen tbon e m ea l. T h is adds 1 .0 m g . o f flu o ride ionto the av erag e da ily d ie t.62 In England , c re ta(ch alk ) is ad ded to a ll flo u r in am oun ts o f 0 .3 iper cen t. C re ta , w ith fluo rid e io n o f 2 30ppm .,6 3 increases th e fluoride ion con ten t o fflour by 0 .7 ppm . above its usu al con ten t. Inbak ing pow der , the flu o rid e io n con ten t hasbeen reported to b e b etw een 19 an d 220pm.64

A rtif ic ially flu o rida ted w a te r and flu o ride io npresen t in dyes an d d e te rg en ts con tribu te fu r-ther to the h igh in tak e of fluo ride io n from food .The m agn itude o f fluo rid e ion from theseso urces has no t ye t been adequa te ly stud ied .Fo r in stance , in a tow n w ith flu orida ted w ate r,a w h ite cak e w ith sev era l c ream laye rs anddecora tive co lo ring , th o ro ugh ly m ix ed be fo reana lysis , con ta in ed fluoride io n in the am ount of4 .52 ppm .

Sa lt con tain s abo u t 5 ppm . ; sea sa lt, 40ppm .65 The la tter is be lieved to accoun t fo ra h igh fluoride io n leve l in the tee th of ch ild renwho reside in areas where sea sa lt is used ex-tensive ly , such as Bom bay , Ind ia . Sa lt fromva rious R uss ian citie s con tain ed 10 to 1 41p .p .m .5# {176} A person usin g 1 5in . of sa lt pe rday w ould consum e 0 .19 m g. from th is sou rcealone.50E f f ec t o f F oo d H ab its o n F lu or ide ion I n tak e

Food hab its a lso com plicate the question ofda ily f luo rid e ion in tak e . In N ew Z ea landwhere tea is a m ajo r sou rce of fluoride ion in -

take , hab itua l tea d rinke rs e lim ina te m orefluor id e ion in urine than non -tea drink ers .66T he leve ls o f fluo rid e ion in the bon es o f Eng lishsu b jects w ith the tea d rink ing hab it a re h ighe rthan in the bon es o f peop le in the U . S . A .24O ne of m y patien ts (a f ifty - five year o ld wom anw ith os teo arth r itis o f th e low er sp ine ) hadhab itua lly im bibed I 5 to 20 cups of tea da ily fo rtw en ty -five years . F rom th is source alon e herd a ily in take of fluoride ion ranged from 1 .82 to2 .44 m g. T he w ate r su pp ly in her hom e con-tam ed 0 .4 p pm . The u rinary excre tion off luo ride io n pe r tw en ty -fo u r ho urs rang ed from1.7 to 6 .3 m g. (s ix de te rm ina tions).

In N ew fo und land , f ish is a m a jo r stap le foo d .T he ave rag e da ily d ie t con ta in s abou t 1 .7 4 m g .o f f luo rid e ion .62 N ew found land ers , w ho drink6 cup s of tea da ily , tak e in 2 .74 m g. o f fluorideio n from these tw o sources a lon e . O n th e is landT ris tan da C un ja , w he re the w a te r con-ta ins on ly 0 .2 ppm ., a h igh inc idence of den ta lf lu oros is has b een a ttribu ted to a d ie t h igh inseafood 67

A patien t w ith ske le ta l flu oros is w as d e-sc ribed by O den tha l and W ien ek e.68 Th ep a tien t ob ta ined p rac tica lly h is en tire da ilyin take o f w ater from a m ounta in spring w hichh e d eem ed espec ia lly con duc ive to health .T he flu o ride io n co n ten t o f the w a te r w as 7 .5ppm . ; h is d a ily fluoride io n in take w as esti-m ated to be 1 1 t o 12 m g .

It is n o t th e p urpose o f th is pape r to d is-cu ss th e c lin ical phase o f ex cess fluoride ionin take . It sho u ld be em ph as ized , how ever,tha t the la titude be tw een what con stitu tes asafe and a tox ic lev e l o f fluo ride io n in take isex trem ely narrow . F urtherm o re, fluoride ionaccum u late s un de r cer ta in con d ition s69 in sub-s tan tia l am ounts in m any so ft tissues, particu -la r ly th e ao rta . T he sign ificance o f su ch ac -cum ula tion is no t k now n a t the p resen t tim e .

SUMMARYF lu orid e is p re sen t in n early ev ery fo od th e

h igh es t concen tra tio ns are found in tea , seafood ,bon e m eal, sp in ach and ge la tin , the least inc itru s fru its , vege tab le s , eg gs and m ilk . T heam oun t o f flu o ride io n tak en in to the sy stem infoo d is unp red ic tab le ; it is dependen t on flu -m ero us facto rs perta in in g to th e food , its p roces-


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F luoride in Food 46 1

sing and prep aration , and on the food hab itso f th e in d iv idua l co nsum er .

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+Waldbott Fluoride in Food AmJrlClinNutr 1963

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