I

103D CONGRESS

2D SESSION H. R. 4284

To require the Secretary of Health and Human Services to review the relationship between calcium intake, bone mass, and osteoporosis, determine

how many Americans consume too little calcium, develop optimal calcium

intake levels, and amend, as appropriate and based on such review,

the standard of identity for enriched flour used in the manufacture

of bread, cereal, and other grain products under the Federal Food,

Drug, and Cosmetic Act to require the addition of calcium.

IN THE HOUSE OF REPRESENTATIVES

APRIL 21, 1994

Mr. MARKEY (for himself, Mr. BONIOR, Mr. KENNEDY, Mr. PARKER, Mr.

RICHARDSON, Mrs. LLOYD, Mr. FRANK of Massachusetts, Mr. MOAKLEY,

Mr. MANTON, Mr. REYNOLDS, Ms. EDDIE BERNICE JOHNSON of Texas,

Mr. TOWNS, Mr. MCDERMOTT, Mr. LEHMAN, Mr. KREIDLER, Mr. SLATTERY, Mr. WYDEN, Mrs. UNSOELD, Ms. BROWN of Florida, Mr. KING,

Mr. GENE GREEN of Texas, Mr. WYNN, Mr. DELLUMS, Ms. SLAUGHTER,

Mr. WALSH, and Mr. FOGLIETTA) introduced the following bill; which

was referred to the Committee on Energy and Commerce

A BILL

To require the Secretary of Health and Human Services

to review the relationship between calcium intake, bone

mass, and osteoporosis, determine how many Americans

consume too little calcium, develop optimal calcium intake levels, and amend, as appropriate and based on

such review, the standard of identity for enriched flour

used in the manufacture of bread, cereal, and other

grain products under the Federal Food, Drug, and Cosmetic Act to require the addition of calcium.
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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Osteoporosis Risk

5 Reduction Act of 1994’’.

6 SEC. 2. FINDINGS.

7 The Congress finds that—

8 (1) Twenty-five million Americans, most of

9 whom are women, suffer from osteoporosis, a reduc10 tion of bone mineral density to a level at or below

11 the fracture threshold,

12 (2) osteoporosis affects as many as 50 percent

13 of women over the age of 45 and 90 percent of

14 women over the age of 75,

15 (3) osteoporosis causes 1.5 million bone frac16 tures every year and is estimated to cost the nation’s

17 health and long-term care systems more than $10

18 billion annually,

19 (4) only 25 to 50 percent of hip fracture pa20 tients can expect to regain their previous level of

21 mobility and independence and as many as one of

22 every five people will die within one year of fractur23 ing a hip,

24 (5) the level of dietary calcium intake, particu25 larly during childhood, adolescence, and young adult-
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1 hood, is related to the amount of bone mineral den2 sity achieved by individuals,

3 (6) many Americans, particularly adolescent

4 girls and young women, fail to consume an adequate

5 amount of calcium through their daily diets, and

6 (7) the risk of osteoporosis can be reduced

7 through adequate calcium consumption.

8 SEC. 3. REVIEW OF DATA AND DEVELOPMENT OF REC9 OMMENDATION.

10 The Secretary of Health and Human Services shall

11 direct the food advisory committee to the Commissioner

12 of Food and Drugs to—

13 (1) review the available data regarding the rela14 tionship between dietary calcium intake, bone min15 eral density, and onset of osteoporosis,

16 (2) determine whether the recommended daily

17 allowances (RDA) for calcium established by the Na18 tional Academy of Science appropriately reflect the

19 relationship described in paragraph (1) and what

20 proportion of children, adolescent males and females,

21 and adult men and women currently achieve the

22 calcium RDA,

23 (3) develop optimum levels of daily calcium in24 take to reduce the risk of osteoporosis for children,
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1 adolescent males and females, and adult men and

2 women, and

3 (4) develop, as appropriate and based on the

4 findings under paragraphs (1), (2), and (3), a rec5 ommendation to the Secretary of Health and Human

6 Services for an amendment to the standard of iden7 tity for enriched flour under section 401 of the Fed8 eral Food, Drug, and Cosmetic Act for the fortifica9 tion of bread, cereal, and other grain products with

10 calcium in an amount sufficient to effectively assist

11 individuals in achieving the optimal intake levels de12 scribed in paragraph (3).

13 The advisory committee shall report its findings and rec14 ommendation to the Secretary within 180 days of the date

15 of the enactment of this Act. In developing its rec16 ommendation, the advisory committee shall take into con17 sideration the issue of bioavailability and the potential for

18 interaction between minerals.

19 SEC. 4. SECRETARIAL ACTION.

20 (a) REVIEW OF RECOMMENDATION AND DEVELOP21 MENT OF AMENDMENT.—The Secretary of Health and

22 Human Services shall review the findings and rec23 ommendation of the advisory committee under section 3

24 and shall, as appropriate and based on the findings and

25 recommendation, develop a proposed amendment to the
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1 identity standard for enriched flour under section 401 of

2 the Federal Food, Drug, and Cosmetic Act which will pro3 vide for the fortification of bread, cereal, and other grain

4 products with calcium at a level that will assist individuals

5 in achieving an adequate intake of calcium and reduce the

6 risk of osteoporosis.

7 (b) REPORT TO CONGRESS.—Not later than 1 year

8 after the date of the enactment of this Act, the Secretary

9 shall report to the Congress the findings and recommenda10 tion of the advisory committee under section 3 and the

11 Secretary’s proposed amendment to the standard of iden12 tity for enriched flour used in the manufacture of bread,

13 cereal, and other grain products described in subsection

14 (a).

15 (c) SCHEDULE.—The Secretary shall take such ac16 tion as may be appropriate to expedite the consideration

17 and promulgation of the amendment to the identity stand18 ard for enriched flour described in subsection (a).

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