Contribution of folic acid-fortified foods to fertile women’s folate Recommended Nutrient Intake through breakfast simulation models

Samaniego-Vaesken, María de Lourdes; Alonso-Aperte, Elena; Varela‐Moreiras, Gregorio

doi:10.1017/s1368980014002572

Cited by 5 publications

(5 citation statements)

References 26 publications

(33 reference statements)

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“…The relative high micronutrient intakes at breakfast observed in the current study are likely to be at least partially driven by current Spanish voluntary fortification practices (mainly in milk and milk products and cereals), although a tendency to decrease the presence of fortified foods (e.g., calcium and folic acid) in the Spanish market in the last years has been reported [ 37 , 38 ]. Notably, fortified breakfast cereal consumption has been associated with a higher dietary adequacy, specifically in relation to B vitamins, vitamin D and iron, without the risk of exceeding the Tolerable Upper Intake Level intake [ 39 ] and also towards a better nutrient-dense breakfast model in Spain [ 40 ]. The contribution of total fats and monounsaturated fatty acids from breakfast are also below the thresholds when compared to the daily energy, particularly for polyunsaturated fatty acids (PUFA).…”

Section: Discussionmentioning

confidence: 99%

Breakfast Consumption in Spain: Patterns, Nutrient Intake and Quality. Findings from the ANIBES Study, a Study from the International Breakfast Research Initiative

et al. 2018

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This study aimed to investigate energy, nutrient and food group intakes at breakfast in Spain and to examine for the first time, their relationship to the overall Diet Quality (DQ). The data used were from the Spanish ANIBES (anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain), a cross-sectional study using a nationally representative sample of the Spanish population (9–75 years old). DQ was assessed using the Nutrient Rich Foods Index, adapted to total diets (NRF9.3d). Most (>85%) of the Spanish population were regular breakfast consumers, although one in five adolescents were breakfast skippers. Breakfast provides just 16–19% of the daily intake of energy. Relative to its daily energy contribution, the Spanish breakfast contributed a higher proportion of daily total carbohydrates, added sugars, sodium, thiamin, riboflavin, folates, iron, potassium, magnesium, phosphorus and especially in calcium. By contrast, the breakfast is low in water intake, protein, dietary fibre, total fat, polyunsaturated fatty acids, beta-carotene and vitamins E and D. In children and teenagers, the most commonly consumed breakfast food was chocolate (mainly as chocolate-flavoured milk and powder), followed by bakery and pastry, whole milk and semi-skimmed milk. In the older groups, a bigger variety of foods were reported. Consumers in the highest NRF9.3d tertile for diet quality tended to have a higher intake of positive nutrients at breakfast than other tertiles, most notably among adults.

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Section: Discussionmentioning

confidence: 99%

Breakfast Consumption in Spain: Patterns, Nutrient Intake and Quality. Findings from the ANIBES Study, a Study from the International Breakfast Research Initiative

et al. 2018

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“…This study also found that the use of antibiotics before or early pregnancy was associated with NTDs. The possible reason is that antibiotic medications may have antifolate effects [ 86 ]. Some specific forms of antibiotics such as sulfonamides are risk for fetus developing NTDs [ 87 , 88 ].…”

Section: Discussionmentioning

confidence: 99%

Determinants of neural tube defects among women who gave birth in hospitals in Eastern Ethiopia: evidence from a matched case control study

Berhane,

Belachew

2023

BMC Women's Health

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Introduction Neural tube defects (NTDs) are severe birth defects caused by nutritional, genetic or environmental factors. Because NTDs continue to have a significant health and economic impact on children and community at large, it is crucial to investigate potential risk factors in order to develop novel approaches to NTDs prevention. Determinants for the development of NTDs differ by country, region as well as within the country. The objective of this study was to identify the determinants of NTDs among newborns delivered in three hospitals found in eastern Ethiopia. Methods A hospital-based matched case-control study was conducted among 138 cases and 138 control women who delivered in three teaching hospitals in Eastern Ethiopia in 2021. Data were collected using a structured and pre-tested interviewer-administered questionnaire. Cases were mothers who delivered a neonate with any type of NTDs regardless of gestational age or fetal viability, whereas controls were mothers who delivered an apparently healthy newborn. Chi-square was used to assess the significant difference between the two groups. Conditional logistic regression model was used to generate adjusted odds ratio with its corresponding 95% confidence intervals and compare the two groups. Results Anencephaly (51.4%) and spinal bifida (34.1%) were the most frequently observed NTDs. None of study participants took preconception folic acid supplementation. Being a non-formal mothers (AOR = 0.34, 95% CI: 0.12–0.92, P = 0.034), rural residence, (AOR = 3.4, 95% CI: 1.18–9.78, P = 0.023), history of spontaneous abortion (AOR = 2.95, 95% CI: 1.15–7.55, P = 0.023), having severe anemia (AOR = 3.4, 95% CI: 1.17–9.87, P = 0.024), history of fever or cold (AOR = 2.75; 95% CI: 1.05–7.15, P = 0.038), and an exposure to various agro-chemicals (AOR = 3.39, 95% CI: 1.11–10.3, P = 0.032) were independent determinants of NTDs. Conclusion and Recommendation In this study, NTDs were associated to several determinant factors in the area, including residential area, history of spontaneous abortion, severe anemia, fever/cold, antibiotic use before or during early pregnancy, and exposure to agrochemicals. Addressing the identified determinants is critical in averting the incidence of NTDs in the study area. Moreover, more research is needed to investigate women’s dietary practices as well as the practice of preconception folic acid supplementation for pregnant women in Ethiopia’s current health care system.

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“…In Spain, women of childbearing age are at risk of insufficient folate intakes since only 50% of recommended folate intake is ingested through diet at present [10]. The daily inclusion of fortified products could provide this population group with 20%–60% of FA recommended intake, when fortification level 4 products are consumed [31]. On the other hand, there is concern that population subgroups, including children and the elderly, may be at risk of consuming usual intakes above the UL.…”

Section: Discussionmentioning

confidence: 99%

“…Data is scarce and therefore quantification of the underestimation of FA intake due to the non-consideration of fortified products is still speculative. According to our previous studies, the non-consideration of FA fortification may underestimate as much as 40% of actual folate and folic acid intake in women [31] and children [32]. In the Irish study [22] the difference in total folate and FA intake between consumers and non-consumers of fortified products is above 50%.…”

Section: Discussionmentioning

confidence: 99%

Voluntary Folic Acid Fortification Levels and Nutrient Composition of Food Products from the Spanish Market: A 2011–2015 Update

2017

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Introduction. Folic acid (FA) is a synthetic compound commonly added for voluntary fortification of food products in many European countries. In our country, food composition databases (FCDB) lack comprehensive data on FA fortification practices and this is considered a priority research need when undergoing nutritional assessment of the population. Methods. A product inventory was collected and updated by visiting retail stores in Madrid Region, conducting online supermarket searches, and by the provision of food label information by manufacturers. Euro-FIR FCDB guidelines for data compilation and harmonization were used. Results. The FCDB, compiled between 2011 and 2015, includes FA as well as macro and micronutrient data from 338 fortified foodstuffs. As compared to previous FCDB updates (May 2010), 37 products have ceased to declare added FA in their labels, mainly yogurt and fermented milk products. The main food subgroup is ‘breakfast cereals’ (n = 95, 34% of total). However, the highest average FA fortification levels per recommended serving were observed in the ‘milk, milk products, and milk substitutes’ group at ≥35% FA Nutrient Reference Values (NRV, 200 µg, EU Regulation 1169 of 2011) (60–76.3 µg FA per 200 mL). Average contribution to the FA NRV per food group and serving ranged between 16%–35%. Conclusion. Our data show a minor decrease in the number of FA fortified products, but vitamin levels added by manufacturers are stable in most food groups and subgroups. This representative product inventory comprises the main FA food source from voluntary fortification in our country. It is therefore a unique compilation tool with valuable data for the assessment of dietary intakes for the vitamin.

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Contribution of folic acid-fortified foods to fertile women’s folate Recommended Nutrient Intake through breakfast simulation models

Abstract: At existing levels of FA fortification, inclusion of fortified products as part of a regular breakfast meal could positively impact the nutritional quality of women's diet without involving a risk of excessive FA exposure.

Cited by 5 publications

References 26 publications

Breakfast Consumption in Spain: Patterns, Nutrient Intake and Quality. Findings from the ANIBES Study, a Study from the International Breakfast Research Initiative

Breakfast Consumption in Spain: Patterns, Nutrient Intake and Quality. Findings from the ANIBES Study, a Study from the International Breakfast Research Initiative

Determinants of neural tube defects among women who gave birth in hospitals in Eastern Ethiopia: evidence from a matched case control study

Voluntary Folic Acid Fortification Levels and Nutrient Composition of Food Products from the Spanish Market: A 2011–2015 Update

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