Effect of food fortification on folic acid intake in the United States

Quinlivan, Eoin P.; Gregory, Jesse F.

doi:10.1093/ajcn/77.1.221

Cited by 249 publications

(179 citation statements)

References 36 publications

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“…Essa discrepância ocorreu em função do enriquecimento das farinhas, pois nosso estudo foi conduzido após a implementação da resolução brasileira que tornou obrigatória a fortificação das farinhas com ácido fólico. Apesar de não haver estudos que avaliaram o impacto da fortificação mandatória no Brasil, muitos são os trabalhos, principalmente estadunidenses, que verificaram a evolução positiva tanto da ingestão, quanto do nível sérico da vitamina entre o período pré-e pós-fortificação 20,23 .…”

Section: Discussionunclassified

Folate, vitamin B6 and vitamin B12 in adolescence: serum concentrations, prevalence of inadequate intakes and sources in food

Steluti¹,

Martini²,

Peters³

et al. 2011

J Pediatr (Rio J)

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Objective: To investigate serum concentrations and the prevalence of inadequate folate intake and also vitamin B6 and vitamin B12 intakes and to identify those foods that make a major contribution to intake levels of these nutrients.Methods: This was a cross-sectional, observational study of adolescents of both sexes aged 16 to 19 years from the town of Indaiatuba, SP, Brazil. Data collection was by non-consecutive 3-day dietary record. The samples' habitual diet was estimated by removing intraindividual variability, and the prevalence rates of inadequate intakes were calculated using the estimated average requirement as cutoff points. Biochemical assays for folate, vitamin B6 and vitamin B12 were conducted in accordance with the methods accepted in the literature. Results:The study sample comprised 99 adolescents, the majority of whom were female (58.6%), with a mean age of 17.6 (standard deviation, [SD] 0.9). Mean serum concentrations for folate, vitamin B6 and vitamin B12 were 9.2 (SD 3.4) ng/mL, 18.7 (SD 5.1) nmol/L and 397.5 (SD 188.4) pg/mL, respectively; and the prevalence rates of inadequate intake for these vitamins were 15.2, 10.2 and < 1%, respectively. The foods that made a major contribution to vitamin intakes were French bread, pasta and beans for folate; white rice, chicken and beef for vitamin B6; and lean beef, whole milk and fatty beef for vitamin B12. Conclusions:The prevalence rates of inadequate folate, vitamin B6 and vitamin B12 intakes were low, which is possibly the result of improved access top and availability of foods that are dietary sources of these vitamins. Beans, which are a part of the traditional Brazilian diet, remain one of the primary food items that contribute to folate intake, even after mandatory fortification with folic acid in Brazil.J Pediatr (Rio J). 2011;87(1):43-49: Nutrition, food consumption, adolescents, vitamins, homocysteine, biomarkers. ResumoObjetivo: Investigar os níveis séricos e a prevalência de inadequação da ingestão dietética de folato e das vitaminas B6 e B12, identificando os alimentos contribuintes para a ingestão desses nutrientes.Métodos: Estudo observacional, transversal, em adolescentes de 16 a 19 anos, de ambos os sexos, conduzido em Indaiatuba (SP). Coletouse o registro alimentar de 3 dias não consecutivos. A dieta habitual foi estimada pela remoção da variabilidade intrapessoal, e a prevalência de inadequação da ingestão, pelo método da estimated average requirement como ponto de corte. As análises bioquímicas de folato, B6 e B12 foram conduzidas de acordo com os métodos aceitos na literatura.Resultados: O estudo foi conduzido com 99 adolescentes, a maioria do sexo feminino (58,6%), com média de idade de 17,6 (desvio padrão, DP 0,9) anos. As médias da concentração sérica de folato, B6 e B12 foram de 9,2 (DP 3,4) ng/mL, 18,7 (DP 5,1) nmol/L e 397,5 (DP 188,4) pg/mL, respectivamente; e a prevalência de inadequação da ingestão das vitaminas foi de 15,2, 10,2 e < 1%, respectivamente. Os alimentos que mais contribuíram para a ingestão dos nu...

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Section: Discussionunclassified

Folate, vitamin B6 and vitamin B12 in adolescence: serum concentrations, prevalence of inadequate intakes and sources in food

Steluti¹,

Martini²,

Peters³

et al. 2011

J Pediatr (Rio J)

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“…In our sample, folate intake is unlikely to have changed substantially between adolescence and early adulthood because folate fortification in the United States was not introduced until 1998. 35,36 However, we cannot evaluate how much individuals modified their own diets after high school; folate intake during the same time period as alcohol consumption may be more relevant, and our use of high school folate intake may underestimate this association.…”

Section: Discussionmentioning

confidence: 99%

Intakes of Alcohol and Folate During Adolescence and Risk of Proliferative Benign Breast Disease

2012

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Alcohol consumption during adolescence and early adulthood has been associated with an increased risk of biopsy-confirmed benign breast disease (BBD), an established risk factor of breast cancer. WHAT THIS STUDY ADDS:This is the first study to analyze the association between adolescent alcohol consumption and risk of biopsy-confirmed proliferative BBD by adolescent folate intake. The result provides no evidence for protective effects of adolescent folate intake on risk of alcohol-associated BBD. abstract OBJECTIVES: To examine the combined effect of alcohol and folate intake during adolescence on the risk of proliferative benign breast disease (BBD). METHODS:We used data from 29 117 women in the Nurses' Health Study II who completed both adolescent alcohol consumption questions in 1989 and an adolescent diet questionnaire in 1998. A total of 659 women with proliferative BBD diagnosed between 1991 and 2001 were confirmed by central pathology review. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals (CIs), adjusted for established risk factors of breast cancer.RESULTS: Adolescent alcohol consumption was dose-dependently associated with an increased risk of proliferative BBD (hazard ratio = 1.15 per 10 g/day consumption; 95% CI, 1.03-1.28). There was no significant association between adolescent folate intake and the risk of proliferative BBD. Stratified analyses showed that each 10-g/day alcohol intake during adolescence was associated with a 21% (95% CI, 1.01-1.45) increase in the risk of proliferative BBD among women with low folate intake during adolescence, which was not significantly different from the alcohol-associated risk among women with moderate and high folate intake during adolescence (P for interaction = 0.18).CONCLUSIONS: Adolescent alcohol consumption is associated with increased risk of proliferative BBD, which may not be reduced by increased folate intake during adolescence.

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“…These data suggest that even if the folate content of the entire egg supply could be enriched two-to threefold (the levels that have been achieved experimentally in feeding trials), the overall contribution to folate intake at a population level would only be about 10-40 mg/d. By comparison, the US mandatory folic acid fortification policy was designed to provide an extra 100 mg folic acid/d, although, according to some reports (62)(63)(64) , it appears to have contributed about twice that amount.…”

Section: Experimental Methodsmentioning

confidence: 99%

Use of FAO food balance sheets to estimate the potential ability of novel folate-enriched eggs to increase the folate supply in European Union countries

Sheehy

Sharma

2010

Public Health Nutr.

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Objective: European governments have yet to introduce mandatory folic acid fortification of foods for neural tube defect prevention because of uncertainty about the long-term safety of high intake of folic acid. Novel folate-enriched eggs have been proposed as offering a practical way of increasing intake of natural folates, which do not have the same safety concerns as synthetic folic acid. Our objective was to estimate the potential increase in folate supply that could occur in European Union (EU) countries if normal eggs were replaced by folate-enriched eggs. Design: FAOSTAT data on daily per capita availability of eggs were linked to mean folate concentrations of un-enriched and folate-enriched eggs from three representative feeding trials from the recent literature. Setting: Data were collated in Microsoft Excel. Subjects: The study used food balance sheets for Europe for 1961-2003 and for twenty-six individual EU countries for 2003.Results: There has been little variation in egg supply in Europe over the past 40 years, with eggs providing only about 1?3-1?6 % of total energy. In 2003, the average per capita egg supply across twenty-six EU countries was 32?8 g/d, equivalent to a little over half an egg. Even if the folate concentrations of all eggs across the EU were increased two-to threefold, per capita folate supply would increase only by about 25 mg/d. Conclusions: At current enrichment levels, the availability of novel folate-enriched eggs will have little impact on folate supply in EU countries. In the absence of mandatory fortification, additional natural folate sources are needed urgently.

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Effect of food fortification on folic acid intake in the United States

Abstract: Typical intakes of folic acid from fortified foods are more than twice the level originally predicted. The effect of this much higher level of fortification must be carefully assessed, especially before calls for higher levels of fortification are considered.

Cited by 249 publications

References 36 publications

Folate, vitamin B6 and vitamin B12 in adolescence: serum concentrations, prevalence of inadequate intakes and sources in food

Folate, vitamin B6 and vitamin B12 in adolescence: serum concentrations, prevalence of inadequate intakes and sources in food

Intakes of Alcohol and Folate During Adolescence and Risk of Proliferative Benign Breast Disease

Use of FAO food balance sheets to estimate the potential ability of novel folate-enriched eggs to increase the folate supply in European Union countries

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