Estimates of Total Dietary Folic Acid Intake in the Australian Population Following Mandatory Folic Acid Fortification of Bread

Mandatory folic acid fortification of wheat flour for making bread was implemented in Australia in September 2009, to improve the dietary folate status of women of child-bearing age, and help reduce the incidence of neural tube defects in the population. This paper presents estimates of folic acid intake in the target population and other subgroups of the Australian population following implementation of the mandatory folic acid fortification standard. In June/July 2010 one hundred samples from seven bread categories were purchased from around the country and individually analysed for the amount of folic acid they contained. A modification to the triple enzyme microbiological method was used to measure folic acid in the individual bread samples. The folic acid analytical values together with national food consumption data were used to generate estimates of the population’s folic acid intake from fortified foods. Food Standards Australia New Zealand’s (FSANZ) custom-built dietary modelling program (DIAMOND) was used for the estimates. The mean amount of folic acid found in white bread was 200 μg/100 g which demonstrated that folic-acid-fortified wheat flour was used to bake the bread. The intake estimates indicated an increase in mean folic acid intake of 159 μg per day for the target group. Other sub-groups of the population also showed increases in estimated mean daily intake of folic acid.

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Folic acid food fortification prevents inadequate folate intake among preschoolers from Ontario

Public Health Nutrition ◽

10.1017/s1368980008004667 ◽

2009 ◽

Vol 12 (9) ◽

pp. 1548-1555 ◽

Cited By ~ 5

Author(s):

Kathleen Hennessy-Priest ◽

Jill Mustard ◽

Heather Keller ◽

Lee Rysdale ◽

Joanne Beyers ◽

...

Keyword(s):

Folic Acid ◽

Public Health Intervention ◽

Folate Intake ◽

Food Fortification ◽

Folic Acid Intake ◽

Cross Sectional ◽

Dietary Folate ◽

Supplement Use ◽

Acid Intake ◽

Fortified Food

AbstractObjectiveFolic acid food fortification has successfully reduced neural tube defect-affected pregnancies across Canada. The effect of this uncontrolled public health intervention on folate intake among Canadian children is, however, unknown. Our objectives were to determine folic acid intake from food fortification and whether fortification promoted adequate folate intakes, and to describe folic acid-fortified food usage among Ontario preschoolers.DesignCross-sectional data were used from the NutriSTEP™ validation project with preschoolers recruited using convenience sampling. Mean daily total folate and folic acid intakes were estimated from 3 d food records, which included multivitamin supplement use. Comparisons were made to Dietary Reference Intakes, accounting for and excluding fortificant folic acid, to determine the prevalence of inadequate and excessive intakes.SettingCanada.SubjectsTwo hundred and fifty-four preschoolers (aged 3–5 years).ResultsAll participants (130 girls, 124 boys) ate folic acid-fortified foods and 30 % (n76) used folic acid-containing supplements. Mean (se) fortificant folic acid intake was 83 (2) μg/d, which contributed 30 % and 50 % to total folate intake for supplement users and non-users, respectively. The prevalence of total folate intakes below the Estimated Average Requirement was <1 %; however, excluding fortificant folic acid, the prevalence was 32 %, 54 % and 47 % for 3-, 4- and 5-year-olds, respectively. The overall prevalence of folic acid (fortificant and supplemental) intakes above the Tolerable Upper Intake Level was 2 % (7 % among supplement users).ConclusionsFolic acid food fortification promotes dietary folate adequacy and did not appear to result in excessive folic acid intake unless folic acid-containing supplements were consumed.

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Predicted contribution of folic acid fortification of corn masa flour to the usual folic acid intake for the US population: National Health and Nutrition Examination Survey 2001–2004

American Journal of Clinical Nutrition ◽

10.3945/ajcn.2008.26331 ◽

2008 ◽

Vol 89 (1) ◽

pp. 305-315 ◽

Cited By ~ 25

Author(s):

Heather C Hamner ◽

Joseph Mulinare ◽

Mary E Cogswell ◽

Alina L Flores ◽

Coleen A Boyle ◽

...

Keyword(s):

Folic Acid ◽

National Health ◽

Nutrition Examination Survey ◽

Folic Acid Intake ◽

Folic Acid Fortification ◽

Acid Intake ◽

Health And Nutrition ◽

The Us ◽

Corn Masa

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Dietary intake of folate by adolescents and the potential effect of flour fortification with folic acid

British Journal Of Nutrition ◽

10.1079/bjn2001425 ◽

2001 ◽

Vol 86 (4) ◽

pp. 529-534 ◽

Cited By ~ 7

Author(s):

P. J. Moynihan ◽

A. J. Rugg-Gunn ◽

T. J. Butler ◽

A. J. Adamson

Keyword(s):

Folic Acid ◽

Dietary Intake ◽

Potential Effect ◽

Folate Intake ◽

Folic Acid Intake ◽

Folic Acid Fortification ◽

Acid Intake ◽

Department Of Health ◽

White Flour ◽

The Uk

The UK Department of Health recently recommended that flour be fortified with folic acid, at 2400 μg/kg. The objectives of the present paper were: to determine the consequence of this on folic acid intake of adolescents; to determine the level of fortification necessary to achieve an intake of 400 μg/d in adolescent girls (the amount recommended periconceptionally); to estimate the consequence of fortification on folic acid intake of high flour consumers; and to report on folate intake of adolescents. Dietary intake of folate and flour were determined by analysis of an existing database of the diets of 379 English adolescents. The folic acid intake that would result from white flour fortification with folic acid at 2400 μg/kg was determined and the level of folic acid fortification necessary to achieve an intake of 400 μg/d in girls from this source was also calculated. Without flour fortification, 6·9 % of girls failed to reach the UK lower reference nutrient intake for total folate. Fortification of white flour with folic acid at 2400 μg/kg would result in an additional folic acid intake of 191(SEM 6) μg/d in girls. To ensure 97 % of girls received 400 μg/d from white flour, white flour would need to be fortified at a level of 10 430 μg/kg, resulting in intakes of 1260 μg/d from flour in the highest (97·5 centile) female white flour consumers and 1422 μg/d from flour in the highest (97·5 centile) male white flour consumers.

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Folic Acid Intake and Spina Bifida in the Era of Dietary Folic Acid Fortification

Epidemiology ◽

10.1097/ede.0b013e3182227887 ◽

2011 ◽

Vol 22 (5) ◽

pp. 731-737 ◽

Cited By ~ 40

Author(s):

Katherine Ahrens ◽

Mahsa M. Yazdy ◽

Allen A. Mitchell ◽

Martha M. Werler

Keyword(s):

Folic Acid ◽

Spina Bifida ◽

Folic Acid Intake ◽

Folic Acid Fortification ◽

Acid Intake

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Estimating the impact of mandatory folic acid fortification on the folic acid intake of Australian women of childbearing age

Australian and New Zealand Journal of Public Health ◽

10.1111/j.1753-6405.2011.00759.x ◽

2011 ◽

Vol 35 (5) ◽

pp. 442-450 ◽

Cited By ~ 7

Author(s):

Jessica K. Emmett ◽

Mark Lawrence ◽

Malcolm Riley

Keyword(s):

Folic Acid ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Folic Acid Intake ◽

Folic Acid Fortification ◽

Acid Intake ◽

The Impact

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Session 1: Public health nutrition Folic acid food fortification: the Irish experience

Proceedings of The Nutrition Society ◽

10.1017/s0029665108008720 ◽

2008 ◽

Vol 67 (4) ◽

pp. 381-389 ◽

Cited By ~ 17

Author(s):

Mary A. T. Flynn ◽

Wayne A. Anderson ◽

Sarah J. Burke ◽

Alan Reilly

Keyword(s):

Public Health ◽

Folic Acid ◽

Public Health Issue ◽

Food Fortification ◽

Folic Acid Intake ◽

Folic Acid Fortification ◽

Risks And Benefits ◽

Acid Intake ◽

Folic Acid Supplements ◽

Baseline Information

Adequate intake of folic acid by women during very early pregnancy can markedly reduce risk of the development of neural-tube defects (NTD). The effectiveness of advice to women to take folic acid supplements is limited, mainly because 50% of pregnancies are unplanned. However, mandatory folic acid food fortification programmes in North America have been very successful in reducing NTD rates. In Ireland higher rates of pregnancies are affected by NTD and the option of termination is illegal. Consequently, the much higher burden of disease makes primary prevention of NTD an important public health issue in Ireland. During 2006 a decision was taken in Ireland to initiate mandatory folic acid fortification of most bread to prevent NTD. Priority work was immediately undertaken to establish reliable and comprehensive baseline information on factors that will be affected by fortification. This information included data on: the national prevalence of pregnancies affected by NTD; the current extent of voluntary folic acid fortification of food on the Irish market and how it affects folic acid intakes; blood folate status indicators assessed for various subgroups of the Irish population. In addition, scientific developments that have arisen since 2006 relating to the risks and benefits of folic acid intake are under ongoing review. The present paper summarises the rationale for mandatory folic acid food fortification in Ireland and recent scientific developments relating to risks and benefits of folic acid intake. In this context, preliminary findings of baseline monitoring investigations in Ireland are considered.

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