Background: All flour in the USA is fortified with folic acid at a level of 140 µg/100 g which is estimated to supply an extra 100 µg daily to the average diet. Some researchers have advocated that this be increased to double and even four times this amount. Based on previous research these higher levels are likely to lead to the appearance of unmetabolised vitamin in the circulation, which may have safety implications for sub-groups of the population. The UK and the Republic of Ireland will likely introduce mandatory fortification also in the next year or so.

The benefit of the introduction of mandatory folic acid fortification of all flour products in the USA in 1998 has been amply demonstrated in a reduction of neural tube defect births. Doubt has been cast on the actual level of fortification and recent calculations have shown that the level of folic acid fortification is likely to have been over twice the amount mandated. The implication of this is that a greater proportion of the population are likely to have consumed folic acid at >1mg/d, the Food and Drug Administration safe upper level of intake. Using the criteria of appearance of synthetic folic acid in serum, the objective of this pilot study was to investigate the consequences of consumption of baked bread preparations containing 1mg folic acid. Four healthy adult volunteers undertook each dosing schedule 2 weeks apart. This consisted of a single dose of 1000μg, two doses of 500μg, three doses of 333μg, five doses of 200μg and, finally, ten doses of 100μg. Serum was collected pre- and postprandially and analysed for synthetic folic acid by a combined HPLC–microbiological assay for folic acid. Folic acid appeared in all subjects at all test doses, with the effect more pronounced as the standard dose was administered in smaller amounts over the test period. Approaches to optimise folic acid intake in target populations as part of a universal fortification strategy should take into consideration the potential hazard of over-exposure in groups consuming high amounts of flour-based products.

A cross-sectional study design was used to examine associations between frequency of physical activity and participation in sports with mental wellbeing, and symptoms of depression and anxiety. Surveys were completed in post-primary schools by 5,661 adolescents from the Republic of Ireland. Validated instruments were used to assess frequency of physical activity, participation in sports, mental wellbeing (WEMWS), depressive symptoms (BDI) and anxiety (BAI). A minority of the sample (11.5% of males and 5.3% of females) were found to meet WHO's physical activity guidelines (60 minutes or more each day). Frequency of activity were found to decline with age. Frequency of activity was positively associated with wellbeing and negatively associated with symptoms of anxiety and depression. Males had higher levels of wellbeing and lower levels of anxiety and depressive symptoms across all subgroups. Adolescents who engaged in sports were found to have higher levels of wellbeing and lower symptoms of anxiety and depression with team sport conferring an additional benefit. Future physical activity recommendations for children and adolescents should include mental as well as physical health benefits.