Synthetic folic acid intakes and status in children living in Ireland exposed to voluntary fortification

Abstract

We showed that there was UFA in the plasma of just >10% of the children sampled after an overnight fast. These findings should be considered by policy makers who are responsible for folic acid fortification. This trial was registered at www.isrctn.com as ISRCTN90038765.

The Effect of Folic Acid Supplementation in the Ovary and Upon Embryo Development

“…High levels of unmetabolized folic acid (UMFA) have been identified due to the limited ability to reduce FA to 5-MTHF by the enzyme DHFR in the gut and the liver (Patanwala et al, 2014). High levels of unmetabolized folic acid (UMFA) have been reported in US children, adolescents and adults, but also in children exposed to voluntary FA fortification in Ireland (Pfeiffer et al, 2015;Vaish et al, 2016). Meanwhile, in countries with non-mandatory fortification, 400μg of FA supplement use is sufficient to detect UMFA in the serum of elderly people in Germany (Obeid et al, 2016).…”

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

“…It has been estimated that fortified foods provide only 5%–8% of the total energy intake of the European population [8], even though, market availability in the last 10 years has been consistently increasing [11]. Interestingly, data from surveys on total intakes of micronutrients (including fortified foods) in Europe and the US show that small proportions of the population, particularly children, may exceed the Upper Intake Levels (UL) for FA [15,16]. However, current fortification practices do not appear to contribute appreciably to the risk of adverse effects derived from nutrient intake [17].…”

The value of food fortification as a public health intervention

“…The aim of folic acid fortification, however, is to compensate a presumed genetic defect in individuals who are at risk but cannot be individually identified; this is conceptually different to boosting the iodine content of foodstuffs to ameliorate a population deficiency. Folic acid fortification thus raises ethical questions about exposing the many for the benefit of a few; concerns have been expressed that exposing children to high levels of folic acid over their entire lifetime may increase their risk of adverse effects 8 …”

“…Folic acid fortification thus raises ethical questions about exposing the many for the benefit of a few; concerns have been expressed that exposing children to high levels of folic acid over their entire lifetime may increase their risk of adverse effects. 8 Making iodine fortification of bread mandatory in Tasmania successfully improved population iodine levels…”