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Folic Acid Food Fortification

Folic Acid Food Fortification. Elizabeth A. Yetley, Ph.D. Center for Food Safety & Applied Nutrition Food and Drug Administration. U.S. Folic Acid Fortification.  folate-responsive NTDs by  folate intakes of women of child-bearing age

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Folic Acid Food Fortification

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  1. Folic Acid Food Fortification Elizabeth A. Yetley, Ph.D. Center for Food Safety & Applied Nutrition Food and Drug Administration

  2. U.S. Folic Acid Fortification •  folate-responsive NTDs by  folate intakes of women of child-bearing age • Mandated folic acid addition to “enriched” cereal grain products • Allowed fortification of breakfast cereals up to 100% DV (400 µg/serving) • No limits on dietary supplements • Effective 1996

  3. Fortification Characteristics • Ubiquitous in food supply • Passive for consumer • Exposures: lifetime & cumulative • Balance: • Safe intake for all consumers • Improve intakes of target consumers • Uncertainty surrounded every decision

  4. Ubiquitous in Food Supply • Orange juice • McDonald’s hamburger • Pastas • Breakfast cereals & bars • Cookies, cakes

  5. Daily Folate Intakes Folate (mcg/day) Food, Supplements, Fortified Food 19-50 M 51+ M 11-18 F 1-3 MF 4-10 MF 11-18 M 19-50 F 51+ F Age in Years

  6. Total Folate Intake Percent Females 19+ Yrs Total Folate (mcg DFEs)

  7. Nutrient: Function/Risk

  8. Nutrient: Function/Risk 1000 - ????? Mcg??? 400 – 800 mcg???

  9. Post-fortification Monitoring? • Assume: underestimate intakes; therefore underestimate effectiveness and safety • Biomarkers of folate status • Changing incidence of NTDs

  10. Dietary Intakes • Unreliable predictors of clinical status • Underestimate calorie intakes • Underestimate food content • Analytical methods • Labeling practices • Overestimate requirements • Consumer responsiveness varies

  11. Intakes as predictors of status?

  12. Changes in Folate Status

  13. Bottom Line • Advantages of national fortification: • Passive exposure • Disadvantages of national fortification: • Passive exposure • Balancing act – competing issues of safety and effectiveness

  14. Summary • Uncertainties • Effective intakes • Safety • Ubiquitous in food supply • Significant increases in folate status

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