Impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults

Sinead Hopkins, Michael J. Gibney, Anne P. Nugent, Helene McNulty, Anne M Molloy, John M Scott, Albert Flynn, Sean Strain, Mary Ward, Janette Walton, Breige A McNulty

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Abstract

Background: Ireland has traditionally operated a liberal policy of voluntary fortification but little is known about how this practice, along with supplement use, affects population intakes and status of folate and vitamin B-12. Objective: To examine the relative impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults. Design: Folic acid and vitamin B-12 from fortified foods and supplements were estimated using brand information for participants from the cross sectional National Adult Nutrition Survey 2008-10. Dietary and biomarker values were compared across six mutually exclusive consumption groups formed on the basis of folic acid intake.Results: Consumption of folic acid through fortified foods at low, medium and high levels of exposure [median intakes (IQR) of 22 (13,32), 69 (56, 84) and 180 (137,248) µg/d respectively], supplements [203 (150,400) µg/d] or both [287 (220,438) µg/d] was associated with significantly higher folate intakes and status compared to non-consumption of folic acid (18% of the population). Median (IQR) red blood cell (RBC) folate increased significantly from 699 (538,934) nmol/L in non-consumers to 1040 (83, 1390) nmol/L in consumers with a high intake of fortified foods (P<0.001) with further non-significant increases in supplement users. Supplement use but not fortification was associated with significantly higher serum vitamin B-12 concentrations relative to non-consumers (P<0.001). Two thirds of young women had suboptimal RBC folate for protection against neural tube defects (NTDs); among non-consumers of folic acid only 16% attained optimal RBC folate.Conclusion: Consumption of voluntarily fortified foods and/or supplement use was associated with significantly higher dietary intakes and biomarker status of folate in Irish adults. Of concern, the majority of young women remain sub optimally protected against NTDs.
Original languageEnglish
Pages (from-to) 1163–1172
JournalThe American journal of clinical nutrition
Volume101
Issue number6
Early online date15 Apr 2015
DOIs
Publication statusPublished - 01 Jun 2015

Keywords

  • Folate intakes: vitamin B-12 intakes: B vitamin biomarkers: voluntary fortification: supplements

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