TY - JOUR
T1 - Impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults
AU - Hopkins, Sinead
AU - Gibney, Michael J.
AU - Nugent, Anne P.
AU - McNulty, Helene
AU - Molloy, Anne M
AU - Scott, John M
AU - Flynn, Albert
AU - Strain, Sean
AU - Ward, Mary
AU - Walton, Janette
AU - McNulty, Breige A
PY - 2015/6/1
Y1 - 2015/6/1
N2 - 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.
AB - 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.
KW - Folate intakes: vitamin B-12 intakes: B vitamin biomarkers: voluntary fortification: supplements
U2 - 10.3945/ajcn.115.107151
DO - 10.3945/ajcn.115.107151
M3 - Article
SN - 0002-9165
VL - 101
SP - 1163
EP - 1172
JO - The American Journal of Clinical Nutrition
JF - The American Journal of Clinical Nutrition
IS - 6
ER -
