Folic acid source, usual intake, and serum folate concentrations in US children, the National Health and Nutrition Examination Survey (NHANES) 2003–2006

Abstract

Our objective was to estimate among US children usual folic acid intake above the tolerable upper intake levels (UL) established for that age group and folate concentrations by three major folic acid sources: enriched cereal grain products (ECGP), ready‐to‐eat cereals (RTE), and supplements (SUP). We analyzed data from 7397 children aged 1–18 years (y) in NHANES 2003–2006. Among children aged 1–3 y, 4–8 y, 9–13 y, and 14–18 y, 21%, 18%, 34%, and 47%, respectively, reported consumption of folic acid from ECGP only. Fifty‐two percent, 45%, 44% and 36%, respectively, reported consumption from ECGP+RTE. Eight to nine percent reported consumption from ECGP+SUP. Eighteen percent, 28%, 13%, and 9%, respectively, reported consumption from ECGP+RTE+SUP. Among all age groups, 0% of the children who consumed folic acid from ECGP only exceeded the UL for their age group. The proportion above the UL for their age group was greater with consumption of RTE and SUP. Compared with consumption of ECGP only, the adjusted geometric mean folate concentrations were progressively higher among those who consumed ECGP + RTE, ECGP + SUP, and ECGP+SUP+RTE in all age groups except children aged 4–8 y. Post‐fortification, US children who consume ECGP only are unlikely to exceed the UL for their age group and the majority of children consume folic acid from either RTE or SUP. Research funded by CDC.