Fortification With Low Amounts of Folic Acid Makes a Significant Difference in Folate Status in Young Women: Implications for the Prevention of Neural Tube Defects

Abstract

The recent advent of fortifying grain products with folic acid is expected to provide an average added daily intake of 100 μg. The present study attempted to estimate the efficacy of this measure by removing a similar amount from the diet of young women choosing to eat folate-fortified food on a regular basis. Twenty-one women who claimed to take fortified foods at least once a week (“consumers”) were compared with 30 others (“nonconsumers”). None of the women were pregnant or planning a pregnancy. The participants were instructed to replace fortified foods with equivalent amounts of isoenergetic, unfortified foods for 12 weeks. Consumers had significantly higher total folate intakes than nonconsumers (265 vs. 197 μg/d) and higher red blood cell folate concentrations (403 vs. 342 μg/liter). Excluding folate-fortified foods led to significant reductions in average total folate intake and red cell folate levels in consumers but not in nonconsumers. Serum folate levels did not differ significantly in the two groups. These findings seem to indicate that providing an extra 100 μg of folate per day will significantly improve red cell folate status in women and that fortified foods are an effective way of doing this. Hopefully, a substantial reduction in neural tube defects will result. Am J Clin Nutr 1999;70:234–239