Abstract
PurposeBesides the adverse health effects of a low folate intake, the risks of high intakes of folic acid have moved into the focus. The aim of this study was to investigate the potential range of folate and folic acid intake of the German population under consideration of different fortification scenarios.Methods Food consumption data of 13,926 participants of the German National Nutrition Survey II (NVS II), collected with two 24-h recalls, were used to calculate the nutrient intake. The nutrient data are based on the German Nutrient Database (BLS), information from a market survey and analyses of multivitamin juices. The scenarios were modelled without, as well as with low and high fortification levels of folic acid.ResultsThe median intake of dietary folate equivalents ranged from 191 µg/d (men) and 168 µg/d (women) without fortification to 425 µg/d (men) and 334 µg/d (women) in the highest fortification scenario. Thus, 12.4–68.2 % (men) and 5.9–56.1 % (women) met the 300 µg/d recommended by the nutrition societies of Germany, Austria and Switzerland. In the highest fortification scenario, 1.9 % (men) and 0.8 % (women) exceeded the tolerable upper intake level (UL) of 1,000 µg/d folic acid given by the European Food Safety Authority. For supplement users, this proportion was 5.2 and 5.4 %.ConclusionsOnly a high fortification of several foods leads to a marked increase of the proportion of population reaching the recommendation. Simultaneously, with a high fortification a higher proportion exceeds the UL, especially in combination with supplements.
Highlights
IntroductionMany studies show the health benefits of natural food folate (reduced methyl and formyl folates) and of folic acid from supplements and fortified foods (pteroylmonoglutamic acid)
Many studies show the health benefits of natural food folate and of folic acid from supplements and fortified foods
The median intake of dietary folate equivalents ranged from 191 lg/d and 168 lg/d without fortification to 425 lg/d and 334 lg/d in the highest fortification scenario
Summary
Many studies show the health benefits of natural food folate (reduced methyl and formyl folates) and of folic acid from supplements and fortified foods (pteroylmonoglutamic acid). Epidemiological studies have suggested an association between high intake of folate and lower risk of cardiovascular disease, some cancers and agerelated cognitive decline [6,7,8]. New scientific evidence has emerged suggesting a possible link between high intake of folic acid and various types of cancer, colorectal cancer [15,16,17,18,19]. Animal studies suggest that high folic acid intakes may have a dual effect: inhibiting the formation of neoplastic lesions in normal tissues and accelerating the malignant transformation of existing neoplasms [20]. Other postulated adverse effects of high folic acid intake include acceleration of cognitive decline during
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