Prevalence of inadequate intake of folate after mandatory fortification: results from the first National Dietary Survey in Brazil.

Abstract

Our aim was to estimate the prevalence of folate inadequacy (POFI) according to life stage, socio-economic status, and geographical regions after the mandatory fortification of wheat and maize flour in Brazil. This was a population-based study. Data from two non-consecutive food records from the National Dietary Survey/Household Budget Survey 2008-2009 were used to estimate the usual dietary folate intake in µg dietary folate equivalents (DFEs). The National Cancer Institute method was used to account for within-person variance and the Estimated Average Requirement (EAR) cut-point method was used to calculate the POFI. The survey included 32,749 individuals, 15,700 males and 17,049 females, over 10years old. Pregnant women, lactating women, and individuals with unreliable energy intake data were excluded. Overall POFI was 31.5% and mean dietary folate intake was 411.1µg DFE. The lowest POFI occurred in the youngest age group of 10-13years in both sexes, while the highest POFI was observed in the group ≥ 71years. In women of childbearing age, POFI was around 32%. The lowest income strata had the highest POFI. The most developed regions (South and Southeast) had the lowest POFI compared to less developed regions. Our data show that folate inadequacy is still prevalent in Brazil mainly in low-income groups and less developed regions. Actions need to be taken to ensure that women of childbearing age, who presented a high prevalence of inadequate folate intake, achieve the recommended daily intake of 400µg DFEs.