Remodeling of data in the 2004 Canadian Community Health Survey 2.2 (CCHS) using actual rather than mandated levels of folic acid fortification suggests a lower prevalence of inadequacy of folate in women of reproductive age

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Folic acid (FA) fortification of grain products has been mandatory in Canada for 10 years. Previously we reported that foods are over‐fortified by approximately 50% of the values in Canada's main food composition database, the Canadian Nutrient File. We used SIDE to calculate usual intakes of folate based on mandated and actual levels (based on 50% overage) of FA fortification from 24‐hour dietary recall data of approximately 35,000 respondents in the CCHS. In women of reproductive age, the prevalence of inadequacy (intakes below the Estimated Average Requirement) based on actual levels decreased by more than half when compared to that based on mandated levels (27.3% to 12.4% in 14‐18y; 24.5% to 10.2% in 19‐30y; 28.1% to 14.2% in 31‐50y). A similar decline was observed in lactating females (27.7% to 12%), while in pregnant females, the decline was more pronounced (50.2% to 18.4%). In sum, given its protective role in the prevention of neural tube defects, women capable of becoming pregnant should consume a FA supplement; however, at actual levels of FA fortification in the Canadian food supply, the prevalence of inadequacy in women of reproductive age is lower than estimated using mandated levels.Grant Funding SourceResearch Training Award