The effect of folate fortification of cereal-grain products on blood folate status, dietary folate intake, and dietary folate sources among adult non-supplement users in the United States
The effect of folate fortification of cereal-grain products on blood folate status, dietary folate intake, and dietary folate sources among adult non-supplement users in the United States
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DOI：
10.1080/07315724.2005.10719474
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发表时间：
2005-08-01
影响因子：
3.5
通讯作者：
Block, G
中科院分区：
文献类型：
--
作者：
Dietrich, M;Brown, CJP;Block, G
目的：自1998年1月起，美国联邦药品监督管理局要求在美国所有强化谷物产品中添加叶酸。该计划旨在增加育龄妇女的叶酸摄入量，以降低她们因神经管缺陷而怀孕的风险。本研究旨在探讨强化叶酸强化后美国成年人群血清和红细胞叶酸状况的变化，以及食物来源和膳食叶酸摄入量的相应变化。方法：我们比较了1988-1994年两次国家健康与营养调查(NHANES III)和1999-2000年国家健康与营养调查(NHANES III)的数据，NHANES III反映叶酸强化前的时间，NHANES 1999-2000年反映强化后的时间。结果：强制性叶酸强化导致所有性别和年龄组的血清和红细胞叶酸浓度均显著升高。在整个研究人群中，平均血清叶酸浓度增加了两倍多(136%)，从11.4nmo1/L增加到26.9nmoL/L，红细胞平均叶酸浓度增加了57%，从375nmo1/L增加到590nmo1/L，只有不到10%的育龄妇女达到推荐的红细胞叶酸浓度超过906nmo1/L，这已被证明与神经管缺陷(NTD)风险的显著降低有关。强化后，“面包、面包和饼干”成为美国人饮食中叶酸总量的最大贡献者，占总摄入量的15.6%，超过了强化前最大的叶酸食物来源蔬菜。除了60岁以上的女性外，几乎所有性别和年龄组的饮食总叶酸摄入量都显著增加。研究人群的平均膳食总叶酸摄入量增加了76mgd(28%)，从275mgd增加到351mgd。结论：强化叶酸强化谷类食品能显著改善美国成年非补充剂人群的血液叶酸状况。然而，育龄妇女可能会服用叶酸补充剂，以达到红细胞叶酸水平，这与NTDS的风险降低有关。
Objective: Since January 1998, the Federal Drug Administration has required folic acid fortification of all enriched cereal-grain products in the U.S. This program intended to increase folic acid intake among women of childbearing, age in order to decrease their risk of pregnancies affected by neural tube defects. The aim of this study was to explore the changes in serum and erythrocyte folate status of the adult U.S. population following folic acid fortification of enriched cereal-grain products and to explore accompanying changes in food sources and dietary total folate intake.Methods: We compared data from two National Health and Nutrition Examination Surveys (NHANES): NHANES III, conducted during 1988 to 1994, reflecting the time prior to folate fortification, and NHANES 1999-2000, reflecting the time period after fortification.Results: Mandatory folic acid fortification led to significant increases in both serum and erythrocyte folate concentrations in all sex and age groups. In the overall study population the mean serum folate concentration increased more than two-fold (136%), from 11.4 nmol/L to 26.9 nmol/L, and the mean erythrocyte folate concentration increased by 57 percent, from 375 nmol/L to 590 nmol/L. Less than 10% of women of childbearing age reached the recommended erythrocyte folate concentration of greater than 906 nmol/L that has been shown to be associated with a significant reduction in neural tube defect (NTD) risk. After fortification, the category "bread, rolls, and crackers" became the single largest contributor of total folate to the American diet, contributing 15.6% of total intake, surpassing vegetables, which were the number one folate food source prior to fortification. Dietary intake of total folate increased significantly in almost all sex and age groups, except in females over 60 years of age. The mean dietary total folate intake of the study population increased by 76 mu g/d (28%), from 275 mu g/d to 351 mu g/d.Conclusions: The fortification of enriched cereal-grain products with folic acid lead to a significant improvement of blood folate status of the overall adult, non-supplement using, US population. However, women of childbearing age may take folic acid supplements to reach erythrocyte folate levels that have been associated with decreased risk of NTDs.