Folic acid intake from fortification in United States exceeds predictions
Folic acid intake from fortification in United States exceeds predictions
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DOI：
10.1093/jn/132.9.2792
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发表时间：
2002-09-01
影响因子：
4.2
通讯作者：
Jacques, PF
中科院分区：
文献类型：
--
作者：
Choumenkovitch, SF;Selhub, J;Jacques, PF
1996 年，美国食品和药物管理局颁布了一项规定，要求在 1998 年 1 月之前所有强化谷物产品都添加叶酸。预计由于这种强化，叶酸摄入量平均将增加 100 杯/天。本研究的目的是评估这种强化对叶酸和总叶酸摄入量的影响，以及对叶酸摄入不足和叶酸摄入量高的个体患病率的影响。我们使用了参加弗雷明汉后代队列研究第 5 次和第 6 次检查的 1480 名个体的食物和营养摄入数据。第六次检查期间设置了设防，实施前检查了 931 名参与者（未暴露），实施后检查了 549 名参与者（暴露）。已发表的有关强化谷物产品中总叶酸的数据用于校正这些食品中的叶酸含量，以反映强化程度。在非补充剂使用者中，暴露参与者的叶酸摄入量平均增加了 190 [95% 置信区间 (CI)：176, 204] 杯/天 (P < 0.001)，总叶酸摄入量平均增加了 323 (95% CI: 296-350) 杯膳食叶酸当量 (DFE)/天 (P < 0.001)。在接受强化的补充剂使用者中也出现了类似的增长。在不使用叶酸补充剂的个体中，总叶酸摄入量低于估计平均需求量（320 微克 DFE/天）的暴露个体的患病率从强化前的 48.6%（95% CI：44.2-53.1%）下降到强化后的 7.0%（95% CI：3.1-10.9%）。对于强化前后的补充剂使用者来说，这种患病率大约为 1% 或更低。仅在接受强化的补充剂使用者中，叶酸摄入量高于可耐受摄入量上限（1000 杯叶酸/天）的个体患病率有所增加（从 1.3% 增加到 11.3%，P < 0.001）。在未暴露的参与者中，随着时间的推移，没有观察到叶酸摄入量的变化。根据这些估计，叶酸强化导致叶酸摄入量平均增加，大约是之前预计的两倍。
In 1996, the U.S. Food and Drug Administration issued a regulation requiring that all enriched cereal-grain products be fortified with folic acid by January 1998. An average increase in folic acid intake of 100 mug/d was projected as a result of this fortification. The objective of the present study was to estimate the effect of this fortification on the intake of folic acid and total folate, and on the prevalence of individuals with inadequate folate intake and with high folic acid intake. We used data on food and nutrient intake from 1480 individuals who participated in the 5th and 6th examinations of the Framingham Offspring Cohort Study. Fortification was instituted during the 6th examination so that 931 participants were examined before its implementation (nonexposed) and 549 after implementation (exposed). Published data on total folate in enriched cereal-grain products were used to correct folate content in these foods to reflect fortification. Among nonsupplement users, folic acid intake increased by a mean of 190 [95% confidence interval (CI): 176, 204] mug/d (P < 0.001) and total folate intake increased by a mean of 323 (95% CI: 296-350) mug dietary folate equivalents (DFE)/d (P < 0.001) in the exposed participants. Similar increases were seen among supplement users exposed to fortification. The prevalence of exposed individuals with total folate intake below the estimated average requirement (320 mug DFE/d) decreased from 48.6% (95% CI: 44.2-53.1%) before fortification to 7.0% (95% CI: 3.1-10.9%) after fortification in individuals who did not use folic acid supplements. This prevalence was similar to1% or less for users of supplements both before and after fortification. Prevalence of individuals with folic acid intake above the upper tolerable intake level (1000 mug folic acid/d) increased only among supplement users exposed to fortification (from 1.3 to 11.3%, P < 0.001). No changes in folic acid intake were observed over time in the nonexposed participants. By these estimations, folic acid fortification resulted in a mean increase in folic acid intake that was approximately twice as large as previously projected.