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Related Experiment Videos

Folic acid: are current fortification levels adequate?

M L Neuhouser1, S A Beresford

  • 1Fred Hutchinson Cancer Research Center, Seattle, WA 98195-7236, USA.

Nutrition (Burbank, Los Angeles County, Calif.)
|October 31, 2001
PubMed
Summary
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Folic acid fortification of grain products aims to prevent neural-tube defects. Evaluating the program

Area of Science:

  • Public Health Nutrition
  • Biochemistry
  • Reproductive Health

Background:

  • Folic acid fortification of cereal and grain products began in the US in 1998 to decrease neural-tube defects.
  • Neural-tube defects are common congenital malformations.
  • Three years post-implementation, an evaluation of the fortification program's effectiveness is warranted.

Purpose of the Study:

  • To assess the effectiveness of folic acid fortification in reducing neural-tube defects.
  • To review the scientific basis and regulatory decisions for food fortification.
  • To propose methods for evaluating current folic acid fortification levels.

Main Methods:

  • Review of folate's role in neural-tube defect etiology.
  • Analysis of Food and Drug Administration (FDA) deliberations on food fortification.

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  • Proposal for using blood biomarkers (red blood cell folate, plasma homocysteine) to assess folate status.
  • Evaluation of biomarker sensitivity and specificity for folate status.

    • Main Results:

    • No national birth defects monitoring system or postmarketing surveillance exists in the US for this program.
    • Blood biomarkers, specifically red blood cell folate and plasma homocysteine levels, are proposed as effective indicators of folic acid fortification program success.
    • These biomarkers may also offer insights into folate's role in other conditions, such as vascular disease.

    Conclusions:

    • Federal agencies should collaborate on population-level folate status monitoring.
    • Collected biomarker data can assess the safety and efficacy of folic acid fortification.
    • Data evaluation will determine if adjustments to fortification levels are necessary.