[Folate and health--new knowledge and new recommendation]

The dietary intake of folate in Norway is not optimal with regard to minimizing the risk of birth defects (especially neural-tube defects), and poSsibly also cardiovascular diseases and other diseases. The National Nutrition Council has therefore initiated a project to evaluate the status of folate in Norway and to recommend actions for necessary improvement. A protective effect of folic acid supplements on neural-tube defects has been found in observational studies and clinical trials. The effects of folate on cardiovascular diseases and cancer are less certain. The estimated average intake of folate from foods in Norway is lower than the recommended 300 micrograms per day for adult women and men, and remarkably lower than the 400 micrograms per day recommended for pregnant and lactating women. Thus, with the aim of minimizing the risk for neural-tube defects, the National Nutrition Council now recommends that all women who are planning pregnancy or who are likely to become pregnant have an intake of at least 400 micrograms folate per day. Because it may be difficult to achieve this through diet alone, and because an additional risk-lowering effect of folic acid supplementation has been shown, a folic acid supplement of 400 micrograms per day is recommended for this group. The supplement should be taken one month before conception and during the first two months of pregnancy. Fortification of foods with folate is not recommended because some groups may then exceed the recommended upper intake level.