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Impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults.
Am J Clin Nutr 2015; 101(6):1163-72AJ

Abstract

BACKGROUND

Ireland has traditionally operated a liberal policy of voluntary fortification, but little is known about how this practice, along with supplement use, affects population intakes and status of folate and vitamin B-12.

OBJECTIVE

The aim was to examine the relative impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults.

DESIGN

Folic acid and vitamin B-12 from fortified foods and supplements were estimated by using brand information for participants from the cross-sectional National Adult Nutrition Survey 2008-2010. Dietary and biomarker values were compared between 6 mutually exclusive consumption groups formed on the basis of folic acid intake.

RESULTS

The consumption of folic acid through fortified foods at low, medium, and high levels of exposure [median (IQR) intakes of 22 (13, 32), 69 (56, 84), and 180 (137, 248) μg/d, respectively]; from supplements [203 (150, 400) μg/d]; or from both sources [287 (220, 438) μg/d] was associated with significantly higher folate intakes and status compared with nonconsumption of folic acid (18% of the population). Median (IQR) red blood cell (RBC) folate increased significantly from 699 (538, 934) nmol/L in nonconsumers to 1040 (83, 1390) nmol/L in consumers with a high intake of fortified foods (P < 0.001), with further nonsignificant increases in supplement users. Supplement use but not fortification was associated with significantly higher serum vitamin B-12 concentrations relative to nonconsumers (P < 0.001). Two-thirds of young women had suboptimal RBC folate for protection against neural tube defects (NTDs); among nonconsumers of folic acid, only 16% attained optimal RBC folate.

CONCLUSIONS

The consumption of voluntarily fortified foods and/or supplement use was associated with significantly higher dietary intakes and biomarker status of folate in Irish adults. Of concern, the majority of young women remain suboptimally protected against NTDs.

Authors+Show Affiliations

From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW). gibney.mike@gmail.com.From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).From the Institute of Food and Health, University College Dublin, Belfield Dublin, Republic of Ireland (SMH, MJG, APN, and BAM); the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, Northern Ireland (HM, JJS, and MW); the School of Clinical Medicine, Trinity College, Dublin, Republic of Ireland (AMM and JMS); and the School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland (AF and JW).

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25877491

Citation

Hopkins, Sinéad M., et al. "Impact of Voluntary Fortification and Supplement Use On Dietary Intakes and Biomarker Status of Folate and Vitamin B-12 in Irish Adults." The American Journal of Clinical Nutrition, vol. 101, no. 6, 2015, pp. 1163-72.
Hopkins SM, Gibney MJ, Nugent AP, et al. Impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults. Am J Clin Nutr. 2015;101(6):1163-72.
Hopkins, S. M., Gibney, M. J., Nugent, A. P., McNulty, H., Molloy, A. M., Scott, J. M., ... McNulty, B. A. (2015). Impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults. The American Journal of Clinical Nutrition, 101(6), pp. 1163-72. doi:10.3945/ajcn.115.107151.
Hopkins SM, et al. Impact of Voluntary Fortification and Supplement Use On Dietary Intakes and Biomarker Status of Folate and Vitamin B-12 in Irish Adults. Am J Clin Nutr. 2015;101(6):1163-72. PubMed PMID: 25877491.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults. AU - Hopkins,Sinéad M, AU - Gibney,Michael J, AU - Nugent,Anne P, AU - McNulty,Helene, AU - Molloy,Anne M, AU - Scott,John M, AU - Flynn,Albert, AU - Strain,J J, AU - Ward,Mary, AU - Walton,Janette, AU - McNulty,Breige A, Y1 - 2015/04/15/ PY - 2015/01/14/received PY - 2015/03/17/accepted PY - 2015/4/17/entrez PY - 2015/4/17/pubmed PY - 2015/8/8/medline KW - B vitamin biomarkers KW - folate intakes KW - supplements KW - vitamin B-12 intakes KW - voluntary fortification SP - 1163 EP - 72 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 101 IS - 6 N2 - BACKGROUND: Ireland has traditionally operated a liberal policy of voluntary fortification, but little is known about how this practice, along with supplement use, affects population intakes and status of folate and vitamin B-12. OBJECTIVE: The aim was to examine the relative impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults. DESIGN: Folic acid and vitamin B-12 from fortified foods and supplements were estimated by using brand information for participants from the cross-sectional National Adult Nutrition Survey 2008-2010. Dietary and biomarker values were compared between 6 mutually exclusive consumption groups formed on the basis of folic acid intake. RESULTS: The consumption of folic acid through fortified foods at low, medium, and high levels of exposure [median (IQR) intakes of 22 (13, 32), 69 (56, 84), and 180 (137, 248) μg/d, respectively]; from supplements [203 (150, 400) μg/d]; or from both sources [287 (220, 438) μg/d] was associated with significantly higher folate intakes and status compared with nonconsumption of folic acid (18% of the population). Median (IQR) red blood cell (RBC) folate increased significantly from 699 (538, 934) nmol/L in nonconsumers to 1040 (83, 1390) nmol/L in consumers with a high intake of fortified foods (P < 0.001), with further nonsignificant increases in supplement users. Supplement use but not fortification was associated with significantly higher serum vitamin B-12 concentrations relative to nonconsumers (P < 0.001). Two-thirds of young women had suboptimal RBC folate for protection against neural tube defects (NTDs); among nonconsumers of folic acid, only 16% attained optimal RBC folate. CONCLUSIONS: The consumption of voluntarily fortified foods and/or supplement use was associated with significantly higher dietary intakes and biomarker status of folate in Irish adults. Of concern, the majority of young women remain suboptimally protected against NTDs. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/25877491/Impact_of_voluntary_fortification_and_supplement_use_on_dietary_intakes_and_biomarker_status_of_folate_and_vitamin_B_12_in_Irish_adults_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.107151 DB - PRIME DP - Unbound Medicine ER -