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Folate intakes from diet and supplements may place certain Canadians at risk for folic acid toxicity.
Br J Nutr. 2016 Oct; 116(7):1236-1245.BJ

Abstract

To examine the prevalence of folate inadequacy and toxicity based on usual intakes from food and supplements, as well as biomarkers of folate, secondary data analyses were performed using cross-sectional, nationally representative data from the Canadian Community Health Survey, Cycle 2.2 (n 32 776), as well as biomarker data from the Canadian Health Measures Survey, Cycles 1, 2 and 3 (n 15 754). On the basis of unfortified food sources, Canadians would struggle to consume adequate amounts of folate. When folate intakes from all food sources were considered, the overall prevalence of folate inadequacy was low across all age/sex groups, with the exception of females >70 years. However, >10 % of supplement users were above the tolerable upper intake level, increasing to almost 18 % when overage factors were accounted for. In addition, between 20 and 52 % of supplement users had elevated erythrocyte folate concentrations, depending on the cut-off used. Results from this study suggest that insufficient dietary intakes of folate in Canadians have been ameliorated because of the fortification policy, although folate inadequacy still exists across all age groups. However, supplement users appear to be at an increased risk of folic acid (FA) overconsumption as well as elevated erythrocyte folate. As such, the general population should be informed of the potential risks of FA overconsumption resulting from supplement use. This study suggests a need for more careful assessment of the risks and benefits of food fortification, particularly fortification above mandated levels, and FA supplement use in the general population.

Authors+Show Affiliations

1Human Nutritional Sciences,University of Manitoba,Winnipeg,MB,CanadaR3T 2N2.2Public Health Agency of Canada,Ottawa,ON,CanadaK1A 0K9.1Human Nutritional Sciences,University of Manitoba,Winnipeg,MB,CanadaR3T 2N2.1Human Nutritional Sciences,University of Manitoba,Winnipeg,MB,CanadaR3T 2N2.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27609220

Citation

Mudryj, Adriana N., et al. "Folate Intakes From Diet and Supplements May Place Certain Canadians at Risk for Folic Acid Toxicity." The British Journal of Nutrition, vol. 116, no. 7, 2016, pp. 1236-1245.
Mudryj AN, de Groh M, Aukema HM, et al. Folate intakes from diet and supplements may place certain Canadians at risk for folic acid toxicity. Br J Nutr. 2016;116(7):1236-1245.
Mudryj, A. N., de Groh, M., Aukema, H. M., & Yu, N. (2016). Folate intakes from diet and supplements may place certain Canadians at risk for folic acid toxicity. The British Journal of Nutrition, 116(7), 1236-1245.
Mudryj AN, et al. Folate Intakes From Diet and Supplements May Place Certain Canadians at Risk for Folic Acid Toxicity. Br J Nutr. 2016;116(7):1236-1245. PubMed PMID: 27609220.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Folate intakes from diet and supplements may place certain Canadians at risk for folic acid toxicity. AU - Mudryj,Adriana N, AU - de Groh,Margaret, AU - Aukema,Harold M, AU - Yu,Nancy, Y1 - 2016/09/09/ PY - 2016/9/10/pubmed PY - 2017/5/26/medline PY - 2016/9/10/entrez KW - CCHS 2.2 Canadian Community Health Survey KW - CHMS Canadian Health Measures Survey KW - DFE dietary folate equivalent KW - DRI dietary reference intakes KW - EAR estimated average requirement KW - FA folic acid KW - IOM Institute of Medicine KW - NHANES National Health and Nutrition Examination Survey KW - NTD neural tube defects KW - POFI prevalence of folate inadequacy KW - UL tolerable upper intake level KW - WCBA women of childbearing age KW - cycle 2.2 KW - Folate KW - Food fortification KW - Health surveys KW - Supplements SP - 1236 EP - 1245 JF - The British journal of nutrition JO - Br J Nutr VL - 116 IS - 7 N2 - To examine the prevalence of folate inadequacy and toxicity based on usual intakes from food and supplements, as well as biomarkers of folate, secondary data analyses were performed using cross-sectional, nationally representative data from the Canadian Community Health Survey, Cycle 2.2 (n 32 776), as well as biomarker data from the Canadian Health Measures Survey, Cycles 1, 2 and 3 (n 15 754). On the basis of unfortified food sources, Canadians would struggle to consume adequate amounts of folate. When folate intakes from all food sources were considered, the overall prevalence of folate inadequacy was low across all age/sex groups, with the exception of females >70 years. However, >10 % of supplement users were above the tolerable upper intake level, increasing to almost 18 % when overage factors were accounted for. In addition, between 20 and 52 % of supplement users had elevated erythrocyte folate concentrations, depending on the cut-off used. Results from this study suggest that insufficient dietary intakes of folate in Canadians have been ameliorated because of the fortification policy, although folate inadequacy still exists across all age groups. However, supplement users appear to be at an increased risk of folic acid (FA) overconsumption as well as elevated erythrocyte folate. As such, the general population should be informed of the potential risks of FA overconsumption resulting from supplement use. This study suggests a need for more careful assessment of the risks and benefits of food fortification, particularly fortification above mandated levels, and FA supplement use in the general population. SN - 1475-2662 UR - https://www.unboundmedicine.com/medline/citation/27609220/Folate_intakes_from_diet_and_supplements_may_place_certain_Canadians_at_risk_for_folic_acid_toxicity_ L2 - https://www.cambridge.org/core/product/identifier/S000711451600307X/type/journal_article DB - PRIME DP - Unbound Medicine ER -