Folate Supplementation: Americans Still Don't Get Enough

N-[4(2-Amino-4-hydroxy-pteridin-6-ylmethylamino)-benzoyl]-L(+)-glutamic
acid is the name of a vitamin.  Since the full name is a bit
awkward, it is more commonly known as folic acid, or href="http://en.wikipedia.org/wiki/Folate">folate.
 The common name is derived from the Latin word for leaf (follium).
 



It is a B-vitamin, necessary for metabolic steps involving the transfer
of single carbon atoms.  It is needed in the replication of
DNA, which obviously is rather important.  The need is
greatest when there is a lot of cell division.



In the 1980's it became apparent that relative deficiency of folate can
increase the risk of certain birth defects, most notably spina bifida,
encephalocele, and anencephaly.  That is one reason why women
who are planning to become pregnant are advised to take prenatal
vitamins.  In fact, all women who might become pregnant,
whether they are planning to or not, should be sure to get enough.
 

Come to think of it, folate deficiency href="http://www.ajcn.org/cgi/content/abstract/82/3/636">increases
the risk for dementia, too.  So probably all persons
with a brain ought to be sure to get enough folate.  But the
need is particularly great during pregnancy.  Pregnancy is the
time of greatest cell division.



The US Public Health Service issued a recommendation for folate
supplementation, which was followed by an FDA mandate in 1998.
 The FDA is in charge of food regulations.  



Now, we learn that the incidence of neural tube defects in newborns has
dropped by 20 to 32 percent in the USA.  That is a pretty good
outcome for a simple, inexpensive intervention.  Even so, it
turns out that the goals are not being met:

href="http://news.yahoo.com/s/nm/20061003/hl_nm/folate_dc_1">U.S.
not meeting folate targets



By Will Boggs, MD Tue Oct 3, 6:15 PM ET



NEW YORK (Reuters Health) - Folate intake in the U.S. is well below
targets established by the Food and Drug Administration when it
mandated folic acid fortification of enriched grain products in 1998,
according to a report in the American Journal of Public Health...



..."The folic acid fortification program was successful in that it
increased the amount of folic acid consumed by women of childbearing
age, and neural tube (birth) defects decreased 20 to 32 percent
following the policy," Dr. Karen M. Kuntz from Harvard School of Public
Health, Boston, told Reuters Health.



"However," she said, "the success of the program falls short of the
Food and Drug Administration's goal to increase the percent of women of
childbearing age consuming a total of at least 400 micrograms per day
of folic acid to 50 percent."...



...Only 39 percent of white women, 26 percent of black women, and 28
percent of Mexican American women have reached the 400 microgram per
day target for folate intake, the researchers note, despite substantial
gains since fortification...

The full study has been published in the American Journal of
Public Health: href="http://www.ajph.org/cgi/content/abstract/AJPH.2005.067371v1">Population-Level
Changes in Folate Intake by Age, Gender, and Race/Ethnicity after Folic
Acid Fortification.



I recall that when I was young, it was common for doctors to tell
people that vitamin supplements were not necessary.  It was
said to be better simply to eat a well-balanced diet.  Now,
however, many doctors have changed their tune.  This is one
reason for that.