A study led by Columbia University Mailman School of Public Health researchers with the National Institute of Public Health (NIPH), Mexico, found that a large proportion of women of childbearing age have folic acid (FA) fortification intake below levels recommended by the World Health Organization (WHO), potentially raising the risk for neural tube defects in their offspring. The study is one of a few to investigate FA intake after fortification, and the first such report for Mexico. Results are in the American Journal of Clinical Nutrition.
Researchers measured FA and folate content in bakery bread and tortillas from geographically diverse areas in Mexico. They then extrapolated the data to the larger population, adjusting FA intake tables from a 2012 national health and nutrition survey — Mexico’s equivalent of U.S. National Health and Nutrition Examination Survey. While overall folate intake improved, between 9 and 32 percent of girls ages 14-18 and between 9 and 28 percent of women ages 19-39 continue to have intakes that are below the WHO recommended levels. They also found that between 5 and 12 percent of children 1-8 years (up to 1.9 million children) are at risk of ingesting FA at levels above the WHO age-specific tolerable upper intake limit. In adults the effects of high exposure are associated with cancer risk.
“Our findings suggest that more regulation and oversight related to monitoring and evaluation of fortification of corn and wheat flour may avoid health risks from overexposure of vulnerable segments of the population, as well as insufficient intake in the population initially targeted by the fortification program,” says first author Dr. Manuela Orjuela-Grimm, assistant professor of epidemiology and pediatrics at the Columbia Mailman and Columbia University Irving Medical Center.Friday Letter Submission, Publish on October 11