Estimated folate intakes: data updated to reflect food fortification, increased bioavailability, and dietary supplement use

Abstract
Background: There is a critical need to estimate dietary folate intakes for nutrition monitoring and food safety evaluations, but available intake data are seriously limited by several factors. Objective: Our objective was to update 2 national food consumption surveys to reflect folate intakes as a result of the recently initiated food fortification program and to correct folate intakes for the apparently higher bioavailability of synthetic folic acid (SFA; ie, folate added to foods or from dietary supplements) than of naturally occurring folate so as to express intakes as dietary folate equivalents. Design: It was not possible to chemically analyze foods, so adjustments were made to food-composition data by using information about food ingredients and characteristics. Total folate intakes were estimated for several sex and age groups by using the modified data coupled with dietary supplement use. Results: Within the limitations of the data, our findings suggested that 67–95% of the population met or surpassed the new estimated average requirement, depending on the sex and age group and survey. Nonetheless, some subgroups had estimated intakes below these standards. Estimated SFA intakes suggested that ≈15–25% of children aged 1–8 y, depending on the survey, had intakes above the newly established tolerable upper intake level. We estimated that 68–87% of females of childbearing age had SFA intakes below the recommended intake of 400 μg/d, depending on the age group and survey. Conclusion: There is a need to explore ways to improve folate intakes in targeted subgroups, including females of childbearing age, while not putting other population groups at risk of excessive intakes.