Nutritional Insight
  • HOME
  • ABOUT
  • SERVICES
  • PUBLICATIONS
  • INSIGHTS
  • CONTACT
Featured Posts
  • Green and Blue Water Footprints: What Are They & How Do They Relate to Food?
  • Stress and Micronutrient Concentrations: Do They Impact Each Other?
  • Does the Nutrition Education of Physicians Need Advancing?
  • Palm Oil: Should it Be Given the Same Attention as Single Use Plastics?
  • Folic Acid Fortification: Assessing the Folate Status of Women After 20 Years of Fortification in the US
  • Vegetarian and Vegan Diets: Good for Gut Microbiota?
  • Choline: Its Role and Requirements During Pregnancy.
  • Could we be over-looking a potential Choline crisis in the UK?

  • Choline: 30 Food Sources.
  • Choline: What is It and How Much Do We Need?
  • HOME
  • ABOUT
  • SERVICES
  • PUBLICATIONS
  • INSIGHTS
  • CONTACT
Followers
Followers
Subscribe
Nutritional Insight
Nutritional Insight
  • HOME
  • ABOUT
  • SERVICES
  • PUBLICATIONS
  • INSIGHTS
  • CONTACT
  • All
  • Folic Acid

Folic Acid Flour Fortification – The Only Way Forward?

  • Posted on November 21, 2018April 1, 2019
Total
0
Shares
0
0

It seems highly likely that flour could be fortified with folic acid in the UK, a decision that has lagged behind other European countries for years. Yet did we hold back for good reason and what are the potential pros and cons of this? This insight post discusses.

Folate Forms
First before we delve into the ins and outs of fortification strategies it’s important to recognise that there are several different folate forms.

  • Folate – this is a general term for a group of water soluble B-vitamins, and is also known as B9. Dark green leafy vegetables such as broccoli, spinach, kale and whole grains can provide folate though the bioavailability of these tends to be poor.
  • Folic acid – this refers to the oxidized synthetic compound used in dietary supplements and food fortification.
  • 5-methyltetrahydrofolate (5-MTHF) or L-methylfolate – this is the pure stable crystalline form of the naturally-occurring predominant form of folate. This type of water-soluble B-vitamin plays a key role in central metabolic pathways, e.g., cell division and repair.

Requirements May be DIFFERENT
This is very important to consider. For example, individuals who have previously had a neural-tube defect (NTD) affected pregnancy or those with diabetes may require up to 5 mg per day. There is also growing evidence that obese women could have higher requirements of this nutrient. Equally, women with underlying polymorphisms in genes related to folate metabolism could benefit from 5-MTHF instead of folic acid

Folate requirements.

  • Healthy women – 0.4 mg/day
  • Women with diabetes – 5mg/day
  • Women who have had a previous NTD-affected pregnancy – 5mg/day
  • Women with obesity – 0.4mg/day ↑

Present Situation
Years 1 to 9 of the UK National Diet and Nutrition survey show a downward trend in folate intakes – especially amongst girls aged 11 to 18 years. For red blood cell folate there was a 19 percentage point increase amongst those aged 11 to 18 years – indicating risk of anaemia. Results showed that folate intakes increased with income.

Amongst women of childbearing age the proportion with a red blood cell folate concentration suggestive of increased risk of neural tube defects (should pregnancy occur) increased from around 2/3s in 2008/9 to almost 90% in 2016/17. The outstanding question here is why?

Genetic Polymorphisms Should be Considered
The MTHFR 677TT genotype polymorphism (when the base code in DNA changes) is present in 10-22% of the European population. These individuals have an increased risk of delivering infants with neural tube defects. Obviously, the key issue here is screening to make women aware that they have this polymorphism. These individuals have lower folate levels and are less responsive to folic acid.

Concluding Points

  1. Will supplementation strategies become confused? One concern is that if flour is fortified with folic acid women may disregard supplements.
  2. Would young girls and women of childbearing age eat enough of these flour fortified foods to generate an effect? Models are yet to be developed so we are not sure about this at present.
  3. What about those with higher requirements and with polymorphisms? For some individuals with higher requirements, the amount of folic acid delivered via flour may not be enough.  Carriers of certain polymorphisms in genes related to folate metabolism or absorption appear to have an increased benefit from 5-methylTHF intake instead of folic acid.
  4. What about the masking of vitamin B12 deficiency? Using 5-MTHF instead of folic acid also reduces the potential for masking haematological symptoms of vitamin B12 deficiency.
  5. And what about ‘unmetabolised folate?’ – do we know enough? Use of 5-MTHF also prevents the potential negative effects of unconverted folic acid in the peripheral circulation also known as ‘unmetabolised folate’.

References:

https://www.gov.uk/government/statistics/ndns-time-trend-and-income-analyses-for-years-1-to-9

Scaglione F & Panzavolta G (2014) Folate, folic acid and 5-methyltetrahydrofolate are not the same thing. Xenobiotica 44(5):480-8.

Obeid R et al. (2013) Is 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects? J Perinat Med 41(5):469-83.

Derbyshire (2011) Nutrition in the Childbearing Years. Wiley Blackwell, West Sussex. pp. 34-36.

SACN (Scientific Advisory Committee on Nutrition) (2006) Folate and Disease Prevention. The Stationary Office: London.

 

 

Total
0
Shares
Tweet 0
Share 0
Related Topics
  • Folic Acid
Nutritional Insight

Previous Article
  • PEER-REVIEWED PUBLICATIONS

Brain Health across the Lifespan: A Systematic Review on the Role of Omega-3 Fatty Acid Supplements

  • Posted on November 20, 2018December 6, 2018
View Post
Next Article
  • All
  • Cardiovascular Disease
  • Tea

Can drinking tea prevent cardiovascular disease?

  • Posted on November 23, 2018December 7, 2018
View Post
You May Also Like
View Post
  • All

Green and Blue Water Footprints: What Are They & How Do They Relate to Food?

  • Posted on November 4, 2019November 4, 2019
View Post
  • All

Stress and Micronutrient Concentrations: Do They Impact Each Other?

  • Posted on November 4, 2019November 4, 2019
View Post
  • All

Does the Nutrition Education of Physicians Need Advancing?

  • Posted on September 27, 2019September 27, 2019
View Post
  • All

Palm Oil: Should it Be Given the Same Attention as Single Use Plastics?

  • Posted on September 27, 2019September 27, 2019
View Post
  • All

Folic Acid Fortification: Assessing the Folate Status of Women After 20 Years of Fortification in the US

  • Posted on September 27, 2019September 27, 2019
View Post
  • All

Vegetarian and Vegan Diets: Good for Gut Microbiota?

  • Posted on September 19, 2019
View Post
  • All

Choline: Its Role and Requirements During Pregnancy.

  • Posted on September 18, 2019September 18, 2019
View Post
  • All
  • choline
  • Uncategorized

Choline: 30 Food Sources.

  • Posted on September 13, 2019September 13, 2019

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Subscription Form
Keep Up to Date
Frequently Searched
ADHD Almonds Antibiotic resistance Assessment Brexit Cardiac Health Children Choline Chrono-Nutrition Chronotype Depression Drug production Eggs Evidence-base Folic Acid Future of Nutrition Future Trends Growing Up Guidelines Health Health Science Information Era Microbiota micronutrients Minerals Novel methods Nutritional Profiling Nutrition and Health Claims Nutrition Exit Omega Orthorexia Polyphenols Precision Nutrition Pregnancy Probiotics Protein Distribution Protein Quality Ratios Red Meat Registered Nutritionists Regulations Supplements Synergy Vertical Farming Vitamins
Nutritional Insight
  • HOME
  • ABOUT
  • SERVICES
  • PUBLICATIONS
  • INSIGHTS
  • CONTACT

Input your search keywords and press Enter.