Modelling the impact of mandatory folic acid fortification of bread or flour in Ireland on the risk of occurrence of NTD-affected pregnancies in women of childbearing age and on risk of masking vitamin B12 deficiency in older adults

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dc.contributor.authorKehoe, Lauraen
dc.contributor.authorWalton, Janetteen
dc.contributor.authorHopkins, Sinead M.en
dc.contributor.authorMcNulty, Breige A.en
dc.contributor.authorNugent, Anne P.en
dc.contributor.authorFlynn, Alberten
dc.contributor.funderDepartment of Agriculture, Food and the Marine, Irelanden
dc.date.accessioned2023-10-19T13:05:01Z
dc.date.available2023-10-19T13:05:01Z
dc.date.issued2019-10-23en
dc.description.abstractPurpose: The rate of neural tube defects (NTDs) in Europe has remained similar since the 1990s despite folic acid supplement recommendations (400 µg/day) for women of childbearing age. Mandatory folic acid fortification of staple foods has proved effective for reducing the prevalence of NTDs in over 80 countries. This study estimated the impact of addition of folic acid to bread or flour in the Republic of Ireland on reducing the risk of occurrence of NTD-affected pregnancies and the possible risk of masking (undiagnosed) vitamin B12 deficiency in older adults. Methods: Analyses were based on the Irish National Adult Nutrition Survey (2008–2010). Folic acid fortification was modelled using DaDiet© software. Estimates were made of the increase in average daily folic acid intake in women (18–50 years) and the risk of exceeding the tolerable upper intake level (UL) of 1000 µg for folic acid in adults over 50 years of age. Results: The fortification scenarios examined would reduce the risk of NTD-affected pregnancies by 8–32%, corresponding to an increase of 39–152 μg in the mean daily folic acid intake of WCBA. The risk of masking anaemia associated with vitamin B12 deficiency in older adults would be negligible as the probability of exceeding the UL for folic acid, even by a small amount, is very low (≤ 0.2%). Conclusions: These levels of addition of folic acid to bread or flour would effectively reduce the risk of NTDs while allowing safe consumption of folic acid at current levels from other fortified foods and supplements.en
dc.description.sponsorshipDepartment of Agriculture, Food and the Marine, Ireland (Food for Health Research Initiative 2007–2012)en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationKehoe, L., Walton, J., Hopkins, S. M., McNulty, B. A., Nugent, A.P. and Flynn. A. (2020) 'Modelling the impact of mandatory folic acid fortification of bread or flour in Ireland on the risk of occurrence of NTD-affected pregnancies in women of childbearing age and on risk of masking vitamin B12 deficiency in older adults', European Journal of Nutrition, 59, 2631-2639. doi: 10.1007/s00394-019-02111-4en
dc.identifier.doi10.1007/s00394-019-02111-4en
dc.identifier.eissn1436-6215en
dc.identifier.endpage2639en
dc.identifier.issn1436-6207en
dc.identifier.journaltitleEuropean Journal of Nutritionen
dc.identifier.startpage2631en
dc.identifier.urihttps://hdl.handle.net/10468/15136
dc.identifier.volume59en
dc.language.isoenen
dc.publisherSpringer Nature Switzerland AGen
dc.rights© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. This version of the article has been accepted for publication, after peer review and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s00394-019-02111-4en
dc.subjectFolic acid fortifcationen
dc.subjectMandatory fortifcationen
dc.subjectIrish adultsen
dc.titleModelling the impact of mandatory folic acid fortification of bread or flour in Ireland on the risk of occurrence of NTD-affected pregnancies in women of childbearing age and on risk of masking vitamin B12 deficiency in older adultsen
dc.typeArticle (peer-reviewed)en
oaire.citation.issue6en
oaire.citation.volume59en
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