Mandatory fortification of flour with folic acid increases blood folate levels

January 01, 0001

Mandatory fortification of flour with folic acid increases blood folate levels

The aim of this study by researchers from Sydney, Australia was to determine the impact that mandatory fortification with folic acid of wheat flour used in breadmaking has had on the blood folate levels of an Australian population since it was introduced in September 2009. It consisted of a retrospective analysis of serum and red blood cell (RBC) folate levels of 20,592 blood samples collected between April 2007 and April 2010 from a wide variety of inpatients and outpatients and analysed in a large public hospital diagnostic pathology laboratory.

Between April 2009 and April 2010, there was a 77% reduction in the prevalence of low serum folate levels (from 9.3% to 2.1%) in all samples tested and an 85% reduction in the prevalence of low RBC folate levels (from 3.4% to 0.5%). In April 2010, the prevalence of low RBC folate levels for females of childbearing age was 0.16% for all samples. There was a 31% increase in mean serum folate level (from 17.7 nmol/L to 23.1 nmol/L), and a 22% increase in mean RBC folate level (from 881 nmol/L to 1071 nmol/L). The greatest increment in mean serum folate levels occurred in September 2009, the month that mandatory fortification was introduced, although there was evidence of a gradual change during the preceding months.

The researchers concluded: "The introduction of mandatory fortification with folic acid has significantly reduced the prevalence of folate deficiency in Australia, including in women of childbearing age."

An important and effective public health measure.

For the full abstract, click here.

MJA 194(2):65-67, 17 January 2011 © The Medical Journal of Australia 2011
The impact of mandatory fortification of flour with folic acid on the blood folate levels of an Australian population. Ross D Brown, Mark R Langshaw, Elaine J Uhr, John N Gibson and Douglas E Joshua. Correspondence to Ross Brown: [email protected]

Category: T. Endocrine/Metabolic/Nutritional, W. Pregnancy/Childbirth/Family Planning. Keywords: mandatory, fortification, flour, folic acid, impact, blood, folate, levels, retrospective analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 4 February 2011

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