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Nutritional Epidemiology

Fortifying Food with Folic Acid Improves Folate Intake in German Infants, Children, and Adolescents¹

Research Institute of Child Nutrition (FKE), University of Bonn, D-44225 Dortmund, Heinstueck 11, Germany

²To whom correspondence should be addressed. E-mail: sichert{at}fke-do.de.

Folate is a critical nutrient and programs to enhance folate intake have been established or are under consideration. We investigated to what extent consumers (C) profit from folic acid–fortified food and dietary supplements compared to nonconsumers (NC) of these products. A total of 6135 weighed records from 861 subjects (47% males, 53% females, age 6 mo to 18 y) from the Dortmund Nutritional and Anthropometric Longitudinally Designed Study between 1990 and 2001 were evaluated. In 61% of the records, at least 1 item fortified with folic acid was reported, and in total 644 different items with a wide range of fortification levels were found. These were primarily commercial infant food (i.e., infant formula, weaning food) (44%), breakfast cereals (20%), and soft drinks (11%). Median dietary folate equivalents (DFEs) in NC increased from 65 and 62 µg/d in boys and girls at 6–12 mo of age, respectively, to 184 and 143 µg/d in adolescents 15–18 y of age. In C, DFEs increased from 109 and 100 µg/d in boys and girls at 6–12 mo of age, respectively, to 370 and 276 µg/d in adolescents 15–18 y of age. Irrespective of gender, NC had 50–70% the DFE intakes of C with a tendency for higher percentages in younger than in older children and adolescents. Folate intakes by male and female consumers of fortified food or supplements exceeded the upper levels in 1.7 and 1.2% of subjects, respectively. Currently, a fortification program for staple foods (e.g., grain products) does not seem necessary in Germany if children and adolescents consume food already fortified with folic acid.

KEY WORDS: • fortification • folate intake • infants • children • adolescents • dietary records