Folate intake still below recommendations despite fortification

Despite significant improvements in public health measures to increase folate intakes through fortification of grain products, dietary intakes still fall well below recommendations. Regular use of a multivitamin supplement containing folic acid is an easy way to ensure that you receive an adequate intake.

Folate is found in foods such as green leafy vegetables, chick peas and lentils, and it is increasingly accepted that folate deficiency in early pregnancy is linked to a risk of neural tube defects such as spina bifida and anencephaly in infants. This connection led to the introduction of public health measures in the US and Canada, whereby all grain products are fortified with folic acid " the synthetic, bioavailable form of folate.

A new study, published in October's American Journal of Public Health, concluded that since fortification was implemented folic acid intake has in fact increased, but not nearly enough to meet FDA goals and recommendations. Even with significant improvements and widespread fortification, only 39 percent of white women, 26 percent of black women, and 28 percent of Mexican American women attained the 400 microgram per day target for folate consumption. In addition, over half the subgroups showed a decrease in folic acid intake since fortification began in 1998.

The FDA recommends at least 400 micrograms of folate daily for nonpregnant women, and adult men, as well as children four and older. However, the daily recommendation for pregnant women increases to at least 800 micrograms per day. Despite the fact that recent surveys show that the majority of women know the importance of folic acid, daily folic acid supplementation appears to be critical since dietary intakes still fall well below recommendations.

Population-Level Changes in Folate Intake by Age, Gender, and Race/Ethnicity after Folic Acid Fortification. American Journal of Public Health. October, 2006.

Mediterranean-style diet cuts risk of Alzheimer's disease by 68 percent

New research indicates that the Mediterranean diet rich in antioxidants and polyphenols reduce oxidative stress and protect against the development of Alzheimer's disease.

The Mediterranean diet, rich in cereals, wine, fruits, nuts, legumes and whole grains, fish and olive oil, has been linked to lower incidence of heart disease, protection against some cancers, and a longer life. The diet's main nutritional components include beta-carotene, vitamin C, tocopherols, polyphenols and essential minerals. A new study published on-line in the Archives of Neurology indicates that it is these antioxidants and polyphenols that appear to offer protection, not simply an improvement in heart health.

After adjusting the results for age, education, BMI, smoking status, and ethnicity, the researchers reported that people with the highest adherence to a model Mediterranean diet were associated with a 60 percent lower risk of Alzheimer's disease, compared to people with the lowest adherence to the diet.

When the researchers took into account general heart health, such as history of stroke, hypertension, heart disease, diabetes, and cholesterol, the associations for the high adherence group grew stronger, with an associated risk reduction of 68 percent.

These results indicate that the protection gained by following a Mediterranean-type diet is not a result of the cardiovascular factors, and it may be more related to factors such as inflammation and oxidative stress. The researchers noted that the Mediterranean diet contains high levels of important antioxidants and polyphenols, and it could be the combination of these various dietary compounds that could partially explain the reduced risk of Alzheimer's Disease.

The study follows another study by the same researchers, published earlier this year in the Annals of Neurology (Vol. 59, pp. 912 - 921), in which elderly individuals whose diet closely resembled the Mediterranean diet had a 40 percent lower risk of Alzheimer's than those who followed the diet the least.