Women Taking a Folic Acid Supplement in Countries with Mandatory Food Fortification Programs May Be Exceeding the Upper Tolerable Limit of Folic Acid: A Systematic Review

Carolyn Ledowsky; Abela Mahimbo; Vanessa Scarf; Amie Steel

doi:10.3390/nu14132715

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Women Taking a Folic Acid Supplement in Countries with Mandatory Food Fortification Programs May Be Exceeding the Upper Tolerable Limit of Folic Acid: A Systematic Review

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Women Taking a Folic Acid Supplement in Countries with Mandatory Food Fortification Programs May Be Exceeding the Upper Tolerable Limit of Folic Acid: A Systematic Review

Carolyn Ledowsky, Abela Mahimbo, Vanessa Scarf and Amie Steel

Nutrients, Vol.14(13), pp.1-26

29/06/2022

DOI: https://doi.org/10.3390/nu14132715

Appears in Recent National Centre for Naturopathic Medicine Publications

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Abstract

5-methyltetrahydrofolate

folate

folic acid

fortification

preconception

unmetabolized folic acid

Background: In preconception and pregnancy, women are encouraged to take folic acid-based supplements over and above food intake. The upper tolerable limit of folic acid is 1000 mcg per day; however, this level was determined to avoid masking a vitamin B12 deficiency and not based on folic acid bioavailability and metabolism. This review’s aim is to assess the total all-source intake of folate in women of childbearing age and in pregnancy in high-income countries with folate food fortification programs. Methods: A systematic search was conducted in five databases to find studies published since 1998 that reported folate and folic acid intake in countries with a mandatory fortification policy. Results: Women of childbearing age do not receive sufficient folate intake from food sources alone even when consuming fortified food products; however, almost all women taking a folic acid-based supplement exceed the upper tolerable limit of folic acid intake. Conclusions: Folic acid supplement recommendations and the upper tolerable limit of 1000 mcg set by policy makers warrant careful review in light of potential adverse effects of exceeding the upper tolerable limit on folic acid absorption and metabolism, and subsequent impacts on women’s health during their childbearing years.

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Title: Women Taking a Folic Acid Supplement in Countries with Mandatory Food Fortification Programs May Be Exceeding the Upper Tolerable Limit of Folic Acid: A Systematic Review
Creators: Carolyn Ledowsky - University of Technology Sydney
Abela Mahimbo - School of Public Health, University of Technology, P.O. Box 123, Sydney, NSW 2007, Australia
Vanessa Scarf - School of Nursing and Midwifery, Faculty of Health, University of Technology, P.O. Box 123, Sydney, NSW 2007, Australia
Amie Steel - School of Public Health, University of Technology, P.O. Box 123, Sydney, NSW 2007, Australia
Publication Details: Nutrients, Vol.14(13), pp.1-26
Publisher: MDPI AG
Identifiers: 991013035757502368
Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Academic Unit: National Centre for Naturopathic Medicine
Language: English
Resource Type: Journal article

Women Taking a Folic Acid Supplement in Countries with Mandatory Food Fortification Programs May Be Exceeding the Upper Tolerable Limit of Folic Acid: A Systematic Review

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