Evaluating food fortification options: general principles revisited with folic acid.
OBJECTIVE
This article uses folic acid as an example to illustrate some of the complex issues and general principles that emerge when evaluating fortification of the food supply as one possible means to address a public health recommendation.


METHODS
Distributions of current daily folate intakes from conventional foods and dietary supplements were estimated. Intakes that might result from fortification of cereal-grain products and ready-to-eat cereals at various levels for eight age-gender groups were also estimated by using the US Department of Agriculture's 1987-1988 Nationwide Food Consumption Survey.


RESULTS
The results illustrate that fortification of the US food supply tends to increase folate intakes of consumers at the high end of the intake distribution curves in the general population to a greater extent than it affects consumers at the low end of the intake distribution curves in the target population.


CONCLUSIONS
The effectiveness of food fortification options for a target population and the safety for the general population impose conflicting challenges that must be considered concurrently when making decisions about fortifying the US food supply.
Crane
N T
NT
Center for Food Safety and Applied Nutrition, Food and Drug Administration, Washington, DC 20204, USA.
Wilson
D B
DB
Cook
D A
DA
Lewis
C J
CJ
Yetley
E A
EA
Rader
J I
JI
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002523:Edible Grain; D002149:Energy Intake; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D014481:United States
D005492:Folic Acid