title: Revised D-A-CH intake recommendations for folate: how much is needed?
abstract: The D-A-CH reference value (D-A-CH arises from the initial letters of the common country identification for the countries Germany (D), Austria (A) and Switzerland (CH)) for folate equivalents had been set at 400 μg/d for adults in the year 2000. By that time, the prevention of cardiovascular diseases through reduction of homocysteine was considered an important target of the reference value. Since that time a number of research papers revealed that in spite of an inverse association between folate-rich diet and chronic diseases, a preventive effect of folic acid intake on cardiovascular events was not supported by randomized controlled trials, and the reduction of plasma homocysteine levels to around 10-12 μmol/l did not reduce the risk for thromboembolic and cardiovascular diseases in persons already affected by these diseases. These results together with the observation that folate intakes below 400 μg/d result in a sufficient folate status justified a review of the current literature and-consequently-a reduction of the reference value to 300 μg/d for adults. This reference value is expressed as dietary folate equivalents that take into account the difference in bioavailability between folic acid and all types of folates in food. The recommendation to take a daily supplement of 400 μg of synthetic folic acid for women who intend to get pregnant and until the end of the first trimester of pregnancy is maintained.
authors.affiliation: Institute of Nutritional Sciences, Justus-Liebig-University, Giessen, Germany.
authors.forename: M B
authors.initials: MB
authors.lastname: Krawinkel
authors.affiliation: Deutsche Gesellschaft für Ernährung e. V., Bonn, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Strohm
authors.affiliation: Bundesinstitut für Risikobewertung, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Weissenborn
authors.affiliation: Max-Rubner-Institut, Karlsruhe, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Watzl
authors.affiliation: Institut für Sozial- und Präventivmedizin, Universität Zürich, Zürich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Eichholzer
authors.affiliation: Tanneichenstrasse 10, 9010 St. Gallen, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Bärlocher
authors.affiliation: Institute of Nutritional Sciences, University of Vienna, Wien, Austria.
authors.forename: I
authors.initials: I
authors.lastname: Elmadfa
authors.affiliation: Deutsche Gesellschaft für Ernährung e. V., Bonn, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Leschik-Bonnet
authors.affiliation: Department of Sports and Health, Universität Paderborn, Paderborn, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Heseker
mesh_terms: D000293:Adolescent; D000328:Adult; D001317:Austria; D001682:Biological Availability; D002648:Child; D002675:Child, Preschool; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005494:Folic Acid Deficiency / Q000517:prevention & control*; D005858:Germany; D006801:Humans; D007223:Infant; D008297:Male; D018673:Nutrition Policy; D009751:Nutritional Requirements; D009752:Nutritional Status; D016742:Preconception Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D013557:Switzerland; D055815:Young Adult
chemical_list: D005492:Folic Acid