alimentary paste is proposed at a level of at least 2.0 mg/kg (Health Canada, 1997). It is estimated that folate fortification will increase the folate intake of most U.S. women by 80 µg/day (136 µg of dietary folate equivalents [DFEs]) or more. This amount would be provided by one cup of pasta plus one slice of bread. Depending on what cereal grains are chosen and how much is consumed, five servings daily might add 220 µg/day or more of folate from fortified foods (nearly 400 µg of DFEs) to the diet (see Chapter 13).
According to the U.S. Department of Agriculture’s CSFII (Appendix G), the mean dietary folate intake by young women in the United States in 1994 through 1995 was approximately 200 µg/day. Intake data from the Third National Health and Nutrition Examination Survey (NHANES III) (Appendix H) gathered from 1988 to 1994 indicate a mean dietary intake of approximately 220 µg for young women and a total intake (including supplements) that was only slightly higher (250 µg). These values substantially underestimate actual current intake, partly because of the problems with analysis of the folate content of food (DeSouza and Eitenmiller, 1990; Pfeiffer et al., 1997b; Tamura et al., 1997), partly because of underreporting of intake (LSRO/FASEB, 1995), and partly because of the change in fortification discussed above. Thus, it is not possible to use these data to accurately assess the adequacy of current folate intake by Americans.
Survey data from the early 1990s from two Canadian provinces found similar or lower mean dietary intakes of folate for young women (approximately 200 µg/day in Québec and 160 µg/day in Nova Scotia) (Appendix I).
The Boston Nutritional Status Survey (Appendix F) conducted from 1981 to 1984 estimated that this relatively advantaged group of people over age 60 who were not taking supplements had median folate intakes of 254 µg/day for men and 208 µg/day for women.
Results of a nationwide telephone survey conducted during January and February 1997 indicated that 43 percent of women of childbearing age reported taking some form of vitamin supplement containing folate. Thirty-two percent reported taking a folate supplement daily and 12 percent reported taking a supplement less frequently (CDC, 1998).