Public Health Nutrition

Research Paper

Folic acid food fortification prevents inadequate folate intake among preschoolers from Ontario

Kathleen Hennessy-Priesta1, Jill Mustarda1, Heather Kellera1, Lee Rysdalea2, Joanne Beyersa2, Richard Goya1 and Janis Randall Simpsona1 c1

a1 Department of Family Relations and Applied Nutrition, University of Guelph, MACS Room 324, Guelph, Ontario, Canada, N1G 2W1

a2 Public Health Research, Education & Development (PHRED) Program, Sudbury & District Health Unit, Sudbury, Ontario, Canada


Objective Folic acid food fortification has successfully reduced neural tube defect-affected pregnancies across Canada. The effect of this uncontrolled public health intervention on folate intake among Canadian children is, however, unknown. Our objectives were to determine folic acid intake from food fortification and whether fortification promoted adequate folate intakes, and to describe folic acid-fortified food usage among Ontario preschoolers.

Design Cross-sectional data were used from the NutriSTEP™ validation project with preschoolers recruited using convenience sampling. Mean daily total folate and folic acid intakes were estimated from 3 d food records, which included multivitamin supplement use. Comparisons were made to Dietary Reference Intakes, accounting for and excluding fortificant folic acid, to determine the prevalence of inadequate and excessive intakes.

Setting Canada.

Subjects Two hundred and fifty-four preschoolers (aged 3–5 years).

Results All participants (130 girls, 124 boys) ate folic acid-fortified foods and 30 % (n 76) used folic acid-containing supplements. Mean (se) fortificant folic acid intake was 83 (2) μg/d, which contributed 30 % and 50 % to total folate intake for supplement users and non-users, respectively. The prevalence of total folate intakes below the Estimated Average Requirement was <1 %; however, excluding fortificant folic acid, the prevalence was 32 %, 54 % and 47 % for 3-, 4- and 5-year-olds, respectively. The overall prevalence of folic acid (fortificant and supplemental) intakes above the Tolerable Upper Intake Level was 2 % (7 % among supplement users).

Conclusions Folic acid food fortification promotes dietary folate adequacy and did not appear to result in excessive folic acid intake unless folic acid-containing supplements were consumed.

(Received December 31 2007)

(Accepted November 13 2008)


c1 Corresponding author: Email