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Folic acid is the form of folate used in dietary supplements and for food fortification, as it is more stable than the naturally-occurring forms in foods.1 Mandatory fortification of wheat flour for bread making flour with folic acid was introduced in Australia in 2009 to help reduce the incidence of neural tube defects (NTDs) in babies, including spina bifida. Given the critical importance of folate in early growth and development, it is recommended that all women of childbearing age, even if they are not planning on becoming pregnant, also take extra folic acid.3 Dietary folate equivalents are used to measure folate intakes to account for the differing bioavailability of natural folate and folic acid.
Approximately one in eleven (9%) adult females (aged 19 and over) did not meet their requirements for folate (as dietary folate equivalents). Almost all males met their requirements for folate (2% with inadequate intakes).
The 2011–12 National Health Measures Survey (NHMS) included tests for folate. The NHMS showed that the vast majority of women of childbearing age had sufficient folate levels in 2011–12 based on their blood tests. Less than 1% had a red cell folate level which indicates an increased risk of NTDs and no women aged 16–44 years were in the range for high risk of NTDs (<453 nmol/L). For more information on folate levels of women of childbearing age see the Feature Article: Women of Childbearing Age from the NHMS. In making comparisons between the NHMS and the usual nutrient intakes, consideration should be given to the differences in the methods used to measure the prevalence of inadequate folate intakes, including the potential contribution of folic acid in dietary supplements to the results of the NHMS.
Less than 5% of the population exceeded the UL for folic acid.
1 National Health and Medical Research Council and New Zealand Ministry of Health, 2006, Nutrient Reference Values for Australia and New Zealand, <http://www.nrv.gov.au/nutrients/folate>, last accessed 4/2/2015
2 Australian Bureau of Statistics, 2014, Australian Health Survey: Nutrition First Results - Foods and Nutrients, 2011-12, 'Table 10: Proportion of Nutrients from food groups', data cube: Excel spreadsheet, cat. no. 4364.0.55.007
3 World Health Organization, Daily iron and folic acid supplementation in pregnant women, 2012, <http://www.who.int/nutrition/publications/micronutrients/guidelines/daily_ifa_supp_pregnant_women/en/index.html>, last accessed 4/2/2015
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