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Am J Public Health. 1995 May; 85(5): 660–666.
PMCID: PMC1615413

Evaluating food fortification options: general principles revisited with folic acid.


OBJECTIVES. 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.

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Selected References

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  • Park YK, Kim I, Yetley EA. Characteristics of vitamin and mineral supplement products in the United States. Am J Clin Nutr. 1991 Oct;54(4):750–759. [PubMed]
  • Mertz W. Food intake measurements: is there a "gold standard"? J Am Diet Assoc. 1992 Dec;92(12):1463–1465. [PubMed]
  • Mertz W, Tsui JC, Judd JT, Reiser S, Hallfrisch J, Morris ER, Steele PD, Lashley E. What are people really eating? The relation between energy intake derived from estimated diet records and intake determined to maintain body weight. Am J Clin Nutr. 1991 Aug;54(2):291–295. [PubMed]
  • Martin JI, Landen WO, Jr, Soliman AG, Eitenmiller RR. Application of a tri-enzyme extraction for total folate determination in foods. J Assoc Off Anal Chem. 1990 Sep-Oct;73(5):805–808. [PubMed]

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