Characteristics of U.S. Adults with Usual Daily Folic Acid Intake above the Tolerable Upper Intake Level: National Health and Nutrition Examination Survey, 2003–2010
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Intakes of Folic Acid and Vitamin B12
2.3. Covariates
2.4. Folic Acid Sources and Consumption Groups
2.5. Folic Acid Supplement Intake Groups
2.6. Statistical Analyses
3. Results
3.1. General Characteristics of Study Participants
3.2. Adults with Usual Daily Intake of Folic Acid Exceeding the UL
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
ECGP | enriched cereal grain products |
LOAEL | lowest observed adverse effect level |
UL | tolerable upper intake level |
NHANES | National Health and Nutrition Examination Survey |
RTE | ready-to-eat cereals |
SUP | supplements containing folic acid |
References
- MRC Vitamin Study Research Group. Prevention of neural tube defects: Results of the Medical Research Council Vitamin Study. Lancet 1991, 338, 131–137. [Google Scholar]
- Czeizel, A.E.; Dudas, I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N. Engl. J. Med. 1992, 327, 1832–1835. [Google Scholar] [CrossRef] [PubMed]
- US Food and Drug Administration. Food Standards: Amendment of standards of identity for enriched grain products to require addition of folic acid, final rule. Fed. Regist. 1996, 61, 8781–8797. [Google Scholar]
- Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline; National Academy Press: Washington, DC, USA, 1998. [Google Scholar]
- Yang, Q.; Cogswell, M.E.; Hamner, H.C.; Carriquiry, A.; Bailey, L.B.; Pfeiffer, C.M.; Berry, R.J. Folic acid source, usual intake, and folate and vitamin B-12 status in US adults: National Health and Nutrition Examination Survey (NHANES) 2003–2006. Am. J. Clin. Nutr. 2010, 91, 64–72. [Google Scholar] [CrossRef] [PubMed]
- Tinker, S.; Cogswell, M.E.; Hamner, H.C.; Berry, R.J. Usual folic acid intakes: A modeling exercise assessing changes in the amount of folic acid in foods and supplements, National Health and Nutrition Examination Survey, 2003–2008. Public Health Nutr. 2012, 15, 1216–1227. [Google Scholar] [CrossRef] [PubMed]
- Bailey, R.L.; Dodd, K.W.; Gahche, J.J.; Dwyer, J.T.; McDowell, M.A.; Yetley, E.A.; Sempos, C.A.; Burt, V.L.; Radimer, K.L.; Picciano, M.F. Total folate and folic acid intake from foods and dietary supplements in the United States: 2003–2006. Am. J. Clin. Nutr. 2010, 91, 231–237. [Google Scholar] [CrossRef] [PubMed]
- National Center for Health Statistics. 2003–2004 National Health and Nutrition Examination Survey (NHANES). Available online: http://wwwn.cdc.gov/nchs/nhanes/search/nhanes03_04.aspx (accessed on 2 January 2016).
- National Center for Health Statistics. 2005–2006 National Health and Nutrition Examination Survey (NHANES). Available online: http://wwwn.cdc.gov/nchs/nhanes/search/nhanes05_06.aspx (accessed on 2 January 2016).
- National Center for Health Statistics. 2007–2008 National Health and Nutrition Examination Survey (NHANES). Available online: http://wwwn.cdc.gov/nchs/nhanes/search/nhanes07_08.aspx (accessed on 2 January 2016).
- National Center for Health Statistics. 2009–2010 National Health and Nutrition Examination Survey (NHANES). Updated 7 November 2011. Available online: http://wwwn.cdc.gov/nchs/nhanes/search/nhanes09_10.aspx (accessed on 2 January 2016).
- National Center for Health Statistics. National Health and Nutrition Examination Survey. Response rates and CPS totals. 2003–2004 Response rates. Available online: http://www.cdc.gov/nchs/data/nhanes/response_rates_cps/RRT0304MF.pdf (accessed on 2 January 2016).
- National Center for Health Statistics. National Health and Nutrition Examination Survey. Response rates and CPS totals. 2005–2006 Response rates. Available online: http://www.cdc.gov/nchs/data/nhanes/response_rates_cps/RRT0506MF.pdf (accessed on 2 January 2016).
- National Center for Health Statistics. National Health and Nutrition Examination Survey. Response rates and CPS totals. 2007–2008 Response rates. Available online: http://www.cdc.gov/nchs/data/nhanes/response_rates_cps/RRT0708MF.pdf (accessed on 2 January 2016).
- National Center for Health Statistics. National Health and Nutrition Examination Survey. Response rates and CPS totals. 2009–2010 Response rates. Available online: http://www.cdc.gov/nchs/data/nhanes/response_rates_cps/RRT0910.pdf (accessed on 2 January 2016).
- National Center for Health Statistics. National Health and Nutrition Examination Survey. Dietary Web Tutorials. Dietary Data Overview. Describe NHANES Dietary Collection Methods. Updated 2 November 2010. Available online: http://www.cdc.gov/nchs/tutorials/dietary/SurveyOrientation/DietaryDataOverview/intro.htm (accessed on 2 January 2016).
- US Department of Agriculture, Agricultural Research Service. USDA Automated Multiple-Pass Method. Modified 29 September 2010. Available online: http://www.ars.usda.gov/services/docs.htm?docid=7710 (accessed on 2 January 2016).
- US Department of Agriculture. Food and Nutrient Database for Dietary Studies, 2.0. (2006). Agricultural Research Service, Food Surveys Research Group: Beltsville, MD, US. Available online: http://www.ars.usda.gov/SP2UserFiles/Place/80400530/pdf/fndds/fndds2_doc.pdf (accessed on 2 January 2016).
- US Department of Agriculture. Food and Nutrient Database for Dietary Studies, 3.0. (2008). U.S. Department of Agriculture, Agricultural Research Service, Food Surveys Research Group: Beltsville, MD, US. Available online: http://www.ars.usda.gov/SP2UserFiles/Place/80400530/pdf/fndds/fndds3_doc.pdf (accessed on 2 January 2016).
- US Department of Agriculture. Food and Nutrient Database for Dietary Studies, 4.1 (2010). U.S. Department of Agriculture, Agricultural Research Service, Food Surveys Research Group: Beltsville, MD, US. Available online: http://www.ars.usda.gov/SP2UserFiles/Place/80400530/pdf/fndds/fndds4_doc.pdf (accessed on 2 January 2016).
- US Department of Agriculture. Food and Nutrient Database for Dietary Studies, 5.0. (2012). U.S. Department of Agriculture, Agricultural Research Service, Food Surveys Research Group: Beltsville, MD, US. Available online: http://www.ars.usda.gov/SP2UserFiles/Place/80400530/pdf/fndds/fndds5_doc.pdf (accessed on 2 January 2016).
- National Center for Health Statistics. 2003–2004 National Health and Nutrition Examination Survey. Dietary Files. 30-Day Dietary Supplement Use Documentation. Updated March 2007. Available online: http://www.cdc.gov/nchs/nhanes/nhanes2003-2004/DSQDOC_C.htm (accessed on 2 January 2016).
- National Center for Health Statistics. 2005–2006 National Health and Nutrition Examination Survey. Dietary Files. 30-Day Dietary Supplement Use Documentation. Updated July 2009. Available online: http://www.cdc.gov/nchs/nhanes/nhanes2005-2006/DSQDOC_D.htm (accessed on 2 January 2016).
- National Center for Health Statistics. 2007–2008 National Health and Nutrition Examination Survey. Changes to the 2007–2008 NHANES Dietary Supplement Files. Available online: http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/dietary_changes.htm (accessed on 2 January 2016).
- National Center for Health Statistics. 2009–2010 National Health and Nutrition Examination Survey. Dietary Files. 30-Day Dietary Supplement Use Documentation. Available online: http://www.cdc.gov/nchs/nhanes/nhanes2009-2010/DSQDOC_F.htm (accessed on 2 January 2016).
- Carriquiry, A.L. Estimation of usual intake distributions of nutrients and foods. J. Nutr. 2003, 133, 601S–608S. [Google Scholar] [PubMed]
- Carriquiry, A.L.; Camano-Garcia, G. Evaluation of dietary intake data using the tolerable upper intake levels. J. Nutr. 2006, 136, 507S–513S. [Google Scholar] [PubMed]
- Dodd, K.W.; Guenther, P.M.; Freedman, L.S.; Subar, A.F.; Kipnis, V.; Midthune, D.; Tooze, J.A.; Krebs-Smith, S.M. Statistical methods for estimating usual intake of nutrients and foods: A review of the theory. J. Am. Diet. Assoc. 2006, 106, 1640–1650. [Google Scholar] [CrossRef] [PubMed]
- National Center for Health Statistics. National Health and Nutrition Examination Survey. Questionnaires, Datasets, and Related Documentation. Analytic Guidelines. Analytic and Reporting Guidelines: National Health and Nutrition Examination Survey. Updated December 2005. Available online: http://www.cdc.gov/nchs/data/nhanes/nhanes_03_04/nhanes_analytic_guidelines_dec_2005.pdf (accessed on 2 January 2016).
- Hamner, H.C.; Tinker, S.C.; Berry, R.J.; Mulinare, J. Modeling fortification of corn masa flour with folic acid: The potential impact on exceeding the tolerable upper intake level for folic acid, NHANES 2001–2008. Food Nutr. Res. 2013. [Google Scholar] [CrossRef] [PubMed]
- Crider, K.S.; Bailey, L.B.; Berry, R.J. Folic acid food fortification-its history, effect, concerns, and future directions. Nutrients 2011, 3, 370–384. [Google Scholar] [CrossRef] [PubMed]
- Vollset, S.E.; Clarke, R.; Lewington, S.; Ebbing, M.; Halsey, J.; Lonn, E.; Armitage, J.; Manson, J.E.; Hankey, G.J.; Spence, J.D.; et al. Effects of folic acid supplementation on overall and site-specific cancer incidence during the randomised trials: Meta-analyses of data on 50,000 individuals. Lancet 2013, 381, 1029–1036. [Google Scholar] [CrossRef]
- Crider, K.S.; Cordero, A.M.; Qi, Y.P.; Mulinare, J.; Dowling, N.F.; Berry, R.J. Prenatal folic acid and risk of asthma in children: A systematic review and meta-analysis. Am. J. Clin. Nutr. 2013, 98, 1272–1281. [Google Scholar] [CrossRef] [PubMed]
- Crider, K.S.; Yang, T.P.; Berry, R.J.; Bailey, L.B. Folate and DNA methylation: A review of molecular mechanisms and the evidence for folate’s role. Adv. Nutr. 2012, 3, 21–38. [Google Scholar] [CrossRef] [PubMed]
- Wien, T.N.; Pike, E.; Wisloff, T.; Staff, A.; Smeland, S.; Klemp, M. Cancer risk with folic acid supplements: A systematic review and meta-analysis. BMJ Open 2012, 2, e000653. [Google Scholar] [CrossRef] [PubMed]
- Qin, X.; Cui, Y.; Shen, L.; Sun, N.; Zhang, Y.; Li, J.; Xu, X.; Wang, B.; Xu, X.; Huo, Y.; et al. Folic acid supplementation and cancer risk: A meta-analysis of randomized controlled trials. Int. J. Cancer 2013, 133, 1033–1041. [Google Scholar] [CrossRef] [PubMed]
- Huo, Y.; Li, J.; Qin, X.; Huang, Y.; Wang, X.; Gottesman, R.F.; Tang, G.; Wang, B.; Chen, D.; He, M.; et al. Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China. JAMA 2015, 313, 1325–1335. [Google Scholar] [CrossRef] [PubMed]
- Surén, P.; Roth, C.; Bresnahan, M.; Haugen, M.; Hornig, M.; Hirtz, D.; Lie, K.K.; Lipkin, W.I.; Magnus, P.; Reichborn-Kjennerud, T.; et al. Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children. JAMA 2013, 309, 570–577. [Google Scholar] [CrossRef] [PubMed]
- Odewole, O.A.; Williamson, R.S.; Zakai, N.A.; Berry, R.J.; Judd, S.E.; Qi, Y.P.; Adedinsewo, D.A.; Oakley, G.P., Jr. Near-elimination of folate-deficiency anemia by mandatory folic acid fortification in older US adults: Reasons for Geographic and Racial Differences in Stroke study 2003–2007. Am. J. Clin. Nutr. 2013, 98, 1042–1047. [Google Scholar] [CrossRef] [PubMed]
- Gibson, T.M.; Weinstein, S.J.; Pfeiffer, R.M.; Hollenbeck, A.R.; Subar, A.F.; Schatzkin, A.; Mayne, S.T.; Stolzenberg-Solomon, R. Pre- and postfortification intake of folate and risk of colorectal cancer in a large prospective cohort study in the United States. Am. J. Clin. Nutr. 2011, 94, 1053–1062. [Google Scholar] [CrossRef] [PubMed]
- Stevens, V.L.; McCullough, M.L.; Sun, J.; Jacobs, E.J.; Campbell, P.T.; Gapstur, S.M. High levels of folate from supplements and fortification are not associated with increased risk of colorectal cancer. Gastroenterology 2011, 141, 98–105. [Google Scholar] [CrossRef] [PubMed]
- Moshfegh, A.J.; Rhodes, D.G.; Baer, D.J.; Murayi, T.; Clemens, J.C.; Rumpler, W.V.; Paul, D.R.; Sebastian, R.S.; Kuczynski, K.J.; Ingwersen, L.A.; et al. The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am. J. Clin. Nutr. 2008, 88, 324–332. [Google Scholar] [PubMed]
- Raper, N.; Perloff, B.; Ingwersen, L.; Steinfeldt, L.; Anand, J. An overview of USDA’s Dietary Intake Data System. J. Food Compos. Anal. 2004, 17, 545–555. [Google Scholar] [CrossRef]
- US Department of Agriculture. USDA Dietary Supplement Ingredient Database; Release 1; US Department of Agriculture: Beltsville, MD, USA.
Characteristics | Those with Usual Daily Folic Acid Intake ≤1000 µg | Those with Usual Daily Folic Acid Intake >1000 µg | ||
---|---|---|---|---|
No. of Participants (Unweighted) | Weighted Percent, (95% Confidence Interval) | No. of Participants (Unweighted) | Weighted Percent, (95% Confidence Interval) | |
Total | 18,025 | 296 | ||
Sex 1 | ||||
Male | 8886 | 48.1 (47.3–48.8) | 126 | 37.8 (32.1–43.5) |
Female | 9139 | 51.9 (51.2–52.7) | 170 | 62.2 (56.5–68.0) |
Age 1 | ||||
19–39 years | 6165 | 36.9 (35.6–38.3) | 86 | 29.1 (22.3–36.0) |
40–59 years | 5626 | 38.3 (37.3–39.3) | 77 | 36.5 (27.8–45.2) |
≥60 years | 6234 | 24.8 (23.5–26.0) | 133 | 34.4 (26.5–42.3) |
Race/ethnicity 1 | ||||
Non-Hispanic white | 9038 | 72.2 (68.9–75.4) | 207 | 86.3 (82.1–90.5) |
Non-Hispanic black | 3662 | 11.1 (9.4–12.8) | 36 | 4.4 (2.6–6.2) |
Mexican American | 3344 | 7.8 (6.1–9.4) | 27 | 3.4 (1.7–5.1) |
Other | 1981 | 9.0 (7.6–10.3) | 26 | 6.0 (3.1–8.8) |
Chronic medical condition 1 | ||||
Presence of ≥1 conditions | 11,225 | 60.3 (58.7–61.8) | 218 | 73.9 (66.6–81.2) |
Supplement use 1 | ||||
Yes | 5707 | 35.7 (34.3–37.2) | 290 | 98.5 (96.7–100) |
Characteristics of U.S. Adults with Usual Daily Folic Acid Intake above the Tolerable Upper Intake Level | Median (25th–75th Percentile) µg/Day |
---|---|
Total | 1477 (1298–1709) |
Sex | |
Male | 1385 (1256–1559) |
Female | 1509 (1295–1819) |
Age | |
19–39 Years | 1464 (1320–1648) |
40–59 Years | 1479 (1251–1822) |
≥60 Years | 1429 (1276–1637) |
Race/Ethnicity | |
Non-Hispanic white | 1482 (1316–1726) |
Non-Hispanic black | 1460 (1285–1711) |
Mexican American | 1433 (1363–1520) |
© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons by Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Orozco, A.M.; Yeung, L.F.; Guo, J.; Carriquiry, A.; Berry, R.J. Characteristics of U.S. Adults with Usual Daily Folic Acid Intake above the Tolerable Upper Intake Level: National Health and Nutrition Examination Survey, 2003–2010. Nutrients 2016, 8, 195. https://doi.org/10.3390/nu8040195
Orozco AM, Yeung LF, Guo J, Carriquiry A, Berry RJ. Characteristics of U.S. Adults with Usual Daily Folic Acid Intake above the Tolerable Upper Intake Level: National Health and Nutrition Examination Survey, 2003–2010. Nutrients. 2016; 8(4):195. https://doi.org/10.3390/nu8040195
Chicago/Turabian StyleOrozco, Angela M., Lorraine F. Yeung, Jing Guo, Alicia Carriquiry, and Robert J. Berry. 2016. "Characteristics of U.S. Adults with Usual Daily Folic Acid Intake above the Tolerable Upper Intake Level: National Health and Nutrition Examination Survey, 2003–2010" Nutrients 8, no. 4: 195. https://doi.org/10.3390/nu8040195
APA StyleOrozco, A. M., Yeung, L. F., Guo, J., Carriquiry, A., & Berry, R. J. (2016). Characteristics of U.S. Adults with Usual Daily Folic Acid Intake above the Tolerable Upper Intake Level: National Health and Nutrition Examination Survey, 2003–2010. Nutrients, 8(4), 195. https://doi.org/10.3390/nu8040195