In the United Kingdom, population studies have revealed that the average intake of folate is around 200 micrograms a day. This is the recommended intake the government suggested back in 1991. However, since 1991 the government has recommended that women who are trying to become pregnant should increase this by a further 400 micrograms a day (to 600 micrograms) to reduce the risk of having a baby with spina bifida.
Furthermore, it would appear from studies that increasing intake of both folic acid and folates in the general population may keep the homocysteine levels on the low rather than high side of normal. The United States has taken a dramatic step in this direction. In January 1998 their Food and Drug Administration passed the law that folic acid was to be added to flour, rice, noodles and corn grits. In other words bread, cakes and pasta, to mention a few commonly consumed cereal-based foods, now contain added folic acid.
The decision to fortify these common grains was encouraged by work carried out by an American called Carol Boushey. Boushey rounded up the results of thirty eight studies looking into folic acid and homocysteine, and concluded that by adding 140 micrograms of folic acid to every 100 grams of grain, it may be possible to prevent around 7 per cent of fatal male heart disease and 5 per cent of female coronary-related deaths. On the basis of Boushey's conclusions, which took into account many other scientists' work in this area, it was decided that, in spite of absence of absolute proof, fortification could go ahead.
This decision was taken primarily to help reduce the number of babies born with spina bifida, but the potential reduction this could bring to homocysteine levels and thus possibly to heart disease was considered an added incentive. The result of fortification is that American intakes of folate and folic acid have jumped on average from 200 to 300 micrograms a day.
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