Folic Acid :: Folic acid in cereal bars, energy bars, and nutritional drinks

Several public health authorities have issued recommendations or policies aimed at improving the folic acid intake among women of childbearing age.

In 1992, the United States Public Health Service issued a recommendation that all women of childbearing age take in at least 0.4 milligrams (mg) of folic acid each day to reduce the chances of having a baby with a neural tube defect (NTD). In 1998, the National Academy of Sciences expanded on this, saying that the 0.4 mg of folic acid should come from fortified foods, vitamin supplements, or both, in addition to a varied diet. In January of that same year, the U.S. Food and Drug Administration (FDA) announced that all enriched grain products are required to be fortified at a level that would provide about 100 mcg additional folic acid to the diet of an average woman of childbearing age.

While public information campaigns aimed at improving daily supplementation rates have met with limited success, folic acid fortification appears to have had a significant impact on NTD rates; both spina bifida and anencephaly rates have declined in the post-fortification period. Improved folic acid intake is also supported by the difference in blood folate levels between the National Health and Nutrition Survey (NHANES) III (1988-1994) and NHANES 1999, which increased in all women aged 15 ? 44 (CDC, 2000 and 2004). However, exactly how and where women are getting their folic acid remains a mystery.

Preliminary research was done by the Texas Birth Defects Epidemiology and Surveillance Branch focusing on one potential source of folic acid: cereal bars, energy bars, and nutritional drinks. A huge market exists for these bars and drinks. According to a June 2003 publication of Consumer Reports, Americans have recently spent more than $1.4 billion a year on such bars, making it the fastest-growing segment of the U.S. food industry (Consumer Reports 2003). The leader in this category, PowerBar, had sales of $142 million in 1999 (Thompson 2000).

Researchers visited several grocery stores in Austin, Texas and abstracted the nutritional information from selected bars/nutritional drinks containing at least 50% of the daily folic acid needs.

Clearly there are many options for obtaining a full days? folic acid, and many more options may become available as this market continues to grow. These (presumably) contain synthetic folic acid and are therefore considered 100% bioavailable, in contrast to food folate which naturally occurs in some foods.

This small study was conducted through several stores in the Central Texas area and there could be many other products available matching our search criteria in other regions of the country. At this time it is difficult to quantify the amount of these products consumed by women of childbearing age (or other consumers). Developers of nutritional surveys such as National Health and Nutrition Examination Survey (NHANES) could improve access into this information by including these products in their surveys. Further study of this material may be warranted to better understand sources of folic acid and other micronutrients and their potential for preventing neural tube defects through fortified products.

Contributed by Krista Weaver, B.S. Community Health, Texas A&M University

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