Adequacy of folate intake and the effect of flour fortification in pregnant women attended by the National Health System of Ribeirão Preto, Brazil.

Abstract

Dietary folate intake during pregnancy is crucial given its role on amino acid metabolism, DNA synthesis and cell multiplication. Lower maternal intakes of folate might be associated with adverse health outcomes on the mother and fetus, such as anemia and neural tube defect. National wide recommendation for the use of dietary supplements of folic acid and wheat and maize flour fortification with this nutrient have been adopted in an attempt to prevent these injuries, but the recommended dose of supplement use levels exceed the upper tolerable intake (UL), also representing a harmful condition in pregnancy. The purpose of this study is to estimate the adequacy of folate naturally present in foods and the impact of wheat and maize flour fortification on the adequacy of the folate intake in pregnant women attended by the National Health System of Ribeirão Preto, Brazil. Additionally, we will evaluate the minimum dose of folic acid supplement required to achieve an acceptable prevalence of nutrient adequacy, without exceeding the UL. The data are from a cohort study conducted among 73 adult pregnant women with normal. Dietary folate intake was assessed by 3 24 hours diet recalls, one in each trimester of pregnancy. The adequacy of folate and folic acid intake will be estimated adopting the EAR cut-point method. The estimation of the optimal folic acid supplement dose will be carried out according to the planning approach for the homogenous groups diets, proposed by the DRIs.