Currently, women planning pregnancy and pregnant women are advised to take folic acid supplements (Food Standards Australia New Zealand, 2006). Consequently, additional calculations were undertaken by FSANZ to estimate folic acid intakes assuming women of child-bearing age received folic acid from folic acid supplements in addition to receiving folic acid via voluntary and mandatory fortification of foods.
Additional calculations were not conducted for each of the non-target groups due to limited information available on supplement use. Also, there are no specific nutrition policies that specify that members of the population other than the target group should take folic acid supplements.
5.1 How were the folic acid intakes from food and supplements calculated?
The methodology used to estimated dietary folic acid intakes from food and supplements is discussed in Attachment 7 of the P295 – Consideration of Mandatory Fortification with Folic Acid Final Assessment report.
5.2 Estimated dietary intakes of folic acid from food and supplements for women of child-bearing age
The results indicate that 5% of Australian and 3% of New Zealand women of child-bearing age met the recommended 400 μg of folic acid per day for Mandatory Fortification scenarios from food alone. The estimated dietary folic acid intakes for Baseline and Mandatory
Fortification scenarios from food and folic acid supplements for Australian and New Zealand women of child-bearing age were compared with the ‘target intake’ (400 μg folic acid per day). The results show an increase in estimated dietary folic acid intakes for Baseline and Mandatory Fortification when additional folic acid is consumed from supplements. These results are also shown in Figures 7a and b.
When a 200 μg per day folic acid supplement is considered in conjunction with Mandatory Fortification, approximately 40% of Australian and New Zealand women of child-bearing age are estimated to meet the recommended amount of folic acid. If a 500 μg or 800 μg folic acid supplement is consumed by all women of child-bearing age, 100% of women of child- bearing age would meet the recommended daily amount of folic acid. Full details can be found in Table 5.
Full results on folic acid intakes from both food and supplements can be found in Appendix 5, table A5.1 for Australia and Table A5.2 for New Zealand).
Figure 7: Estimated mean dietary folic acid intakes from food and folic acid supplements for Baseline and Mandatory Fortification scenarios for Australian and New Zealand women of child-bearing age (16-44 years)
a: Australia
b: New Zealand
Table 5: Proportion of respondents with folic acid intakes of at least 400 àg/day from food with and without supplements for Australian and New Zealand women of child- bearing age (16-44 years)#
Scenario % of respondents with folic acid intakes of at least 400 μg/day from food ± supplements
Australia New Zealand
No Supplement
200àg Supplement
500àg Supplement
No Supplement
200àg Supplement
800àg Supplement
Baseline 2 11 100 <1 4 100
Mandatory
Fortification♦ 5 42 100 3 42 100
# Number of respondents aged 16-44 years: Australia = 3,178; New Zealand = 1,509
♦ Mandatory folic acid fortification of ‘wheat flour for making bread, for Australia and mandatory folic acid fortification of ‘all bread’ for New Zealand
5.3 Comparison of the estimated dietary intakes from food and supplements with the Upper Level
The results indicate that when Australian and New Zealand women of child-bearing age consume additional folic acid from a supplement, there is likely to be an increase in the proportion of the target group exceeding the UL of 800 àg of folic acid per day for women aged 16-18 years and 1,000 àg of folic acid per day for women aged 19-44 years (see Table 6 for a summary of results). Full results can be found in Table A5.3 and Table A5.4 of
Appendix 5.
When consumption of supplements was considered for the target group, the proportion of respondents aged 16-44 years exceeding the UL increased as the concentration of folic acid in the supplement increased. There was no change in the proportion of the Australian target population exceeding the UL with a folic acid supplement of 200 àg per day from Baseline to Mandatory Fortification. With a 500 àg supplement, the proportion of the Australian target population exceeding the UL increases slightly from 2% at Baseline to 4% under the Mandatory Fortification scenario.
There was minimal change in the proportion of the New Zealand target population exceeding the UL with a folic acid supplement of 200 àg per day for all scenarios assessed. In New Zealand, supplements containing 800 àg of folic acid are available. If all New Zealand women of child-bearing age consumed this supplement, a high proportion (46%) would be likely to exceed the UL under the Mandatory Fortification scenario. With an 800 àg
supplement, the proportion of the New Zealand target population exceeding the UL increases from 10% at Baseline to 46% under the Mandatory Fortification scenario.
Table 6: Proportion of respondents with folic acid intakes from food and supplements above the Upper Level for Australian and New Zealand women of child-bearing age (16- 44 years)#
Scenario % of respondents with folic acid intakes from food and supplements > UL
Australia New Zealand
200àg Supplement 500àg Supplement 200àg Supplement 800àg Supplement
Baseline <1 2 <1 10
Mandatory Fortification♦ <1 4 <1 46
# Number of respondents aged 16-44 years: Australia = 3,178; New Zealand = 1,509
♦ Mandatory folic acid fortification of ‘wheat flour for making bread’ for Australia and mandatory folic acid fortification of ‘all bread’ for New Zealand