Folic AcidPage 2 of 4
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What are the Dietary Reference Intakes for
Recommendations for folate are given in the
Dietary Reference Intakes (DRIs) developed by the Institute of Medicine of the National Academy of Sciences. Dietary Reference Intakes is
the general term for a set of reference values used
for planning and assessing nutrient intake for healthy people. Three important types of reference values included in the DRIs are
Recommended Dietary Allowances (RDA), Adequate Intakes (AI), and Tolerable Upper Intake Levels (UL).
The RDA recommends the average daily intake that is sufficient to meet the nutrient requirements of nearly all (97-98%) healthy
individuals in each age and gender group. An AI is set when there is insufficient scientific
data available to establish a RDA. AIs meet or exceed the amount
needed to maintain a nutritional state of adequacy in nearly all members of a specific age and gender group. The UL, on the other hand,
is the maximum daily intake unlikely to result in adverse health effects.
The RDAs for folate are expressed in a term called
the Dietary Folate Equivalent.
The Dietary folate
Equivalent (DFE) was developed to help account for the differences in absorption
of naturally occurring dietary folate
and the more bioavailable synthetic folic acid.
Table 2 lists the RDAs for folate, expressed in micrograms (mcg) of DFE, for children and adults.
Table 2: Recommended Dietary Allowances for
for Children and Adults
|Males and Females|
*1 DFE = 1 food folate = 0.6 folic acid from
supplements and fortified foods
There is insufficient information on folate to establish an RDA for infants. An Adequate Intake (AI) has
been established that is based on the amount of
consumed by healthy infants who are fed breast milk.
Table 3 lists the Adequate Intake for folate
, in micrograms (mcg), for infants.
Table 3: Adequate Intake for folate for infants
|0 to 6
|7 to 12||80|
The National Health and Nutrition Examination
Survey (NHANES III 1988-94) and the Continuing Survey of Food Intakes by Individuals (1994-96 CSFII) indicated that most individuals surveyed did not
consume adequate folate. However, the folic acid fortification program, which was initiated in
1998, has increased folic acid
content of commonly eaten foods such as cereals and grains, and as a result most diets in the United States (US) now
provide recommended amounts of folate equivalents.
When can folatefolate
deficiency occur?A deficiency of folate can occur when an increased need for folate is not matched by an increased intake,
when dietary folate intake does not meet recommended needs, and when folate excretion increases. Medications that interfere with the metabolism of
folate may also increase the need for this vitamin and risk of deficiency.
Medical conditions that increase the need for folate or result in
increased excretion of folate
Medications that interfere with folate utilization include:
- pregnancy and lactation (breastfeeding)
- alcohol abuse
- kidney dialysis
- liver disease
- certain anemias
- anti-convulsant medications (such as dilantin, phenytoin and primidone)
- metformin (sometimes prescribed to control blood sugar in type 2 diabetes)
- sulfasalazine (used to control inflammation associated with Crohn's
disease and ulcerative colitis)
- triamterene (a diuretic)
- methotrexate (used for cancer and other diseases such as rheumatoid arthritis)
(used as sedatives)
What are some common signs and symptoms of folate deficiency?
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