• Nutrition Research and Practice
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• v.1 no.3
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• pp.163-174
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• 2007

Folate has received international attention regarding its role in the risk-reduction of birth defects, specifically neural tube defects (NTDs). In 1998 health officials in Canada, like the United States, mandated the addition of folic acid to white flour and select grain product's to increase the folate intake of reproductive-aged women. Subsequent to this initiative there has been an increase in blood folate concentrations in Canada and a 50% reduction in NTDs. Many countries, including Korea, have not mandated folic acid fortification of their food supply. Reasons vary but often include concern over the masking of vitamin $B_{12}$ deficiency, a belief that folate intakes among womenare adequate, low priority relative to other domestic issues, and the philosophy that individuals have the right not to consume supplemental folic acid if they so choose. Prior to folic acid fortification of the food supply in Canada, the folate intakes of women were low, and their blood folate concentrations while not sufficiently low to produce overt signs of folate deficiency (eg. anemia) were inconsistent with a level known to reduce the risk of an NTD-affected pregnancy. The purpose of this article is to describe the role of folate during the periconceptional period, pregnancy, and during lactation. The rationale for, and history of recommending folic acid-containing supplements during the periconceptional period and pregnancy is described as is folic acid fortification of the food supply. The impact of folic acid fortification in Canada is discussed, and unresolved issues associated with this policy described. While the incidence of NTDs in Canada pre-folic acid fortification were seemingly higherthan that of Korea today, blood folate levels of Korean women are strikingly similar. We will briefly explore these parallels in an attempt to understand whether folic acid fortification of the food supply in Korean might be worth consideration.

• Journal of the Korean Society of Food Science and Nutrition
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• v.26 no.5
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• pp.983-992
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• 1997

During pregnancy and lactation, folate status is important because folate requirements increase during the periods as well as maternal folate status influences on pregnancy outcome and human milk folate; especially folate deficiency around periconceptional period may induce neural tube defects(NTDs) of fetus. There have been a plenty of evidences that maternal folate status deteriorates during pregnancy of fetus. There have been a plenty of evidences that maternal folate status deteriorates during pregnancy and lactation if folate needed is not sufficiently provided. The Public health Service of the United States recommends all child-bearing is not sufficiently provided. The Public Health Service of the United States recommends all child-bearing women to intake 0.4mg of folate daily, and the Food and Drug Administration the folate status of child-bearing women and to reduce the rate of occurrence of NTDs. Many authors have insisted that the current recommended dietary allowances of folate for Americans are too low to maintain good folate status. There are little data about Korean folate status including pregant and lactating women. A couple of reports indicated that the folate intakes of Korean pregant and lactating women are below the Korean RDAs of folate and serum folate levels of them are subnormal. The authors pregnant and lactating women. Therefore, it is worth to review the assessment methods of folate status of pregnant and lactating women, folate RDAs for them, the relationships between maternal folate status and pregnancy outcome as well as human milk folate, the methods to increase folate intake, and the problems of large dose of folic acid supplementatiion.

• Journal of Nutrition and Health
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• v.55 no.3
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• pp.330-347
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• 2022

Folate, a water-soluble vitamin, acts as a coenzyme for one-carbon metabolism in nucleic acid synthesis and amino acid metabolism. Adequate folate nutritional status during the periconceptional period is known to prevent neural tube defects. In addition, insufficient folate intake is associated with various conditions, such as anemia, hyperhomocysteinemia, cardiovascular disease, cancer, cognitive impairment, and depression. This review discusses the rationale for the revision of the 2020 Korean dietary reference intakes for folate, and suggestions for future revisions. Based on the changes in the standard body weight in 2020, the adequate intake (AI) for infants (5-11 months) and the estimated average requirements (EARs) for 15-18 years of age were revised, but there were no changes in the recommended nutrient intakes (RNIs) and tolerable upper intake levels (ULs) for all age groups. Mean folate intake did not reach RNI in most age groups and was particularly low in women aged 15-29 years, according to the results of the 2016-2018 Korea National Health and Nutrition Examination Survey (KNHANES). The percentages of folate intake to RNI were lower than 60% in pregnant and lactating women, but serum folate concentrations were higher than those in other age groups, presumably due to the use of supplements. Therefore, total folate intake, from both food and supplements, should be evaluated. In addition, the database of folate in raw, cooked, and fortified foods should be further expanded to accurately assess the folate intake of Koreans. Determination of the concentrations of erythrocyte folate and plasma homocysteine as well as serum folate is recommended, and quality control of the analysis is critical.