Publicação
Risk-benefit assessment of bread fortification with folic acid in Portugal
| Resumo: | ABSTRACT - Folate plays an important role in the human body. The principal objective of this study was to examine the impact of fortifying bread with folic acid on the health of the Portuguese population, employing a risk-benefit assessment methodology. Among the synthetic forms of vitamin B9, folic acid is the most used in food fortification. The evaluation included a range of fortification levels, from 0 to 420 µg per 100 g of bread, as well as supplementation with 400 µg of folic acid per day for women of childbearing age. The beneficial effects were found to be a reduction in the incidence of neural tube defects and megaloblastic anaemia. Conversely, the adverse effect was the masking of vitamin B12 deficiency and the subsequent progression of irreversible neurological damage. The findings indicate that there is no discernible public health advantage associated with the implementation of a policy of fortifying bread with folic acid. This is primarily because elevated levels of fortification have the potential to elevate health risks among the older adults. Therefore, the utilisation of supplementation following the established guidelines among women of childbearing age had a more favourable impact on overall health, as it prevents the development of neural tube defects without placing other population groups at risk. The findings of this study indicate that there is a need to emphasise policies that promote the use of folic acid supplements before and during pregnancy. It can be concluded that this study provides a valuable contribution to the evidence base for decision-making in the formulation of public health policies in Portugal. It is therefore recommended that strategies be prioritized to ensure compliance with the recommendations for folic acid supplementation before and during pregnancy, as this is the most effective and safest measure. Finally, the consumption of folate-rich foods should be promoted and favoured over synthetic forms of this micronutrient |
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| Autores principais: | Oliveira, Ana Beatriz Lopes Carvalho |
| Assunto: | Dietary Supplements Folic Acid Food Fortification Neural Tube Defects Risk Assessment Ácido Fólico Avaliação de Risco Defeitos do Tubo Neural Fortificação Alimentar Suplementos Alimentares |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso embargado |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | ABSTRACT - Folate plays an important role in the human body. The principal objective of this study was to examine the impact of fortifying bread with folic acid on the health of the Portuguese population, employing a risk-benefit assessment methodology. Among the synthetic forms of vitamin B9, folic acid is the most used in food fortification. The evaluation included a range of fortification levels, from 0 to 420 µg per 100 g of bread, as well as supplementation with 400 µg of folic acid per day for women of childbearing age. The beneficial effects were found to be a reduction in the incidence of neural tube defects and megaloblastic anaemia. Conversely, the adverse effect was the masking of vitamin B12 deficiency and the subsequent progression of irreversible neurological damage. The findings indicate that there is no discernible public health advantage associated with the implementation of a policy of fortifying bread with folic acid. This is primarily because elevated levels of fortification have the potential to elevate health risks among the older adults. Therefore, the utilisation of supplementation following the established guidelines among women of childbearing age had a more favourable impact on overall health, as it prevents the development of neural tube defects without placing other population groups at risk. The findings of this study indicate that there is a need to emphasise policies that promote the use of folic acid supplements before and during pregnancy. It can be concluded that this study provides a valuable contribution to the evidence base for decision-making in the formulation of public health policies in Portugal. It is therefore recommended that strategies be prioritized to ensure compliance with the recommendations for folic acid supplementation before and during pregnancy, as this is the most effective and safest measure. Finally, the consumption of folate-rich foods should be promoted and favoured over synthetic forms of this micronutrient |
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