Search

Introduction: Folic acid is a potentially relevant factor in the prevention of a number of pathologies (congenital abnormalities, cardiovascular disease, colorectal cancer and neurocognitive decline). This has led to the introduction of different strategies in order to increase folate intake: nutritional education, pharmacological supplementation and mandatory or voluntary fortification of staple foods with folic acid. In Spain there is a growing number of folic acid fortified products on a voluntary basis, but there is also a lack of reliable data to assess their impact on the population's dietary folate intakes. Objective: To gather a better knowledge of folic acid food fortification practices in Spain. Methods: A Food Composition Database was developed using data from a market study. Also, previously published data of unfortified staple foods from Food Composition Tables was reviewed. Results and discussion: The Database included 260 folic acid fortified food items and it was periodically updated. Food groups included were primarily 'Cereals and derivatives' (52%) followed by 'Dairy products'. Most of these foodstuffs lacked a target population for their consumption (37%) or were aimed at 'Weight control' (28%) and 'Children' (23%), but only 2% targeted women at a reproductive age. Number of unfortified foods included was 690. Fortification levels declared by manufacturers ranged between 15 and 430% of the Recommended Dietary Allowances (RDA) for folic acid per 100 g/ml, and simultaneous addition of B6 and B12 vitamins was observed in75% of the products. Currently, Spain market offers a significant number of folic acid fortified products on a voluntary basis and at a level >/= 15% of the RDA per 100 g/ml or serving declared by manufacturers. [ABSTRACT FROM AUTHOR]

Introduction: Folic acid is a potentially relevant factor in the prevention of a number of pathologies (congenital abnormalities, cardiovascular disease, colorectal cancer and neurocognitive decline). This has led to the introduction of different strategies in order to increase folate intake: nutritional education, pharmacological supplementation and mandatory or voluntary fortification of staple foods with folic acid. In Spain there is a growing number of folic acid fortified products on a voluntary basis, but there is also a lack of reliable data to assess their impact on the population's dietary folate intakes. Objective: To gather a better knowledge of folic acid food fortification practices in Spain. Methods: A Food Composition Database was developed using data from a market study. Also, previously published data of unfortified staple foods from Food Composition Tables was reviewed. Results and discussion: The Database included 260 folic acid fortified food items and it was periodically updated. Food groups included were primarily "Cereals and derivatives" (52%) followed by "Dairy products". Most of these foodstuffs lacked a target population for their consumption (37%) or were aimed at "Weight control" (28%) and "Children" (23%), but only 2% targeted women at a reproductive age. Number of unfortified foods included was 690. Fortification levels declared by manufacturers ranged between 15 and 430% of the Recommended Dietary Allowances (RDA) for folic acid per 100 g/ml, and simultaneous addition of B6 and B12 vitamins was observed in 75% of the products. Currently, Spain market offers a significant number of folic acid fortified products on a voluntary basis and at a level ≥ 15% of the RDA per 100 g/ml or serving declared by manufacturers. [ABSTRACT FROM AUTHOR]

There are nationwide folic acid (FA) fortification programmes of staple foods established or under consideration in order to prevent neural tube defects. Universal FA fortification still remains controversial because of the concern that additional FA in the diets of population groups (e.g. children and elderly) not initially targeted for fortification may suffer adverse effects. However, dietary surveys regarding folate generally deal with adults and little is known about the consumption and long-term effects of fortified food and supplements in growing individuals. Recent reports from our laboratory show several effects of high-dose folate supplementation in rats. In the present work, we studied the effect of FA on the methionine cycle in weanling (3-week-old) male rats after 4 weeks of supplementation with 40??mg FA/kg diet v. control (1??mg FA/kg diet). FA supplementation resulted in a reduction of homocysteine and creatinine concentrations v. control group. FA supplementation did not alter S-adenosylmethionine/S-adenosylhomocysteine ratio, DNA methylation, enzymatic activities or concentrations of vitamins involved in the nutritional regulation of the methionine cycle, except for folate. FA supplementation of 40??mg/kg did not lead to hepatic or renal damage. In conclusion, there were no apparent adverse effects on one-carbon metabolism after FA supplementation in the studied conditions. [ABSTRACT FROM PUBLISHER]

There is new evidence that a good folate status may play a critical role in the prevention of neural-tube defects and in lowering elevated homocysteine concentrations. This adequate folate status may be achieved through folic acid dietary supplementation. Folate is a water-soluble vitamin with a low potential toxicity. However, the possible consequences of long-term high-dose folic acid supplementation are unknown, especially those related to the methionine cycle, where folate participates as a substrate. With the aim of evaluating such possible effects, four groups of Wistar rats were classified on the basis of physiological status (virgin v. pregnant) and the experimental diet administered (folic-acid-supplemented, 40 mg/kg diet v. control, 2 mg folic acid/kg diet). Animals were fed on the diets for 3 weeks. Results showed that gestation outcome was adequate in both groups regardless of the dietary supplementation. However, there were reductions (P < 0??001) in body weight and vertex-coccyx length in fetuses from supplemented dams v. control animals. Folic acid administration also induced a higher (P < 0??01) S-adenosylmethionine : S-adenosylhomocysteine value due to increased S-adenosylmethionine synthesis (P < 0??01). However, hepatic DNA methylation and serum methionine concentrations remained unchanged. Serum homocysteine levels were reduced in supplemented dams (P < 0??05). Finally, pregnancy caused lower serum folate, vitamin B6 and vitamin B12 levels (P < 0??05). Folic acid administration prevented the effect of pregnancy and raised folate levels in dams, but did not change levels of vitamins B12 and B6. These new findings are discussed on the basis of potential benefits and risks of dietary folic acid supplementation. [ABSTRACT FROM PUBLISHER]

There is new evidence that good folate status may play a critical role in the prevention of neural tube defects and in the maintenance of adequate homocysteine levels, an amino acid recently identified as a risk factor for cardiovascular disease. This has led to different folate recommendations, all of them much higher than the present dietary recommendations. Folic acid is a water-soluble vitamin with a low potential toxicity. However, the possible consequences of long-term, high folate intakes are unknown. Therefore, the present study was undertaken to determine the effects of long-term, high dietary folate supplementation on gestational and nutritional markers in pregnant and virgin rats. Four groups of Wistar rats were classified on the basis of physiological status (virgin or pregnant) and the experimental diets administered (folic acid supplemented, 40 mg/kg diet; or control diet, 2 mg folic acid/kg diet). Rats were fed their respective diets for 3 wk. Two critical periods were used for metabolic balance studies (experimental d 1-5 and 17-21), which involved the determination of fat and protein digestibilities as well as metabolic protein utilization (MPU) and net protein utilization (NPU). Gestational development (number of live fetuses) was adequate in both diet groups regardless of folate supplementation. However, body weight and vertex-coccyx length in fetuses from supplemented dams were less than (P < 0.0001) in fetuses of control dams. Fat and nitrogen digestibilities were not affected by supplementation, but MPU and NPU coefficients were significantly lower (P < 0.05) in the folic acid-supplemented groups, irrespective of physiological status, compared to control rats. These new findings of macro-micronutrient interactions caused by high folate supplementation are discussed on the basis that the vitamin may act as a xenobiotic more than as a nutrient. [ABSTRACT FROM AUTHOR]

Aim: To analyse the diet and the dietary food habits in a sample of 1,218 Spanish women, aged 40 to 77 years, in the menopausal or perimenopausal condition. Women were recruited nationwide and the diet was assessed using a food frequency questionnaire. Results: Diet in our population group was close to the representative dietary habits of the Spanish population, except for dairy products. These were highly consumed (approximately 4 servings/day) by menopausal women. Energy, protein and cholesterol intakes, as well as most vitamins and mineral intakes, were very high, as compared to recommended dietary allowances. We only found marginal deficient intakes for folate and vitamin D. Women over 60 years consume less eggs, sweats, sugar and miscellany, and therefore less lipids and cholesterol, as well as vitamin D, than younger women. A high rate (61%) of overweight and obesity (BMI > 25) was present in our population group and was associated with a higher intake of meat, fish and eggs, as well as energy. A healthier diet (high intake of dairy products, fresh vegetables, fruits, legumes, cereals and fish) was associated with a healthier lifestyle (no smoking, physical exercise) and the use of fortified foods and vitamin/mineral supplements. A high percentage of women regularly consumed fortified food (52,7%) and micronutrient supplements (22,8%) although diets provided enough vitamins and minerals. Conclusion: Diet in our study group is in accordance to healthy dietary habits and physical activity recommendations. This is probably due to a greater concern for health in women close to the menopause condition. [ABSTRACT FROM AUTHOR]

Context: The melanocortin-4 receptor gene (MC4R) is associated with a higher risk of obesity by the presence of the C allele in rs17782313, but the mechanisms are not clear., Objective: The present systematic review and meta-analysis aimed to explore the association between the different genotypes of MC4R rs17782313 and energy intake and appetite., Data Sources: A literature search was conducted up to June 2023 in PubMed, Scopus, Web of Science, and Cochrane Collaboration databases, following PRISMA guidelines., Data Extraction: Inclusion criteria were studies in humans measuring energy intake, appetite, or satiety in all ages and physiological conditions. Studies dealing solely with body mass index were excluded. Twenty-one articles representing 48 560 participants were included in the meta-analysis., Data Analysis: According to the NHLBI (National Heart, Lung, and Blood Institute) quality-assessment criteria, all case-control studies and 6 out of 17 cohort and cross-sectional studies were classified as "good," while the rest scored as "fair." Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in a (CT+CC) vs TT dominant model, and both random-effects and fixed-effects models were used. A statistically significant association between the presence of the C allele and increased appetite was found (OR = 1.25; 95% CI: 1.01-1.49; P = .038) using the fixed-effects model, but the random-effects model proved nonsignificant. However, no association with energy intake was found. None of the variables considered (sample size, year of publication, sex, age group, type of population, origin, and quality) were identified as effect modifiers, and no publication biases were found after subgroup and meta-regression analyses., Conclusion: To our knowledge, this is the first systematic review and meta-analysis that has analyzed the association between rs17782313 of MC4R and energy intake and appetite. Identifying people genetically predisposed to increased appetite may be of great interest, not only to prevent obesity in younger populations but also to avoid malnutrition in elderly persons. This paper is part of the Nutrition Reviews Special Collection on Precision Nutrition., Systematic Review Registration: PROSPERO registration no. CRD42023417916., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute.)

Eating a nutritionally balanced breakfast can be a challenge when following a gluten-free diet (GFD). We assessed the ingredients and nutrient composition of 364 gluten-free breakfast products (GFPs) and 348 gluten-containing counterparts (GCCs), and we analysed the nutritional quality of breakfast in a group of Spanish children and adolescents with celiac disease (CD) ( n = 70), as compared to controls ( n = 67). Food intakes were estimated using three 24 h dietary records. The composition of GFPs and GCCs was retrieved from the package labels of commercially available products. Most participants (98.5%) ate breakfast daily, and only one person in each group skipped breakfast once. The breakfast contribution of the total daily energy was 19% in participants with CD and 20% in controls. CD patients managed a balanced breakfast in terms of energy (54% from carbohydrates; 12% from proteins; 34% from lipids) and key food groups (cereals, dairy, fruits), but their intake of fruits needs improvement. Compared to controls, breakfast in the CD group provided less protein and saturated fat, a similar amount of carbohydrates and fibre, and more salt. Fibre is frequently added to GFPs, but these contain less protein because of the flours used in formulation. Gluten-free bread contains more fat and is more saturated than is GCC. Sugars, sweets, and confectionery contribute more to energy and nutrient intakes in participants with CD, while grain products do so in controls. Overall, breakfast on a GFD can be adequate, but can be improved by GFPs reformulation and a lower consumption of processed foods.

Gluten-free products (GFP) are a good choice for the replacement of cereals when following a gluten-free diet due to celiac disease (CD). However, commercial GFP are made with highly refined flours and may contain more fat, sugar, and salt, and less fiber and micronutrients than gluten-containing analogues, thus challenging the nutritional adequacy of the diet. The aim of this study is to assess the contribution of GFP to the diets of children and adolescents with CD. Food intakes were assessed in a cross-sectional study on 70 children and adolescents with CD (aged four to 18, 50% females), using three 24-h dietary records. GFP consumption reached 165 g a day and comprised mostly bread and fine bakery ware, followed by pasta. GFP contributed with a high percentage (>25%) to total energy, carbohydrates, fiber, and salt daily intakes and, to a lesser extent (<20%), to fat (including saturated fat), sugars and protein. Contribution of homemade products was testimonial. GFP contribution to total energy intake is significant and, consequently, relevant to the nutritional adequacy of the diet. Children and adolescents with CD could benefit from fat, saturated fat, and salt reduction, and fiber enrichment of processed GFP.

The Mediterranean diet is a healthy dietary pattern in which fish consumption is an important key element. In Spain, fish intake is the second highest in Europe. Dietary guidelines recommend an intake of 1-3 portions a week of fish. However, Spanish fish sales have been decreasing since 2008. The unexpected pandemic spread of the SARS-CoV-2 in 2020 led the Spanish Government to take restrictive measures that had an impact on people's behavior, including food purchases and consumption. The aim of the study was to analyze purchase data of fish, seafood, and fish products during the lockdown in Spain, using data from loyalty card holders (>5,000,000 participants) from a hypermarket chain in Spain. The results show a 45% increase in the purchase of all types of fish, seafood, and fish products, with the highest increment observed in the retiree (+65 years) as compared to the younger populations. Moreover, the retiree, in spite of the digital divide, were also the ones that most increased online shopping. These data should be considered since events like COVID-19 confinement can have a permanent impact on people's dietary habits, a possibility that should be monitored in the future.

The only available treatment for celiac disease is life-long gluten exclusion. We conducted a cross-sectional age- and gender-matched study in 64 celiac adults on a long-term (>1 year) gluten-free diet and 74 non-celiac volunteers from Spain, using dietary, anthropometric, and biochemical parameters, as well as assessing bone mineral density and physical activity. Celiac adults had deficient intake (below 2/3 of the recommended intake) for folates, vitamin E, and iodine and low intake of calcium (below 80% of the recommended intake). Iron intake was also below 2/3 of the recommended intake in celiac women. Vitamin D intake was extremely low, and 34% of celiac patients had moderately deficient plasma levels. According to bone mineral density, celiac women may be more prone to osteopenia and osteoporosis. However, we found a perfectly analogous nutritional status scenario in celiac as compared to healthy volunteers, with the dietary deviations found being similar to those of the Spanish population, i.e., both groups followed a high-lipid, high-protein, and low-carbohydrate diet. Values for biochemical parameters were found within the reference ranges. Celiac disease had no influence on body weight, but body fat in celiac patients tended to be higher. According to our results, vitamin D, calcium, folates, vitamin E, iodine, and iron nutritional status should be specifically assessed and monitored in the celiac population.

We developed a new database to evaluate the nutritional composition of lactose-free products from Spain. The database includes dairy products and other products, all of which show the "lactose-free" declaration on their label, accounting for 327 products in total. Of these, 123 are dairy products, 16 are non-dairy products which include a dairy ingredient (5%) and 188 items (57% of the sample) are non-dairy products that do not contain any dairy ingredient. The main subgroups are yogurt (25%), milk (24%), and cheese (17%). Nineteen percent of the compiled products included nutritional claims on their labels. Most lactose-free products did not contain either added sugars or low- or no-calorie sweeteners (58%), while 34% included added sugars and only 6%, sweeteners or a combination of both (2%). We found that 19.5%, mainly within the milk subgroup, were fortified with vitamins A, D, E, K, B 9 , and B 12 , P, and Ca. There were no significant differences in the nutritional composition between lactose-free products and traditional products. According to the NOVA classification, 55% of compiled lactose-free products were ultra-processed, and 20% processed. The array of lactose-free products marketed in Spain proves that there are enough, both in quantity and quality, to satisfy the dairy needs of lactose intolerants.

Moving towards sustainable food systems and food consumption are proposed as strategies to reduce environmental impact. However, these strategies require joint action between different stakeholders, including the general population's knowledge and perception, as final consumers. To assess the knowledge and awareness on food sustainability and environmental impact concepts in a representative sample of Spanish adult population, we conducted a cross-sectional, nationally representative telephone survey. After random selection, 2052 respondents aged ≥18 years (57% woman and 43% men) participated. A questionnaire was specifically designed for the research. Participants showed a good attitude towards sustainable diets, which were described as healthy by 40% of the population. Most of the responders (>70%), did not well understand ecological and carbon footprints, and green and blue water concepts. Men declared a higher understanding of sustainability concepts, as compared to women. More than 50% of the population misunderstood the impact of meat and derivatives production on sustainability, and 70% perceived the same for fish and dairy products. Women were more prone to pay more money to afford a sustainable diet than men were. In conclusion, although consumers show a positive attitude towards sustainability, important misconceptions remain, and thus require intervention through education, information, and motivation.

We developed a comprehensive composition database of 629 cereal-based gluten free (GF) products available in Spain. Information on ingredients and nutritional composition was retrieved from food package labels. GF products were primarily composed of rice and/or corn flour, and 90% of them included added rice starch. The most common added fat was sunflower oil (present in one third of the products), followed by palm fat, olive oil, and cocoa. Only 24.5% of the products had the nutrition claim "no added sugar". Fifty-six percent of the GF products had sucrose in their formulation. Xanthan gum was the most frequently employed fiber, appearing in 34.2% of the GF products, followed by other commonly used such as hydroxypropyl methylcellulose (23.1%), guar gum (19.7%), and vegetable gums (19.6%). Macronutrient analysis revealed that 25.4% of the products could be labeled as a source of fiber. Many of the considered GF food products showed very high contents of energy (33.5%), fats (28.5%), saturated fatty acids (30.0%), sugars (21.6%), and salt (28.3%). There is a timid reformulation in fat composition and salt reduction, but a lesser usage of alternative flours and pseudocereals.

Introduction: Background: evidence from research suggests that the development of cancer disease is associated with environmental factors. There are few studies evaluating nutritional status in women suffering from cancer in Spain. Objectives: this study aimed to assess the nutritional status in breast cancer female patients at diagnosis in a northern region of Spain (Asturias), where breast cancer rates are particularly high when compared to the rest of Spain. Material and methods: a cross-sectional study was conducted in a sample of 76 newly diagnosed female cancer patients. Lifestyle factors, anthropometry, biochemical, and dietary intake data were collected immediately after diagnosis and prior to the initiation of the prescribed treatment. Results: a high percentage of these women diagnosed with cancer were sedentary (59.2%). Their average body mass index (BMI) was 27.3 ± 5.5 kg/m2. They also showed a high percentage of body fat, 38.3%, as well as a large waist circumference of 92.2 cm. Patients reported a low intake of fruits, vegetables, legumes, and nuts, and a high intake of red meat, meat products, and sweet foodstuffs as compared to the Spanish dietary guidelines (p < 0.01). Conclusion: the results showed a low intake of folate, calcium, and vitamin D, which is particularly relevant in women. In conclusion, these breast cancer patients showed overweight and high sedentarism levels, and reported unbalanced dietary patterns at the time of diagnosis.

Patients who follow a gluten-free diet (GFD) may be prone to nutritional deficiencies, due to food restriction and consumption of gluten-free products. The aim was to assess nutritional status in celiac children and adolescents on a long-term GFD. A cross-sectional age and gender-matched study in 70 celiac and 67 non-celiac volunteers was conducted, using dietary, anthropometric, biochemical parameters, and assessing bone mineral density and physical activity. Adequacy of vitamin D intake to recommendations was very low, in both groups, and intakes for calcium and magnesium were significantly lower in celiac volunteers. Celiac children and adolescents may have a higher risk of iron and folate deficiencies. Both groups followed a high-lipid, high-protein, low fiber diet. Median vitamin D plasma levels fell below reference values, in celiac and non-celiac participants, and were significantly lower in celiac girls. Other biochemical parameters were within normal ranges. Anthropometry and bone mineral density were similar within groups. With the exception of some slightly lower intakes, children and adolescents following a GFD appear to follow the same trends as healthy individuals on a normal diet. No effect of food restriction or gluten-free product consumption was observed., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

This study focuses on understanding factors that influence food agency in the Spanish population, specifically with regard to cooking habits, knowledge, and determinants and their possible relationship with body weight. A cross-sectional telephone survey was conducted. Individuals were asked about their cooking responsibilities, how they learned to cook, factors that affect their food choices, and their preferred cooking techniques. Anthropometric data were also recorded. Participants were randomly selected, and we finally had 2026 respondents aged ≥18 years (60% women, 40% men). A total of 90.5% of participants stated that they had cooking skills. Women were mainly responsible for cooking tasks ( p < 0.05) at all ages. A significantly higher proportion of people under 50 years self-reported that they were "able to cook" in comparison with groups over 50 years. Regardless of age, most participants learned to cook either by practice (43.3%) or from a family member (42.2%). Men tended to be more autodidactic, whereas women reported learning from family. No relation was found between weight status and the evaluated factors investigated. In conclusion, women bear the responsibility for the entire cooking process in families, indicating a gender gap in the involvement of men in cooking responsibilities and competence. More research is needed to assess the influence of cooking knowledge on obesity prevention., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Information on grocery shopping patterns is one key to understanding dietary changes in recent years in Spain. This report presents an overview of Spanish food shopping patterns in the adult population. A cross-sectional, nationally representative telephone survey was conducted in Spain. Individuals were asked about food shopping responsibility roles, types of visited food stores, time spent, additional behaviors while shopping, the influence of marketing/advertising and, in particular, fresh produce shopping profile. Binary logistic regression models were developed. The final random sample included 2026 respondents aged ≥18 years, of which 1223 were women and 803 were men. Women reported being in charge of most of the food shopping activities. Looking for best prices, more than looking for healthy or sustainable foods, seemed to be a general behavior. Supermarkets were the preferred retail spaces for food price consideration, convenience, variety and availability. Fresh produce shopping was associated with traditional markets and neighborhood stores in terms of reliance and personalized service. It is essential to highlight the importance of the role played by women. They are the main supporters concerned in preserving adequate dietary habits. Economic factors, more than health or food sustainability, are commonly considered by the population. Traditional markets may play an important role in preserving some healthy dietary habits of the Mediterranean food culture in Spain., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Introduction: Folic acid (FA) is a synthetic compound commonly added for voluntary fortification of food products in many European countries. In our country, food composition databases (FCDB) lack comprehensive data on FA fortification practices and this is considered a priority research need when undergoing nutritional assessment of the population., Methods: A product inventory was collected and updated by visiting retail stores in Madrid Region, conducting online supermarket searches, and by the provision of food label information by manufacturers. Euro-FIR FCDB guidelines for data compilation and harmonization were used., Results: The FCDB, compiled between 2011 and 2015, includes FA as well as macro and micronutrient data from 338 fortified foodstuffs. As compared to previous FCDB updates (May 2010), 37 products have ceased to declare added FA in their labels, mainly yogurt and fermented milk products. The main food subgroup is 'breakfast cereals' ( n = 95, 34% of total). However, the highest average FA fortification levels per recommended serving were observed in the 'milk, milk products, and milk substitutes' group at ≥35% FA Nutrient Reference Values (NRV, 200 µg, EU Regulation 1169 of 2011) (60-76.3 µg FA per 200 mL). Average contribution to the FA NRV per food group and serving ranged between 16%-35%., Conclusion: Our data show a minor decrease in the number of FA fortified products, but vitamin levels added by manufacturers are stable in most food groups and subgroups. This representative product inventory comprises the main FA food source from voluntary fortification in our country. It is therefore a unique compilation tool with valuable data for the assessment of dietary intakes for the vitamin.

Objective: To assess the potential contribution of foods fortified with folic acid (FA) to target population intakes when included as part of a healthy breakfast., Design: Breakfast models aligned with the Spanish Dietary Guidelines were studied using the recommended, average and 95th percentile of serving sizes consumed by women of childbearing age. Food composition data were obtained from a database including FA analytical data from sixty-eight products and the Spanish food composition tables. Different scenarios were assessed with the inclusion of one, two or three FA-fortified products and with two different fortification levels: ≤ 33 µg/serving (L1) and ≥ 70 µg/serving (L4). FA contents provided by the different models for each scenario were compared with the Recommended Nutrient Intake (RNI) for folate and the Upper Level (UL) of intake for FA., Setting: Madrid Region, Spain., Subjects: Women aged 16-49 years were considered., Results: Overall, simulation of ten breakfast models and three scenarios of product inclusion accounted for 20-25% of total daily energy recommendations for women. Unfortified breakfast models provided on average 4-23% of the folate RNI. Inclusion of one L4 FA-fortified food contributed 20-60% of the RNI. Fortified yoghurt and milk had the highest FA contents per serving. Scenarios with two or three fortified products delivered 40-80% of the RNI. None of the evaluated models exceeded the FA UL., Conclusions: At existing levels of FA fortification, inclusion of fortified products as part of a regular breakfast meal could positively impact the nutritional quality of women's diet without involving a risk of excessive FA exposure.

Ready-to-eat foods have nowadays become a significant portion of the diet. Accordingly, nutritional composition of these food categories should be well-known, in particular its folate content. However, there is a broad lack of folate data in food composition tables and databases. A total of 21 fresh-cut vegetable and fruit packed products were analysed for total folate (TF) content using a validated method that relies on the folate-dependent growth of chloramphenicol-resistant Lactobacillus casei subspecies rhamnosus (NCIMB 10463). Mean TF content ranged from 10.0 to 140.9μg/100g for the different matrices on a fresh weight basis. Higher TF quantity, 140.9-70.1μg/100g, was found in spinach, rocket, watercress, chard and broccoli. Significant differences were observed between available data for fresh vegetables and fruits from food composition tables or databases and the analysed results for fresh-cut packed products. Supplied data support the potential of folate-rich fresh-cut ready-to-eat vegetables to increase folate intake significantly., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Introduction: In the last years, the consumption of ready-to-eat foods has become an increasing part of the current Spanish diet. Accordingly, the nutritional composition of these food categories should be investigated in order to estimate its contribution to vitamin and nutrient intakes, in particular its folate content. The broad lack of folate data in food composition tables and databases justifies this approach., Objectives: The aim of this work was to screen the current availability and to supply new folate data in ready-to-eat commercial products in the Spanish market., Methods: Seventeen ready-to-eat foods, including mainly vegetable ingredients, were analysed for total folate content using a validated method that relies on Lactobacillus casei ssp. rhamnosus chloramphenicol-resistant folate dependent growth. The accuracy of the analytical procedure was checked using a certified reference material and by a recovery test., Results: Mean TF content ranged from 13.6 to 103.8 μg/100 g in different food matrices on a fresh weight basis. Higher TF quantity was found for vegetable hamburguers, recipes including chickpeas, peas or artichockes. Selected precooked products were also analysed after a soft heat treatment as recommended by the manufacter before its consumption. No significant differences were found in the folate content after processing. The coefficient of variation for the duplicates of the same product was less than 15%., Conclusion: Folate content in ready-to-eat products indicates the potential to considerably increase folate intake by choosing folate-rich foods. There have been no previous reports on folate data in chilled ready-to-eat meals. The present data will assist dietary studies to estimate and evaluate the adequacy of population folate intakes., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Purpose: Folic acid (FA) is an emerging nutritional factor in the pathogenesis of diverse neurodegenerative disorders by still unknown mechanisms. The hippocampus is altered during the loss of cognitive abilities in humans and selectively affected when homocysteine increases. The aim was to evaluate the potential protective role of folic acid in the maintenance of biochemical markers related to the methionine cycle, as well as the integrity of the hippocampus as part of the brain in aged rats., Methods: Male Sprague-Dawley rats (18 months old) were assigned to four different folic acid groups (0 mg FA/kg diet, deficient; 2 mg FA/kg diet, control; 8 mg FA/kg diet, moderate supplementation; 40 mg FA/kg diet, extra supplementation) for 30 days. We evaluated several parameters related to the methionine cycle. In addition, hippocampus areas were immunostained for specific neuronal markers and astrocytes., Results: Serum folate levels increased according to FA dietary level (p < 0.01). There was a significant increase in the serum homocysteine concentrations in the folic acid-deficient diet group (p < 0.01). However, brain S-adenosylmethionine and S-adenosylhomocysteine did not differ significantly between the folic acid groups. Consequently, the methylation ratio was also unchanged. The morphometric analysis did not show any differences in the number of neurons and astrocytes between groups, except when comparing the folic acid-deficient diet versus folic acid-supplemented diet in the striatum of the hippocampus., Conclusions: Clearly, the dietary FA deficiency negatively affects the methionine metabolism biomarkers, while excessive supplementation seems to be unnecessary for optimal maintenance of the methylation cycle and hippocampus integrity.

Historically, food fortification has served as a tool to address population-wide nutrient deficiencies such as rickets by vitamin D fortified milk. This article discusses the different policy strategies to be used today. Mandatory or voluntary fortification and fortified foods, which the consumer needs, also have to comply with nutritional, regulatory, food safety and technical issues. The 'worldwide map of vitamin fortification' is analysed, including differences between develop and developing countries. The vitamins, folate and vitamin D, are taken as practical examples in the review of the beneficial effect of different strategies on public health. The importance of the risk-benefit aspect, as well as how to identify the risk groups, and the food vehicles for fortification is discussed.

Objective: The aim was to investigate whether pregnancy-induced changes in total homocysteine (tHcy) are associated with folate and vitamin B12 nutritional status, genetic C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) enzyme, and gestation outcome at a time when folic acid supplementation started to be recommended in the Spanish health system., Methods: In total 154 pregnant women were recruited from among gynecologic patients of the Alcorcón Public Hospital Outpatient Clinic (Madrid, Spain). Blood tests were performed at weeks 15, 24, and 32 of pregnancy. Total Hcy, folate, and vitamin B12 serum fasting concentrations were measured using an IMx system. Genotype analyses were done by polymerase chain reaction/restriction fragment/length polymorphism analysis., Results: Folate and vitamin B12 serum concentrations decreased significantly (P < 0.01) through pregnancy and reached the lowest values in the third trimester. Serum tHcy concentrations were significantly (P < 0.01) lower in the second trimester but increased in the third trimester. Frequencies of MTHFR C667T genotype were CC (35.7%), CT (57.2%), and TT (7.1%). Total Hcy concentration was not statistically influenced by maternal genotype. Plasma folate was the single negative predictor of maternal tHcy in the first trimester of pregnancy; 11.1% of gestations resulted in intrauterine growth restriction, 7.9% in gestational diabetes mellitus, and 4.8% in gestational hypertension. No significant differences in serum folate, vitamin B12, or tHcy concentrations were found in complicated pregnancies and these were unrelated to MTHFR genotype., Conclusion: Although tHcy seems to be physiologically low in this Spanish population and unrelated to folate and B12 nutritional status, C677T MTHFR genotype, and some pregnancy complications, we support the statement that appropriate folate concentration may be important throughout pregnancy to prevent abnormalities associated with altered status (e.g., neural tube defects). According to our study, supplementation with folic acid seems to achieve this purpose because diet alone may be insufficient. In addition, a poor vitamin B12 status, as measured by plasma levels, may indicate that supplementation of both vitamins is needed., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background: Since mandatory folic acid fortification of grains and cereals was introduced in order to prevent neural tube defects, the number of products that are being fortified with folic acid is growing, especially milk and dairy products. However, the effectiveness of this action remains controversial., Aim of the Study: To investigate the efficiency of skimmed milk as a vehicle for folic acid fortification by the determination of the acute absorption from low-fat fortified milk compared to fortified and unfortified whole milk in healthy subjects., Design: A single-dose bioavailability study was performed using three commercially available milks (whole and skimmed milk fortified with folic acid and unfortified whole milk). Healthy volunteers (3 women, 2 men) were administered a single dose of 430 ml of each milk, at 1-week intervals between test days. Plasma total folate concentrations, at baseline and hourly from 1.5 up to 6.5 h after ingestion, were measured., Results: Plasma folate concentration was significantly increased, when compared to baseline values, 1.5 h after ingestion of skimmed fortified milk, and 2.5 h after whole fortified milk, and remained significantly higher than baseline values for up to 6.5 h after both treatments. The highest plasma folate concentration (20.9 ± 3.1 nmol/l) was obtained 6.5 h postprandial in response to skimmed fortified milk. The acute absorption of folic acid, calculated on the basis of area under the plasma folate concentration curve, was significantly higher from skimmed fortified milk compared to fortified and unfortified whole milk., Conclusions: The absorption of folic acid from fortified skimmed milk is faster than the absorption of folic acid from fortified whole milk, and it renders significantly higher plasma folate concentration when compared to whole milk. These findings indicate that skimmed milk could be considered an efficient food matrix for folic acid fortification.

The SENECA study started in 1988 and consisted of a random age- and sex-stratified sample of inhabitants of 19 European towns. A total of 2.100 elderly people were finally able to be included in the study. The present study includes results for total plasma homocysteine (tHcy) and the related vitamins folate, B12 and B6. Other style factors as alcohol consumption or smoking have been also evaluated. The lowest values for tHcy corresponded to Mediterranean countries (Portugal, Spain, and Greece), compared to central or northern european countries (Netherland or Belgium (differences higher than 4 micromol/l). In addition, an interesting north-south gradient is observed, with the lowest values for tHcy corresponding to Betanzos (Spain), 12.38 micromol/l followed by both centers in Portugal, whereas the highest concentrations are found in Maki (Poland), 21.92 pmol/I and Culemborg (Netherlands), 20.41 mircromol/l. The mean tHcy concentration for all the European centers was 15.98 micromol/l. Effect of sex has been also evaluated: those countries with the lowest tHcy concentration (i.e. Spain or Portugal) show significant (p < 0.01) higher tHcy concentration in men vs women, whereas these differences by sex are not observed in countries with the highest tHcy values. The effect of "aging" within the same individuals after ten years of follow up was also evaluated: a significant difference was observed for the same individuals in the 10-years period. Plasma folic acid was compared to tHcy values, resulting also in marked differences between north and southern countries. Plasma vitamin B12 also shows a close pattern. Either plasma folate or vitamin B12 were shown as strong predictors of tHcy. This effect was not observed for plasma vitamin B6. Total alcohol intake was positively and significantly (p < 0.01) correlated with tHcy ("no" intake corresponded with the lowest tHcy, 14.3 micromol/l vs "high" intake-over 30 g/d-with the highest tHcy, 17 micromol/l). The type of alcoholic beverage was also evaluated: wine and spirits drinkers showed positively significant (p < 0.005) correlation whereas beer intake was not significantly associated. Smoking was also analysed: "never" smokers had the lowest tHcy concentration (13.82 +/- 0.20 micromol/1) vs "current" smokers (16.64 +/- 0.35 pmol/1), a significant difference (p < 0.05).