How much folate is in Canadian fortified products 10 years after mandated fortification?

OBJECTIVE: In 1998, the Canadian government mandated folic acid fortification of white flour and enriched grain products to lower the prevalence of neural tube defects. There is now growing concern over the potential harmful effects of too much folic acid on some segments of the population. Given that the actual amount of folate in Canadian foods is unknown, the objective of this study was to measure the folate content in selected fortified foods. METHODS: Using data from the 2001 Food Expenditure Survey and the ACNielsen Company, 95 of the most commonly purchased folic acid-fortified foods in Canada were identified. Folate concentrations in these foods were determined using tri-enzyme digestion followed by microbiological assay. Analyzed values were compared to those in the Canadian Nutrient File (2007b, CNF) and to label values. RESULTS: The analyzed folate content of foods was, on average, 151% +/- 63 of the CNF values. Analyzed values as a percent of CNF values ranged from 116% in the "rolls and buns" category to 188% in "ready-to-eat cereals". Analyzed values were higher than label values for "breads", "rolls and buns" and "ready-to-eat cereals" (141%, 118% and 237%, respectively [p < 0.05]). CONCLUSIONS: Ten years after folic acid fortification of the food supply, neither the CNF nor label values accurately reflect actual amounts of folate in foods. Further, overage differences by food category hinder the development of future strategies designed to strike the right balance between health benefits and risks; monitoring of fortified foods for their nutrient content is required.

Relative bioavailability of iron and folic acid from a new powdered supplement compared to a traditional tablet in pregnant women.

BACKGROUND: Deficiencies of iron and folic acid during pregnancy can lead to adverse outcomes for the fetus, thus supplements are recommended. Adherence to current tablet-based supplements is documented to be poor. Recently a powdered form of micronutrients has been developed which may decrease side-effects and thus improve adherence. However, before testing the efficacy of the supplement as an alternate choice for supplementation during pregnancy, the bioavailability of the iron needs to be determined. Our objective was to measure the relative bioavailability of iron and folic acid from a powdered supplement that can be sprinkled on semi-solid foods or beverages versus a traditional tablet supplement in pregnant women. METHODS: Eighteen healthy pregnant women (24 - 32 weeks gestation) were randomized to receive the supplements in a crossover design. Following ingestion of each supplement, the changes (over baseline) in serum iron and folate over 8 hours were determined. The powdered supplement contained 30 mg of iron as micronized dispersible ferric pyrophosphate with an emulsifier coating and 600 mug folic acid; the tablet contained 27 mg iron from ferrous fumarate and 1000 mug folic acid. RESULTS: Overall absorption of iron from the powdered supplement was significantly lower than the tablet (p = 0.003). There was no difference in the overall absorption of folic acid between supplements. Based on the differences in the area under the curve and doses, the relative bioavailability of iron from powdered supplement was lower than from the tablet (0.22). CONCLUSION: The unexpected lower bioavailability of iron from the powdered supplement is contrary to previously published reports. However, since pills and capsules are known to be poorly accepted by some women during pregnancy, it is reasonable to continue to explore alternative micronutrient delivery systems and forms of iron for this purpose. TRIAL REGISTRATION: ClinicalTrials.gov NCT00789490.

Lung transplantation: does oxidative stress contribute to the development of bronchiolitis obliterans syndrome?

Lung transplantation is the ultimate treatment of end-stage lung disease. After transplantation, the 1-year survival rate is 80%. However, 5-year survival rates drop to 50% due to bronchiolitis obliterans syndrome (BOS). Ischemia/reperfusion injury, infections, and acute rejection are major risk factors contributing to the development of BOS. These risk factors are also associated with increased oxidative stress. Oxidative stress is a condition whereby prooxidants overwhelm the antioxidant defense system and may contribute to the pathogenesis of BOS by inducing more tissue injury and inflammation. This article reviews the current state of knowledge on oxidative stress in lung transplantation and BOS.