Canada began to fortify its flour and bread with vitamin B when it entered the Second World War. The decision was informed by the biology of vitamin B and therefore I suggest that the complexity of this political maneuver can best be understood by considering the specificity of the biochemistry of vitamin B. In this paper I will show that the specific biology of vitamin B allowed the Canadian government the possibility of a healthier population under wartime conditions but also allowed the government a variety of means by which to develop and organize food processing practices to this end.
This study examined 3 approaches to achieving the public health recommendation that all women of child-bearing age ingest 0.40 mg of folic acid per day to reduce the occurrence of neural tube defects (NTDs).
A total of 1136 mothers of infants with major malformations from the Boston and Philadelphia areas, whose pregnancies began from 1993 to 1995, were interviewed within 6 months of delivery about vitamin supplementation, dietary intakes, and other factors.
Seventy-one percent of the 1136 women in the study did not take folic acid--containing supplements daily before conception, but the proportion decreased over the years of the study. Women not taking supplements consumed an average of 0.25 mg of naturally occurring folates daily. On the basis of dietary intakes reported by women not taking folic acid supplements, a simulation of cereal grain fortification with folic acid at the level required by the US Food and Drug Administration showed that an average of only 0.13 mg of folic acid would be ingested daily.
With consumption of folic acid only through dietary intake, sizeable portions of the childbearing population would receive less than the level of folic acid recommended for preventing NTDs. Even with food fortification, women of childbearing age should be advised to take folic acid--containing supplements on a daily basis.
Cites: Am J Epidemiol. 1988 Jan;127(1):188-993337073
Cites: JAMA. 1988 Dec 2;260(21):3141-53184392
Cites: Am J Clin Nutr. 1989 Aug;50(2):353-82667316
Cites: JAMA. 1989 Nov 24;262(20):2847-522478730
Cites: N Engl J Med. 1992 Dec 24;327(26):1832-51307234
Despite assumed similarities in Canadian and US dietary habits, some differences in food availability and nutrient fortification exist. Food-frequency questionnaires designed for the USA may therefore not provide the most accurate estimates of dietary intake in Canadian populations. Hence, we undertook to evaluate and modify the National Cancer Institute's Diet History Questionnaire (DHQ) and nutrient database.
Of the foods queried on the DHQ, those most likely to differ in nutrient composition were identified. Where possible these foods were matched to comparable foods in the Canadian Nutrient File. Nutrient values were examined and modified to reflect the Canadian content of minerals (calcium, iron, zinc) and vitamins (A, C, D, thiamin, riboflavin, niacin, B6, folate and B12). DHQs completed by 13 181 Alberta Cohort Study participants aged 35-69 years were analysed to estimate nutrient intakes using the original US and modified versions of the DHQ databases. Misclassification of intake for meeting the Dietary Reference Intake (DRI) was determined following analysis with the US nutrient database.
Twenty-five per cent of 2411 foods deemed most likely to differ in nutrient profile were subsequently modified for folate, 11% for vitamin D, 10% for calcium and riboflavin, and between 7 and 10% for the remaining nutrients of interest. Misclassification with respect to meeting the DRI varied but was highest for folate (7%) and vitamin A (7%) among men, and for vitamin D (7%) among women over 50 years of age.
Errors in nutrient intake estimates owing to differences in food fortification between the USA and Canada can be reduced in Canadian populations by using nutrient databases that reflect Canadian fortification practices.
Adequacy of intake for niacin, folate, and vitamin B12 from food was estimated in an adult population in Newfoundland and Labrador (NL). Also considered was whether study findings support current Canadian food fortification policies.
Four hundred randomly selected adult NL residents were surveyed by telephone. Secondary analysis was performed on two 24-hour food recalls for each participant. Mean daily intakes of niacin, folate, and vitamin B12 were estimated from foods only and compared by sex/age subgroup. Adequacy of intakes was estimated. Contributions of folate by ready-to-eat cereal and bread products were also estimated.
Intakes of all three nutrients were higher in men. In comparison with recommendations, daily niacin intakes were as follows: excessive for 21.9% of all participants (and for 56.8% of men aged 28 to 54), within the recommended range for 73.6%, and less than adequate for 4.5%. In comparison with recommendations, daily folate intakes were as follows: within the recommended range for 18.1% of participants and less than adequate for 81.9%. In comparison with recommendations, daily vitamin B12 intakes were less than adequate for 36.3% of participants.
More than 20% of those surveyed were consuming, from food alone, niacin at levels above the maximum recommended. Food fortification policies pertaining to niacin should be revisited. In addition, despite fortification, NL adults may be consuming inadequate amounts of folate from foods.
The effect of dietary supplements of xylitol, sorbitol and glucose on bone composition was studied in rats. The supplementation, expressed as a % of the dry diet, was gradually increased up to 20% over 3 weeks and continued for 5 weeks. The control group was fed a stock diet only. Each group consisted of nine rats aged 12 weeks at the beginning of the experiment. Ca, Mg, P, CO3 and citrate were analysed from the femur and Ca and citrate also from the serum and urine. The results showed that xylitol supplementation significantly increased the concentrations of Ca and citrate in bone (P less than 0.001) and sorbitol that of Ca only, whereas glucose slightly reduced both CO3 and citrate. The citrate concentration was found to correlate significantly with Ca and P (P less than 0.001), and also with Mg (P less than 0.002). Both xylitol and sorbitol increased serum Ca and the urinary excretion of Ca and citrate. In conclusion, high xylitol or sorbitol supplementation affects Ca and citrate metabolism. The results suggest a connection between citrate and Ca in bone.
To investigate the use of alternative drugs for the climacteric in Finland, which products are used, and who are the women using them.
The study was based on a population-based survey conducted in 1989 among 2000 Finnish women aged 45-64 (response rate 86%).
11% of the women reported the use of alternative drugs for the climacteric. Food supplements and bee products were the most common types of alternative drugs used. Some of them may have allergic or other side effects. Users differ little from other women judging by health habits and the utilization of health care services. The best predictors for alternative drug use were urban residence, more than 9 years of general education, and among 50 54-year olds, the use of prescription or OTC drugs for menopause. Over half of the users of alternative drugs had also used hormone therapy.
Women using alternative drugs during and after the climacteric represent a large group. More information is needed about the clinical effects of alternative drugs, and the characteristics of alternative drug users.
Alcohol consumption is known to increase during Christmas time and excessive alcohol consumption has been proven to be associated with gastrointestinal bleeding and certain vitamin deficiencies. While food fortification is well known and practiced in most countries, food or beverages fortified with medicine has never been practiced on a wider scale, just as alcohol rarely is fortified. In this article it is speculated how alcohol fortified with proton pump inhibitor and vitamin B would effect alcohol-related morbidity.