FOLATE INTAKE IN EUROPE - RECOMMENDED, ACTUAL AND DESIRED INTAKE

Objectives: To evaluate possible inconsistencies between recommended, actual and desired folate intake in European adult populations. Design : Review of dietary recommendations, of food consumption surveys, and of intervention and observational studies relating folate intake to th e risk of neural tube defects and plasma homocysteine levels. Results: In Europe, mean dietary folate intake in adults is 291 mu g/d (range 197-326) for men and 247 mu g/d (range 168-320) for women. The recomme nded intakes vary between 200-300 mu g/d (men) and 170-300 mu g/d (wom en). However, women with a previous pregnancy affected by a neural tub e defect (NTD), are recommended to take 4000 mu g/d of supplemental fo lic acid when planning a subsequent pregnancy. For those without a his tory of NTD, the use of 400 mu g/d of supplemental folic acid is the b est option to prevent the occurrence of NTDs. A daily dose of 650 mu g supplemental folic acid normalises elevated plasma homocysteine level s, which is a risk factor for cardiovascular diseases. A dietary folat e intake of at least 350 mu g/d is desired to prevent an increase in p lasma homocysteine levels of the adult population in general. Conclusi ons: Mean dietary folate intake in Europe is in line with recommendati ons, but the desired dietary intake of > 350 mu g/d is only reached by a small part of studied European populations. It is considered unethi cal to investigate whether supplements with a dose lower than 400 mu g /d of folic acid are also protective against NTDs. However, research t o establish the lowest effective dose of dietary folate/supplemental f olic acid to optimise homocysteine levels and research on the bioavail ability of folate is required. This will enable the choice of a strate gy to achieve desired folate intakes in the general population. In the meantime, consumption of plant foods like vegetables, fruits, and cer eals should be stimulated to reach the desired level of 350 mu g of di etary folate per day.