Data from the National Health and Nutrition Examination Surveys. Very large increases in blood fo... more Data from the National Health and Nutrition Examination Surveys. Very large increases in blood folate levels of the U.S. population occurred between 1988-1994 and 1999-2000. Small fluctuations in blood folate levels occurred over the time period 1999-2006. The median red blood cell (RBC) folate level of the U.S. population 4 years of age and older was 266 ng/mL in 2005-2006. The median serum folate level of the U.S. population 4 years of age and older was 12.2 ng/mL in 2005-2006. In 2005-2006, the prevalence of low RBC folate (less than 140 ng/mL) among U.S. women of childbearing age (15-45 years) was 4.5%. In 2005-2006, the prevalence of low serum folate (less than 3 ng/mL) among U.S. women of childbearing age was 0.5%. Folate is an essential vitamin for good health. Women of childbearing age are among the population subgroups that have been shown previously to have low blood folate levels. Low blood folate levels are associated with an increased risk of neural tube birth defects. Beginning in 1998, the Food and Drug Administration (FDA) required the addition of folic acid (a form of folate) to all enriched breads, cereals, flours, corn meal, pasta products, rice, and other cereal grain products sold in the United States. Blood folate data from the National Health and Nutrition Examination Surveys (NHANES) have documented improvements in the folate status of the U.S. population after folate fortification was implemented. Red blood cell (RBC) folate measures long-term folate intake and low levels are associated with adverse health effects. Serum folate reflects recent folate intake and low levels are an early indicator of inadequate folate status. Pre- and postfortification blood folate levels of the U.S. population 4 years of age and older and prevalence of low blood folate among women of childbearing age (15-45 years) are reported.All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
The American Journal of Clinical Nutrition, Sep 1, 2007
Background: Monitoring the folate status of US population groups over time has been a public heal... more Background: Monitoring the folate status of US population groups over time has been a public health priority for the past 2 decades, and the focus has been enhanced since the implementation of a folic acid fortification program in the mid-1990s. Objective: We aimed to determine how population concentrations of serum and red blood cell (RBC) folate and serum vitamin B-12 have changed over the past 2 decades. Design: Measurement of blood indicators of folate and vitamin B-12 status was conducted in Ȃ23 000 participants in the prefortification third National Health and Nutrition Examination Survey (NHANES III; and in Ȃ8000 participants in 3 postfortification NHANES periods (together covering 1999 -2004). Results: Serum and RBC folate concentrations increased substantially (by 119 -161% and 44 -64%, respectively) in each age group in the first postfortification survey period and then declined slightly (by 5-13% and 6 -9%, respectively) in most age groups between the first and third postfortification survey periods. Serum vitamin B-12 concentrations did not change appreciably. Prevalence estimates of low serum and RBC folate concentrations declined in women of childbearing age from before to after fortification (from 21% to 1% and from 38% to 5%, respectively) but remained unchanged thereafter. Prevalence estimates of high serum folate concentrations increased in children and older persons from before to after fortification (from 5% to 42% and from 7% to 38%, respectively) but decreased later after fortification. Conclusions: The decrease in folate concentrations observed longer after fortification is small compared with the increase soon after the introduction of fortification. The decrease is not at the low end of concentrations and therefore does not raise concerns about inadequate status.
A C 30 column successfully separated the cis and trans isomers of vitamin K 1 in margarines, redu... more A C 30 column successfully separated the cis and trans isomers of vitamin K 1 in margarines, reduced-fat margarine-like products and in their ingredient oils. We also measured the compound 2 H 3 H -dihydro-vitamin K 1 , a derivative formed during hydrogenation of oils containing vitamin K 1 . We compared an enzymatic procedure, currently under AOAC collaborative study for milk and infant formulas, with a more direct extraction method in analyzing margarines and margarine-like products. Both methods have good precision and were applicable to the majority of products examined.
The initial nutritional status of experimental animals can influence their response to subsequent... more The initial nutritional status of experimental animals can influence their response to subsequent dietary regimens. In the present study, we determined the variations in minerals in diet NIH-31, a breeding colony stock diet, and in tissues of weanling rats nursed by dams fed this diet. Inductively coupled plasma-atomic emission spectrometry (ICP-AES) was used to determine nine elements (Ca, Cu, Fe, K, Mg, Mn, Na, P and Zn) in diet and in liver, kidney, spleen, duodenum and femur from 22- to 26-day-old rats. Wet digestions were performed in mixtures of nitric, perchloric, and sulfuric acids (diets and soft tissues) or nitric and perchloric acids (femur). Solution concentrations ranged from less than 25 ng/ml for the trace elements to greater than 100 micrograms/ml for the major elements. Large variations in mineral content were found between batches of commercially prepared NIH-31 diet; relative amounts of Cu, Fe, Mn and Zn varied markedly. Significant differences in concentrations of major and trace minerals in liver, kidney, spleen and duodenal tissue were found among groups of weanling rats obtained from the same supplier at different times. Mn was readily quantitated in all tissues except spleen, where it was below detection limits. The precision obtained with the ICP-AES methodology has significant advantages for establishing variations in tissue mineral levels.
Standardized purified diets limited to required nutrients are needed for nutritional and toxicolo... more Standardized purified diets limited to required nutrients are needed for nutritional and toxicological studies. In the present study, we formulated a biotinand cellulose-free diet of reproducible mineral composition (diet A), based on diet AIN-76, and fed it to weanling Long-Evans rats for 3 wk. Inductively coupled argon plasma atomic emission spectrometry was used to determine Ca, Cu, Fe, K, Mg, Mn, Na, P and Zn in liver, duodenum, kidney, spleen and femur. Results were compared with those obtained with rats fed biotin-and/or cellulose-supplemented variations of diet A, diet AIN-76 and diet NIH-31 (an open-formula stock diet). Weanling rats grew slowly and steadily on purified diet A. Growth rates increased when diet A was sup plemented with biotin and cellulosa In general, differences among tissue mineral levels in rats fed diet NIH-31 and those fed diet AIN-76 were more pronounced than those among groups fed our purified diets. Values for hemoglobin and hematocrit were significantly lower in rats fed all purified diets than in those fed diet NIH-31. Diets A + biotin, A + cellulose and A + cellulose + biotin appear satisfactory as reference diets for measuring mineral interactions at near-requirement levels as well as effects of fiber on mineral utilization or for studies on vitamins whose endogenous synthesis may be influenced by dietary fiber.
Journal of the American Dietetic Association, 2001
MEDFICTS is a dietary assessment instrument designed to evaluate patient adherence to the Nationa... more MEDFICTS is a dietary assessment instrument designed to evaluate patient adherence to the National Cholesterol Education Program Step 1 and Step 2 diets. It provides a quick way to record food intake, portion size, and frequency of intake while focusing on foods that are the primary contributors of total fat, saturated fat, and cholesterol in the average American diet (i.e., Meats, Eggs, Dairy, Fried foods, fat In baked goods, Convenience foods, fats added at the Table and Snacks). MEDFICTS was validated in a pilot study using 16 computer-analyzed sets of 4-day food records randomly selected from 7-day food records collected in the Diet Modification Clinic at Baylor College of Medicine, Houston, Tex). MEDFICTS correctly identified the 11 patients consuming a Step 1 diet, the 2 patients consuming the Step 2 diet and the 3 patients consuming an average American diet. Pearson correlation coefficients between MEDFICTS and the 4-day records were significant for percent energy from total fat (r = 0.81, P < .0002), saturated fat (r = 0.79, P < .0003), and cholesterol (r = 0.52, P < .039). Pearson correlation coefficients from 2 follow-up validation studies (3-day diet records [n = 22] through the Mary Imogene Bassett Research Institute, Cooperstown, NY, and a second study at the Diet Modification Clinic [n = 26]) also correlated significantly with percent energy from total fat (r = 0.56, P < .006; r = 0.71, P < .0001), saturated fat (r = 0.60, P < .003; r = 0.71, P < .0001), and approached significance for cholesterol intake (r = 0.54, P < .009; r = 0.39, P < .051) respectively. MEDFICTS is a quick, efficient tool that can be used in cardiovascular health screening, clinical practice, or research for the assessment of adherence to Step 1 or 2 diets. It can be self administered, and when reviewed with a dietitian, can provide an opportunity for nutrition education.
Weanling male Holtzman rats were fed calcium.deficient, phosphorus-deficient, or control diets fo... more Weanling male Holtzman rats were fed calcium.deficient, phosphorus-deficient, or control diets for 8 wk. Parathyroid hormone (PTH) was measured by radioimmunoassay, and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) by a competitive binding assay. Rats fed the calcium-deficient diet (0.01% calcium, 0.6% phosphorus) became mildly hypocalcemic after 6 days. Serum calcium levels reached 5.5 +/- 0.4 mg/dl (mean +/- SD) in 5 wk (control 10.3 +/- 0.4 mg/dl). PTH increased from 285 +/- 112 to 3658 +/- 428 pg/ml within 6 wk. Maximum serum levels of 1,25(OH)2D3 (111.8 +/- 17.3 vs. control 11.4 +/- 3.8 ng/dl) were reached at 3 wk and thereafter declined to 44.6 +/- 14.0 ng/dl. In rats fed the phosphorus-deficient diet (0.6% calcium, 0.04% phosphorus), serum phosphorus fell within 24 h from 9.1 +/- 0.6 to 3.2 +/- 0.1 mg/dl, recovered to 5.6 +/- 0.4 mg/dl for 2-3 days, and then declined again. Serum calcium reached a maximum of 14.4 +/- 0.4 mg/dl at day 2 (control 10.8 +/- 0.5 mg/dl) and then slowly declined. PTH decreased within 24 h from 243 +/- 59 to 36 +/- 0 pg/ml in phosphorus-depleted rats. Serum levels of 1,25(OH)2D3 increased within 24 h and remained elevated after 6 wk of phosphorus deprivation (61.2 +/- 11.7 ng/dl vs. control 18.3 +/- 0.4 ng/dl).
In 1996, the U.S. Food and Drug Administration issued a regulation requiring that all enriched ce... more In 1996, the U.S. Food and Drug Administration issued a regulation requiring that all enriched cereal-grain products be fortified with folic acid by January 1998. An average increase in folic acid intake of 100 micro g/d was projected as a result of this fortification. The objective of the present study was to estimate the effect of this fortification on the intake of folic acid and total folate, and on the prevalence of individuals with inadequate folate intake and with high folic acid intake. We used data on food and nutrient intake from 1480 individuals who participated in the 5th and 6th examinations of the Framingham Offspring Cohort Study. Fortification was instituted during the 6th examination so that 931 participants were examined before its implementation (nonexposed) and 549 after implementation (exposed). Published data on total folate in enriched cereal-grain products were used to correct folate content in these foods to reflect fortification. Among nonsupplement users, folic acid intake increased by a mean of 190 [95% confidence interval (CI): 176, 204] micro g/d (P < 0.001) and total folate intake increased by a mean of 323 (95% CI: 296-350) micro g dietary folate equivalents (DFE)/d (P < 0.001) in the exposed participants. Similar increases were seen among supplement users exposed to fortification. The prevalence of exposed individuals with total folate intake below the estimated average requirement (320 micro g DFE/d) decreased from 48.6% (95% CI: 44.2-53.1%) before fortification to 7.0% (95% CI: 3.1-10.9%) after fortification in individuals who did not use folic acid supplements. This prevalence was approximately 1% or less for users of supplements both before and after fortification. Prevalence of individuals with folic acid intake above the upper tolerable intake level (1000 micro g folic acid/d) increased only among supplement users exposed to fortification (from 1.3 to 11.3%, P < 0.001). No changes in folic acid intake were observed over time in the nonexposed participants. By these estimations, folic acid fortification resulted in a mean increase in folic acid intake that was approximately twice as large as previously projected.
There is currently no official method for the analysis of fatty acids (including trans fatty acid... more There is currently no official method for the analysis of fatty acids (including trans fatty acids) in infant formulas. AOAC Official Method 996.01 for Fat Analysis in Cereal Products was extended to the analysis of milk-based infant formula Standard Reference Material (SRM)1846 to determine its applicability for use with infant formulas. Following the analysis of SRM 1846, 2 infant formulas, one milk-based liquid and one soy-based powdered infant formula, were analyzed for total fatty acid composition. Fatty acid methyl esters were prepared and analyzed by gas chromatography. The results of the analysis of SRM 1846 show that the mean analyzed values were highly reproducible as indicated by low coefficients of variation (CV). The CVs were <5% for the major fatty acids. Mean analyzed values for individual fatty acids in SRM 1846 were within ± 1 standard deviation of the certificate values. The analyzed value for total fat as triglycerides (26.27 ± 0.25%) agreed well with the certificate value (27.1 ± 0.59%). Analyses of infant formulas showed that the concentrations of linoleic acid and fat meet the requirements for such formulas.
Twelve powdered and 13 liquid infant formulas were analyzed by using an extension of AOAC Officia... more Twelve powdered and 13 liquid infant formulas were analyzed by using an extension of AOAC Official Method 996.01 for fat analysis in cereal products. Samples were hydrolyzed with 8 N HCl and extracted with ethyl and petroleum ethers. Fatty acid methyl esters were prepared by refluxing the mixed ether extracts with methanolic sodium hydroxide in the presence of 14% boron trifluoride in methanol. The extracts were analyzed by gas chromatography. In powdered formulas, saturated fatty acid (SFA) content (mean +/- SD; n = 12) was 41.05 +/- 3.94%, monounsaturated fatty acid (MUFA) content was 36.97 +/- 3.38%, polyunsaturated fatty acid (PUFA) content was 20.07 +/- 3.08%, and total trans fatty acid content was 1.30 +/- 1.27%. In liquid formulas, SFA content (mean +/- SD; n = 13) was 42.29 +/- 2.98%, MUFA content was 36.05 +/- 2.47%, PUFA content was 20.65 +/- 2.40%, and total trans fatty acid content was 0.88 +/- 0.54%. Total fat content in powdered formulas ranged from 4.4 to 5.5 g/100 kc...
In 1996, U.S. Food and Drug Administration regulations mandated the fortification of enriched cer... more In 1996, U.S. Food and Drug Administration regulations mandated the fortification of enriched cereal-grain products with folic acid, thereby emphasizing the need for validated methods for total folates in foods, particularly cereal products. The AOAC Official Methods (944.12, 960.46) currently used for the analysis of folate in foods for compliance purposes are microbiological methods. When the fortification regulations were finalized, no Official AOAC or Approved AACC methods for folate in cereal-grain products were in place. The AOAC Official Method (992.05) for folic acid in infant formula does not incorporate important improvements in the extraction procedure and was not considered suitable for the analysis of folates in foods in general. A microbiological assay protocol using a trienzyme extraction procedure was prepared and submitted for comments to 40 laboratories with recognized experience in folate analysis. On the basis of comments, the method was revised to have the conju...
The initial nutritional status of experimental animals can influence their response to subsequent... more The initial nutritional status of experimental animals can influence their response to subsequent dietary regimens. In the present study, we determined the variations in minerals in diet NIH-31, a breeding colony stock diet, and in tissues of weanling rats nursed by dams fed this diet. Inductively coupled plasma-atomic emission spectrometry (ICP-AES) was used to determine nine elements (Ca, Cu, Fe, K, Mg, Mn, Na, P and Zn) in diet and in liver, kidney, spleen, duodenum and femur from 22- to 26-day-old rats. Wet digestions were performed in mixtures of nitric, perchloric, and sulfuric acids (diets and soft tissues) or nitric and perchloric acids (femur). Solution concentrations ranged from less than 25 ng/ml for the trace elements to greater than 100 micrograms/ml for the major elements. Large variations in mineral content were found between batches of commercially prepared NIH-31 diet; relative amounts of Cu, Fe, Mn and Zn varied markedly. Significant differences in concentrations o...
Monitoring the folate status of US population groups over time has been a public health priority ... more Monitoring the folate status of US population groups over time has been a public health priority for the past 2 decades, and the focus has been enhanced since the implementation of a folic acid fortification program in the mid-1990s. We aimed to determine how population concentrations of serum and red blood cell (RBC) folate and serum vitamin B-12 have changed over the past 2 decades. Measurement of blood indicators of folate and vitamin B-12 status was conducted in approximately 23,000 participants in the prefortification third National Health and Nutrition Examination Survey (NHANES III; 1988-1994) and in approximately 8000 participants in 3 postfortification NHANES periods (together covering 1999-2004). Serum and RBC folate concentrations increased substantially (by 119-161% and 44-64%, respectively) in each age group in the first postfortification survey period and then declined slightly (by 5-13% and 6-9%, respectively) in most age groups between the first and third postfortifi...
Data from the National Health and Nutrition Examination Surveys. Very large increases in blood fo... more Data from the National Health and Nutrition Examination Surveys. Very large increases in blood folate levels of the U.S. population occurred between 1988-1994 and 1999-2000. Small fluctuations in blood folate levels occurred over the time period 1999-2006. The median red blood cell (RBC) folate level of the U.S. population 4 years of age and older was 266 ng/mL in 2005-2006. The median serum folate level of the U.S. population 4 years of age and older was 12.2 ng/mL in 2005-2006. In 2005-2006, the prevalence of low RBC folate (less than 140 ng/mL) among U.S. women of childbearing age (15-45 years) was 4.5%. In 2005-2006, the prevalence of low serum folate (less than 3 ng/mL) among U.S. women of childbearing age was 0.5%. Folate is an essential vitamin for good health. Women of childbearing age are among the population subgroups that have been shown previously to have low blood folate levels. Low blood folate levels are associated with an increased risk of neural tube birth defects. ...
Data from the National Health and Nutrition Examination Surveys. Very large increases in blood fo... more Data from the National Health and Nutrition Examination Surveys. Very large increases in blood folate levels of the U.S. population occurred between 1988-1994 and 1999-2000. Small fluctuations in blood folate levels occurred over the time period 1999-2006. The median red blood cell (RBC) folate level of the U.S. population 4 years of age and older was 266 ng/mL in 2005-2006. The median serum folate level of the U.S. population 4 years of age and older was 12.2 ng/mL in 2005-2006. In 2005-2006, the prevalence of low RBC folate (less than 140 ng/mL) among U.S. women of childbearing age (15-45 years) was 4.5%. In 2005-2006, the prevalence of low serum folate (less than 3 ng/mL) among U.S. women of childbearing age was 0.5%. Folate is an essential vitamin for good health. Women of childbearing age are among the population subgroups that have been shown previously to have low blood folate levels. Low blood folate levels are associated with an increased risk of neural tube birth defects. Beginning in 1998, the Food and Drug Administration (FDA) required the addition of folic acid (a form of folate) to all enriched breads, cereals, flours, corn meal, pasta products, rice, and other cereal grain products sold in the United States. Blood folate data from the National Health and Nutrition Examination Surveys (NHANES) have documented improvements in the folate status of the U.S. population after folate fortification was implemented. Red blood cell (RBC) folate measures long-term folate intake and low levels are associated with adverse health effects. Serum folate reflects recent folate intake and low levels are an early indicator of inadequate folate status. Pre- and postfortification blood folate levels of the U.S. population 4 years of age and older and prevalence of low blood folate among women of childbearing age (15-45 years) are reported.All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
The American Journal of Clinical Nutrition, Sep 1, 2007
Background: Monitoring the folate status of US population groups over time has been a public heal... more Background: Monitoring the folate status of US population groups over time has been a public health priority for the past 2 decades, and the focus has been enhanced since the implementation of a folic acid fortification program in the mid-1990s. Objective: We aimed to determine how population concentrations of serum and red blood cell (RBC) folate and serum vitamin B-12 have changed over the past 2 decades. Design: Measurement of blood indicators of folate and vitamin B-12 status was conducted in Ȃ23 000 participants in the prefortification third National Health and Nutrition Examination Survey (NHANES III; and in Ȃ8000 participants in 3 postfortification NHANES periods (together covering 1999 -2004). Results: Serum and RBC folate concentrations increased substantially (by 119 -161% and 44 -64%, respectively) in each age group in the first postfortification survey period and then declined slightly (by 5-13% and 6 -9%, respectively) in most age groups between the first and third postfortification survey periods. Serum vitamin B-12 concentrations did not change appreciably. Prevalence estimates of low serum and RBC folate concentrations declined in women of childbearing age from before to after fortification (from 21% to 1% and from 38% to 5%, respectively) but remained unchanged thereafter. Prevalence estimates of high serum folate concentrations increased in children and older persons from before to after fortification (from 5% to 42% and from 7% to 38%, respectively) but decreased later after fortification. Conclusions: The decrease in folate concentrations observed longer after fortification is small compared with the increase soon after the introduction of fortification. The decrease is not at the low end of concentrations and therefore does not raise concerns about inadequate status.
A C 30 column successfully separated the cis and trans isomers of vitamin K 1 in margarines, redu... more A C 30 column successfully separated the cis and trans isomers of vitamin K 1 in margarines, reduced-fat margarine-like products and in their ingredient oils. We also measured the compound 2 H 3 H -dihydro-vitamin K 1 , a derivative formed during hydrogenation of oils containing vitamin K 1 . We compared an enzymatic procedure, currently under AOAC collaborative study for milk and infant formulas, with a more direct extraction method in analyzing margarines and margarine-like products. Both methods have good precision and were applicable to the majority of products examined.
The initial nutritional status of experimental animals can influence their response to subsequent... more The initial nutritional status of experimental animals can influence their response to subsequent dietary regimens. In the present study, we determined the variations in minerals in diet NIH-31, a breeding colony stock diet, and in tissues of weanling rats nursed by dams fed this diet. Inductively coupled plasma-atomic emission spectrometry (ICP-AES) was used to determine nine elements (Ca, Cu, Fe, K, Mg, Mn, Na, P and Zn) in diet and in liver, kidney, spleen, duodenum and femur from 22- to 26-day-old rats. Wet digestions were performed in mixtures of nitric, perchloric, and sulfuric acids (diets and soft tissues) or nitric and perchloric acids (femur). Solution concentrations ranged from less than 25 ng/ml for the trace elements to greater than 100 micrograms/ml for the major elements. Large variations in mineral content were found between batches of commercially prepared NIH-31 diet; relative amounts of Cu, Fe, Mn and Zn varied markedly. Significant differences in concentrations of major and trace minerals in liver, kidney, spleen and duodenal tissue were found among groups of weanling rats obtained from the same supplier at different times. Mn was readily quantitated in all tissues except spleen, where it was below detection limits. The precision obtained with the ICP-AES methodology has significant advantages for establishing variations in tissue mineral levels.
Standardized purified diets limited to required nutrients are needed for nutritional and toxicolo... more Standardized purified diets limited to required nutrients are needed for nutritional and toxicological studies. In the present study, we formulated a biotinand cellulose-free diet of reproducible mineral composition (diet A), based on diet AIN-76, and fed it to weanling Long-Evans rats for 3 wk. Inductively coupled argon plasma atomic emission spectrometry was used to determine Ca, Cu, Fe, K, Mg, Mn, Na, P and Zn in liver, duodenum, kidney, spleen and femur. Results were compared with those obtained with rats fed biotin-and/or cellulose-supplemented variations of diet A, diet AIN-76 and diet NIH-31 (an open-formula stock diet). Weanling rats grew slowly and steadily on purified diet A. Growth rates increased when diet A was sup plemented with biotin and cellulosa In general, differences among tissue mineral levels in rats fed diet NIH-31 and those fed diet AIN-76 were more pronounced than those among groups fed our purified diets. Values for hemoglobin and hematocrit were significantly lower in rats fed all purified diets than in those fed diet NIH-31. Diets A + biotin, A + cellulose and A + cellulose + biotin appear satisfactory as reference diets for measuring mineral interactions at near-requirement levels as well as effects of fiber on mineral utilization or for studies on vitamins whose endogenous synthesis may be influenced by dietary fiber.
Journal of the American Dietetic Association, 2001
MEDFICTS is a dietary assessment instrument designed to evaluate patient adherence to the Nationa... more MEDFICTS is a dietary assessment instrument designed to evaluate patient adherence to the National Cholesterol Education Program Step 1 and Step 2 diets. It provides a quick way to record food intake, portion size, and frequency of intake while focusing on foods that are the primary contributors of total fat, saturated fat, and cholesterol in the average American diet (i.e., Meats, Eggs, Dairy, Fried foods, fat In baked goods, Convenience foods, fats added at the Table and Snacks). MEDFICTS was validated in a pilot study using 16 computer-analyzed sets of 4-day food records randomly selected from 7-day food records collected in the Diet Modification Clinic at Baylor College of Medicine, Houston, Tex). MEDFICTS correctly identified the 11 patients consuming a Step 1 diet, the 2 patients consuming the Step 2 diet and the 3 patients consuming an average American diet. Pearson correlation coefficients between MEDFICTS and the 4-day records were significant for percent energy from total fat (r = 0.81, P &lt; .0002), saturated fat (r = 0.79, P &lt; .0003), and cholesterol (r = 0.52, P &lt; .039). Pearson correlation coefficients from 2 follow-up validation studies (3-day diet records [n = 22] through the Mary Imogene Bassett Research Institute, Cooperstown, NY, and a second study at the Diet Modification Clinic [n = 26]) also correlated significantly with percent energy from total fat (r = 0.56, P &lt; .006; r = 0.71, P &lt; .0001), saturated fat (r = 0.60, P &lt; .003; r = 0.71, P &lt; .0001), and approached significance for cholesterol intake (r = 0.54, P &lt; .009; r = 0.39, P &lt; .051) respectively. MEDFICTS is a quick, efficient tool that can be used in cardiovascular health screening, clinical practice, or research for the assessment of adherence to Step 1 or 2 diets. It can be self administered, and when reviewed with a dietitian, can provide an opportunity for nutrition education.
Weanling male Holtzman rats were fed calcium.deficient, phosphorus-deficient, or control diets fo... more Weanling male Holtzman rats were fed calcium.deficient, phosphorus-deficient, or control diets for 8 wk. Parathyroid hormone (PTH) was measured by radioimmunoassay, and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) by a competitive binding assay. Rats fed the calcium-deficient diet (0.01% calcium, 0.6% phosphorus) became mildly hypocalcemic after 6 days. Serum calcium levels reached 5.5 +/- 0.4 mg/dl (mean +/- SD) in 5 wk (control 10.3 +/- 0.4 mg/dl). PTH increased from 285 +/- 112 to 3658 +/- 428 pg/ml within 6 wk. Maximum serum levels of 1,25(OH)2D3 (111.8 +/- 17.3 vs. control 11.4 +/- 3.8 ng/dl) were reached at 3 wk and thereafter declined to 44.6 +/- 14.0 ng/dl. In rats fed the phosphorus-deficient diet (0.6% calcium, 0.04% phosphorus), serum phosphorus fell within 24 h from 9.1 +/- 0.6 to 3.2 +/- 0.1 mg/dl, recovered to 5.6 +/- 0.4 mg/dl for 2-3 days, and then declined again. Serum calcium reached a maximum of 14.4 +/- 0.4 mg/dl at day 2 (control 10.8 +/- 0.5 mg/dl) and then slowly declined. PTH decreased within 24 h from 243 +/- 59 to 36 +/- 0 pg/ml in phosphorus-depleted rats. Serum levels of 1,25(OH)2D3 increased within 24 h and remained elevated after 6 wk of phosphorus deprivation (61.2 +/- 11.7 ng/dl vs. control 18.3 +/- 0.4 ng/dl).
In 1996, the U.S. Food and Drug Administration issued a regulation requiring that all enriched ce... more In 1996, the U.S. Food and Drug Administration issued a regulation requiring that all enriched cereal-grain products be fortified with folic acid by January 1998. An average increase in folic acid intake of 100 micro g/d was projected as a result of this fortification. The objective of the present study was to estimate the effect of this fortification on the intake of folic acid and total folate, and on the prevalence of individuals with inadequate folate intake and with high folic acid intake. We used data on food and nutrient intake from 1480 individuals who participated in the 5th and 6th examinations of the Framingham Offspring Cohort Study. Fortification was instituted during the 6th examination so that 931 participants were examined before its implementation (nonexposed) and 549 after implementation (exposed). Published data on total folate in enriched cereal-grain products were used to correct folate content in these foods to reflect fortification. Among nonsupplement users, folic acid intake increased by a mean of 190 [95% confidence interval (CI): 176, 204] micro g/d (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and total folate intake increased by a mean of 323 (95% CI: 296-350) micro g dietary folate equivalents (DFE)/d (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) in the exposed participants. Similar increases were seen among supplement users exposed to fortification. The prevalence of exposed individuals with total folate intake below the estimated average requirement (320 micro g DFE/d) decreased from 48.6% (95% CI: 44.2-53.1%) before fortification to 7.0% (95% CI: 3.1-10.9%) after fortification in individuals who did not use folic acid supplements. This prevalence was approximately 1% or less for users of supplements both before and after fortification. Prevalence of individuals with folic acid intake above the upper tolerable intake level (1000 micro g folic acid/d) increased only among supplement users exposed to fortification (from 1.3 to 11.3%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). No changes in folic acid intake were observed over time in the nonexposed participants. By these estimations, folic acid fortification resulted in a mean increase in folic acid intake that was approximately twice as large as previously projected.
There is currently no official method for the analysis of fatty acids (including trans fatty acid... more There is currently no official method for the analysis of fatty acids (including trans fatty acids) in infant formulas. AOAC Official Method 996.01 for Fat Analysis in Cereal Products was extended to the analysis of milk-based infant formula Standard Reference Material (SRM)1846 to determine its applicability for use with infant formulas. Following the analysis of SRM 1846, 2 infant formulas, one milk-based liquid and one soy-based powdered infant formula, were analyzed for total fatty acid composition. Fatty acid methyl esters were prepared and analyzed by gas chromatography. The results of the analysis of SRM 1846 show that the mean analyzed values were highly reproducible as indicated by low coefficients of variation (CV). The CVs were <5% for the major fatty acids. Mean analyzed values for individual fatty acids in SRM 1846 were within ± 1 standard deviation of the certificate values. The analyzed value for total fat as triglycerides (26.27 ± 0.25%) agreed well with the certificate value (27.1 ± 0.59%). Analyses of infant formulas showed that the concentrations of linoleic acid and fat meet the requirements for such formulas.
Twelve powdered and 13 liquid infant formulas were analyzed by using an extension of AOAC Officia... more Twelve powdered and 13 liquid infant formulas were analyzed by using an extension of AOAC Official Method 996.01 for fat analysis in cereal products. Samples were hydrolyzed with 8 N HCl and extracted with ethyl and petroleum ethers. Fatty acid methyl esters were prepared by refluxing the mixed ether extracts with methanolic sodium hydroxide in the presence of 14% boron trifluoride in methanol. The extracts were analyzed by gas chromatography. In powdered formulas, saturated fatty acid (SFA) content (mean +/- SD; n = 12) was 41.05 +/- 3.94%, monounsaturated fatty acid (MUFA) content was 36.97 +/- 3.38%, polyunsaturated fatty acid (PUFA) content was 20.07 +/- 3.08%, and total trans fatty acid content was 1.30 +/- 1.27%. In liquid formulas, SFA content (mean +/- SD; n = 13) was 42.29 +/- 2.98%, MUFA content was 36.05 +/- 2.47%, PUFA content was 20.65 +/- 2.40%, and total trans fatty acid content was 0.88 +/- 0.54%. Total fat content in powdered formulas ranged from 4.4 to 5.5 g/100 kc...
In 1996, U.S. Food and Drug Administration regulations mandated the fortification of enriched cer... more In 1996, U.S. Food and Drug Administration regulations mandated the fortification of enriched cereal-grain products with folic acid, thereby emphasizing the need for validated methods for total folates in foods, particularly cereal products. The AOAC Official Methods (944.12, 960.46) currently used for the analysis of folate in foods for compliance purposes are microbiological methods. When the fortification regulations were finalized, no Official AOAC or Approved AACC methods for folate in cereal-grain products were in place. The AOAC Official Method (992.05) for folic acid in infant formula does not incorporate important improvements in the extraction procedure and was not considered suitable for the analysis of folates in foods in general. A microbiological assay protocol using a trienzyme extraction procedure was prepared and submitted for comments to 40 laboratories with recognized experience in folate analysis. On the basis of comments, the method was revised to have the conju...
The initial nutritional status of experimental animals can influence their response to subsequent... more The initial nutritional status of experimental animals can influence their response to subsequent dietary regimens. In the present study, we determined the variations in minerals in diet NIH-31, a breeding colony stock diet, and in tissues of weanling rats nursed by dams fed this diet. Inductively coupled plasma-atomic emission spectrometry (ICP-AES) was used to determine nine elements (Ca, Cu, Fe, K, Mg, Mn, Na, P and Zn) in diet and in liver, kidney, spleen, duodenum and femur from 22- to 26-day-old rats. Wet digestions were performed in mixtures of nitric, perchloric, and sulfuric acids (diets and soft tissues) or nitric and perchloric acids (femur). Solution concentrations ranged from less than 25 ng/ml for the trace elements to greater than 100 micrograms/ml for the major elements. Large variations in mineral content were found between batches of commercially prepared NIH-31 diet; relative amounts of Cu, Fe, Mn and Zn varied markedly. Significant differences in concentrations o...
Monitoring the folate status of US population groups over time has been a public health priority ... more Monitoring the folate status of US population groups over time has been a public health priority for the past 2 decades, and the focus has been enhanced since the implementation of a folic acid fortification program in the mid-1990s. We aimed to determine how population concentrations of serum and red blood cell (RBC) folate and serum vitamin B-12 have changed over the past 2 decades. Measurement of blood indicators of folate and vitamin B-12 status was conducted in approximately 23,000 participants in the prefortification third National Health and Nutrition Examination Survey (NHANES III; 1988-1994) and in approximately 8000 participants in 3 postfortification NHANES periods (together covering 1999-2004). Serum and RBC folate concentrations increased substantially (by 119-161% and 44-64%, respectively) in each age group in the first postfortification survey period and then declined slightly (by 5-13% and 6-9%, respectively) in most age groups between the first and third postfortifi...
Data from the National Health and Nutrition Examination Surveys. Very large increases in blood fo... more Data from the National Health and Nutrition Examination Surveys. Very large increases in blood folate levels of the U.S. population occurred between 1988-1994 and 1999-2000. Small fluctuations in blood folate levels occurred over the time period 1999-2006. The median red blood cell (RBC) folate level of the U.S. population 4 years of age and older was 266 ng/mL in 2005-2006. The median serum folate level of the U.S. population 4 years of age and older was 12.2 ng/mL in 2005-2006. In 2005-2006, the prevalence of low RBC folate (less than 140 ng/mL) among U.S. women of childbearing age (15-45 years) was 4.5%. In 2005-2006, the prevalence of low serum folate (less than 3 ng/mL) among U.S. women of childbearing age was 0.5%. Folate is an essential vitamin for good health. Women of childbearing age are among the population subgroups that have been shown previously to have low blood folate levels. Low blood folate levels are associated with an increased risk of neural tube birth defects. ...
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