Evidence suggests that intakes of certain essential micronutrients are falling in Western populations. This may be a direct result of the low quality typical Western diet that is eaten by much of the Western population. In particular, the milling and refining of cereal grains reduces the micronutrient content considerably and this may contribute to the low levels of particularly B vitamin seen in Western populations. This is of concern because low levels of folic acid and vitamin B12 are associated with neural tube birth defects. Eating a high quality diet containing whole grains that retain their micronutrient content is the best way to make sure that adequate intakes of these vitamins in obtained. Supplement have also been shown to improve B vitamin status in those who regularly consume them. A further option is to fortify food with B vitamins, and in many cases this is already done, as B vitamins are often added to breads and cereals in order to replace some, but not all, of the B vitamins removed during refining.
A number of studies have investigated the effects of supplements and food fortification on the B vitamin status of free living populations in Western countries. In such studies estimates of B vitamin intake can be made from dietary surveys and food label information. In one such study1, consumption of folate fortified foods was associated with improved folate status in adult aged between 18 and 90 years living in the Republic of Ireland. In particular, red blood cell folate levels were significantly higher in subjects exposed to high levels of fortified foods, compared to those with no exposure of fortified foods. Increased consumption of fortified foods was not associated with improved vitamin B12 status, but consumption of vitamin B12 supplements did improve the vitamin B12 status of the subjects. Two thirds of the women of childbearing age had suboptimal red blood cell folate levels, suggesting they may be at higher risk of neural tube defects in their offspring. As acknowledged by the researchers this is a worrying finding.
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