BACKGROUND AND PURPOSE: Additional folic acid (FA) treatment appears to have a neutral effect on reducing vascular risk in countries that mandate FA fortification of food (e.g., USA and Canada). However, it is uncertain whether FA therapy reduces stroke risk in countries without FA food fortification. The purpose of this study was to comprehensively evaluate the efficacy of FA therapy on stroke prevention in countries without FA food fortification. METHODS: PubMed, EMBASE, and clinicaltrials.gov from January 1966 to August 2016 were searched to identify relevant studies. Relative risk (RR) with 95% confidence interval (CI) was used as a measure of the association between FA supplementation and risk of stroke, after pooling data across trials in a random-effects model. RESULTS: The search identified 13 randomized controlled trials (RCTs) involving treatment with FA that had enrolled 65,812 participants, all of which stroke was reported as an outcome measure. After all 13 RCTs were pooled, FA therapy versus control was associated with a lower risk of any future stroke (RR, 0.85; 95% CI, 0.77 to 0.95). FA alone or combination of FA and minimal cyanocobalamin (≤0.05 mg/day) was associated with a lower risk of future stroke (RR, 0.75; 95% CI, 0.66 to 0.86) whereas combination of FA and cyanocobalamin (≥0.4 mg/day) was not associated with a lower risk of future stroke (RR, 0.95; 95% CI, 0.86 to 1.05). CONCLUSIONS: FA supplement reduced stroke in countries without mandatory FA food fortification. The benefit was found mostly in patients receiving FA alone or combination of FA and minimal cyanocobalamin.
Folic Acid ; Food, Fortified ; Humans ; Outcome Assessment (Health Care) ; Stroke ; Vitamin B 12

OBJECTIVES: To determine the effectiveness of iron-fortified chocolate drinks with the Sangkap Pinoy Seal on the hemoglobin, hematocrit and RBC indices among five year old pre-school children of the Eskwelahang Munti Barangay Potrero, Malabon City.

MATERIALS AND METHODS: Five-year old pre-school children enrolled at the Eskwelahang Munti Barangay Potrero, Malabon City were taken blood samples. Blood was drawn through skin puncture by a trained medical technologist. Baseline hemoglobin, hematocrit and RBC indices were taken. Children with histories of acute and chronic illness, blood dyscrasias, current febrile illness and sever anemia (Hb<8g/dl) were all excluded in the study. The subjects were divided into control and experimental groups, and dewormed by giving Mebendazole 250mg/paper tab single dose prior to treatment. The control group received ferrous sulfate syrup 1.7ml (containing 8.9mg of elemental iron) once daily for 6 weeks. The experimental group was given iron-fortified chocolate drink with the Sangkap Pinoy Seal, one glass (containing 8.9mg of elemental iron) a day also for 6 weeks. The two groups were supervised by 2 research assistants. Repeat hemoglobin, hematocrit and RBC indices determination were done by the same medical technologist. The results obtained were tabulated and subjected to statistical analysis.

RESULTS: The study showed that the iron-fortified chocolate drink and ferrous sulfate had a significant effect on both the Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH). But it was the iron-fortified chocolate drink that was more effective in increasing the hemoglobin, hematocrit and RBC levels among the 5 year old pre-school children at the Eskwelahang Munti Barangay Potrero, Malabon City.

CONCLUSION: Based on the results of the study: 1.) The iron-fortified chocolate drink increased significantly the hemoglobin, hematocrit and RBC levels among the five year old pre-school children while the ferrous sulfate supplement did not increase significantly, and 2.) Comparing the increase in the hemoglobin, hematocrit and RBC levels between the 2 groups, there is significant difference favoring the iron-fortified chocolate drink relative to the ferrous sulfate supplement.

Human ; Male ; Female ; Child Preschool ; ANEMIA, IRON-DEFICIENCY ; Iron ; Food, Fortified ; Ferrous sulfate ; Hemoglobins ; Hematocrit ; Diet, Food, and Nutrition

OBJECTIVESIn order to understand the effect of long term consumption of mineral-fortified dephytinized soy milk powder on skeletal health in children, biological effects of mineral-fortified dephytinized soy milk powder, dephytinized mineral-unfortified soy milk powder and fresh mineral-fortified cow milk were compared.

METHODSTotally, 90 boys aged 12 to 14 years were involved in the study and were given daily with mineral-fortified dephytinized soy milk powder, dephytinized soy milk powder and fresh fortified cow milk, respectively, for two months. The blood samples were collected from all the subjects for measuring activity of serum bone specific alkaline phosphatase and serum level of oesteocalcin, and the urine samples were collected for determining urine C-terminal telopeptides of type I collagen (CTx).

RESULTSAfter two-month intervention, serum level of oesteocalcin increased significantly in the all groups, (16.42 +/- 11.25) micro g/L for the group with fortified soy milk powder, (18.86 +/- 11.57) microg/L for the group with unfortified soy milk powder and (13.81 +/- 10.06) microg/L for the group with fortified cow milk, respectively. The activity of bone specific alkaline phosphatase significantly decreased in the all groups, by (0.28 +/- 0.40) micromol x s(-1) x L(-1) for the group with fortified soy milk powder, (0.26 +/- 0.35) micromol x s(-1) x L(-1) for the group with unfortified soy milk powder, and (0.17 +/- 0.28) micromol x s(-1) x L(-1) for the group with fortified cow milk, respectively. As well as, urine level of CTx decreased significantly, by (349.1 +/- 380.3) mg/L for the group with fortified soy milk powder, (260.4 +/- 412.4) mg/L for the group with unfortified soy milk powder, and (354.4 +/- 404.7) mg/L for the group with fortified cow milk, respectively.

CONCLUSIONSLong term consumption of mineral-fortified and dephytinized soy milk powder could improve bone mass retention and calcium nutrition status efficiently in children.

Adolescent ; Bone Density ; drug effects ; physiology ; Child ; Dietary Supplements ; Food, Fortified ; Humans ; Male ; Minerals ; pharmacology ; Phytic Acid ; metabolism ; Soybeans ; chemistry

OBJECTIVENaFeEDTA was considered as a promising iron fortificant for controlling iron deficiency anemia. Soy sauce is a suitable food carrier for iron fortification and is a popular condiment in China. Iron absorption rates of NaFeEDTA and FeSO4 were observed and compared in adult female subjects.

METHODSThe stable isotope tracer method was used in Chinese females consuming a typical Chinese diet. Ten healthy young Chinese women were selected as subjects in the 15-day study. A plant-based diet was used based on the dietary pattern of adult women in the 1992 National Nutrition Survey. Six milligram of 54Fe in 54FeSO4 soy sauce and 3 mg 58Fe in Na58FeEDTA soy sauce were given to the same subjects in two days. Food samples and fecal samples were collected and analyzed.

RESULTSIron absorption rates of NaFeEDTA and FeSO4 were 10.51% +/- 2.83 and 4.73% +/- 2.15 respectively. The 58Fe (NaFeEDTA) absorption was significantly higher than that of 54Fe (FeSO4) (P < 0.01). The iron absorption rate from NaFeEDTA was 1.2 times higher than that from FeSO4 in Chinese adult women consuming a typical Chinese diet.

CONCLUSIONThe higher absorption rate of NaFeEDTA suggested that NaFeEDTA would be a better iron fortificant used in soy sauce for the controlling of iron deficiency anemia in China.

Adolescent ; Adult ; China ; Edetic Acid ; pharmacokinetics ; Female ; Ferric Compounds ; pharmacokinetics ; Ferrous Compounds ; pharmacokinetics ; Food, Fortified ; Humans ; Iron ; pharmacokinetics ; Soy Foods

For children, voluntary addition of micronutrients to foods must be done without health risk to any of them. This study examined safe maximum levels of vitamin A and C, and calcium for children based on nutrient intake data from the 2001-2002 and 2005 National Health and Nutrition Examination Survey (NHANES) in Korea, while using the safe strategy for addition of micronutrients to foods suggested by EU. For the respective 2001-2002 and 2005 NHANES data proportions of potentially fortifiable energy intake ranged 0.36-0.40 and 0.31-0.34 and the 95th percentile intake of energy were 2,325-3,296 kcal and 2,286-3,814 kcal depending upon age groups. Ninety-fifth percentile intake levels of vitamin A were over or close to UL, even without considering supplement intake for some age groups, which suggest that vitamin A fortification to foods required further consideration. For calcium, 12-14 year old children were the most sensitive group for excessive intake and nutrient fortification to foods. In these children, maximum levels for fortification were 242-290 mg and 484-580 mg with 0.135 and 0.068 proportions of fortified food (PFF) assumed, respectively, without considering calcium intake from supplements. With consideration of calcium intake from both diet and supplement, the maximum levels for fortification were 20-36% of those without supplement intake. The maximum fortification levels of vitamin C were the lowest in 3-5 year old children, showing 77-187 mg and 68-164 mg with and without supplement intake, respectively. These results suggest that the model used for risk assessment in this study can be used to help risk managers to set maximum levels for safe addition of micronutrients to foods.
Ascorbic Acid ; Calcium ; Child ; Diet ; Energy Intake ; Food, Fortified ; Humans ; Korea ; Micronutrients ; Nutrition Surveys ; Risk Assessment ; Vitamin A

Current status of nutrient fortification in processed food in Korea were presented by analyzing the information shown on food labels. The obtained information was assessed by the regulations on food fortification in both Korea and other countries including Codex. The most current regulations were gathered from internet. The results are summarized as follows. 1. Major nutrients fortified were calcium, Vit C, Vit B complex, iron and fiber. The forfified foods were not limitted to certain food group with more frequent fortification in snackfoods, cereal, ramyun, retort pouch foods, milk, and youguart. The descriptive terms of nutrition label for the fortification were various including high, supplemented, added, source, fortified, and abundance though the difference among these terms were not distinct. 2. Current regulation on nutrition laber requires to give the content of the fortified nutrient and % RDA. However not all of food items carry above information. Also some ingredients such as chitosan, DHA, taurine, omega-3 fatty acid, chondrichin, bifidus were supplemented mainly to the snack foods which FDA(USA) does not allow to be fortified. 3. The nutrient most frequently fortified was calcium and general practice of fortification appears to follow the regulation in Korea. Presently the regulation itself is not well described, this nutient fortification can cause toxic effect. Since calcium was supplemented to wide range of food group consumers who are not conscious of the safe upper limit may intake the fortified food up to the level of 2g/day. 4. For the effective fortification in Korea, the regulation on fortification should be reformed in accordance with the international guideline Codex and the regulations in other countries especially in America and Japan.
Americas ; Calcium ; Edible Grain ; Chitosan ; Food Labeling* ; Food, Fortified ; General Practice ; Internet ; Iron ; Japan ; Korea ; Milk ; Snacks ; Social Control, Formal ; Taurine

OBJECTIVETo assess the effectiveness of complementary food supplements with protein and multi-micronutrients on hemoglobin and anemia in infants and young children.

METHODSIn 5 poor counties of Gansu, 984 children aged 6-12 months were enrolled and divided into two groups. In addition to the usual home-made complementary food, all the children were fed one sachet of either Formula I or Formula II supplements each day. Protein and micronutrients were provided in Formula I, while the same energy intake was secured in Formula II as in Formula I. A massive dose of vitamin A was supplemented to all the children every 6 months. Hemoglobin test was done at the same time.

RESULTSPrevalence of anemia was about 35% in both Formula I and Formula II group at baseline, and there were no differences in hemoglobin concentration between the two groups. During the 6-month and 12-month supplementation, hemoglobin of children in Formula I group was higher than that in Formula II group (P < 0.05), and hemoglobin increase in Formula I group was significantly higher than that in Formula II group (P < 0.001). After 6- and 12-month supplementation, the prevalence of anemia in Formula I group dropped to 19.1% and 8.2% respectively, and it was 28.0% and 12.4% in Formula 2 group. The prevalence of anemia in Formula I group was significantly lower than that in Formula II group (P < 0.05). After adjusting age and hemoglobin level at baseline, the hemoglobin increase at age of 24 months in formula 1 group was higher (10.7 g/L vs 7.9 g/L, P < 0.0001).

CONCLUSIONMicronutrient fortified complementary food supplements, with large-dose vitamin A, is effective for children aged 6-12 months in terms of iron deficiency prevention.

Anemia, Iron-Deficiency ; blood ; prevention & control ; China ; Dietary Supplements ; Food, Fortified ; analysis ; Hemoglobins ; metabolism ; Humans ; Infant ; Infant Food ; analysis ; Iron, Dietary ; administration & dosage ; pharmacology ; Poverty ; Rural Population

In recent years a concern of excessive intakes of vitamins and minerals from various sources is increasing, since there has been a marked increase in production and consumption of vitamin and mineral supplements and fortified foods. The purpose of this study was to assess the maximum exposure of vitamins and minerals from various sources including diet, fortified foods, and health functional foods among Koreans. As a result, the highest exposure group of most vitamins and minerals from diet was adults (30 - 49 years of age) according to 2001 Korean National Nutrition and Health Survey Report. Maximum dietary intakes of vitamin A, B1, B2, C, nicotinamide, calcium, phosphorus and iron were 0.5 - 7 times of the RDA for Koreans, 7th ed. Maximum intakes of vitamins and minerals from fortified foods by adults (20 - 59 years of age) were 8 - 760% of the Korean RDA. In addition, maximum exposure of vitamins and minerals from vitamin.mineral health functional foods by middle aged people was 35 - 140% of the upper limits (UL: DRI for Koreans). As a consequence, maximum combined intakes of vitamin B6, vitamin C, calcium, iron and zinc from the above sources including diet, fortified foods and vitamin.mineral health functional foods were greater than the UL. These results would be applied for determining the safe upper limits of vitamin and mineral of health functional foods.
Adult ; Ascorbic Acid ; Asian Continental Ancestry Group ; Calcium ; Diet ; Food, Fortified ; Functional Food ; Health Surveys ; Humans ; Iron ; Middle Aged ; Minerals* ; Niacinamide ; Phosphorus ; Vitamin A ; Vitamin B 6 ; Vitamins* ; Zinc

The purpose of this study was to describe the pattern of "health functional food (HFF)" intake and related factors in Busan and Gyeongnam area and provide useful information for health promotion through the use of HFF. Among subjects of this study (n = 634), about 64% of the subjects reported that they are currently taking HFFs or other health foods or had HFFs in the last year. The reason of subjects taking HFF was to maintain and promote their health. They choose HFF by their own judgement or knowledge and the main place of purchasing HFF was the HFF store. Main food sources for promoting health in study subjects were nutrient fortified foods (76.8%), fruit or vegetable extracts (64.8%), HFF (64%), herbs or oriental medicines (29.6%), folk remedies or unidentified remedies (24.9%), respectively. The preference type of the products was capsule and liquid. 60.6% of consumers thought that HFF are expensive. 9.7% of consumers experienced the side effect such as stomachache and gastroenteric trouble. Using logistic regression analysis, the use of HFF was 1.9 times higher in female than male subjects indicating strong association between gender and HFF use. Additionally higher prevalence was found in female subjects for right conception of HFF and distinction of HFF. Interestingly subjects who consume less salts exhibited a higher tendency (-1.5 folds) in HFF intake than who prefer to use salt and seasonings in diets. In total study subjects 83.9% of them have known and heard about definition of the HFF. The major route of acquiring the information about HFF was mass media such as TV, internet and newspapers. Also subjects who had taken HFF exhibited high a proper conception toward the knowledge about 'distinction of HFF'. Taken together education programs considering gender, dietary habit and life style is necessary for consumers to select proper HFF.
Adult* ; Busan* ; Diet ; Education ; Female ; Fertilization ; Food Habits ; Food, Fortified ; Fruit ; Functional Food* ; Food, Organic ; Health Promotion ; Humans ; Internet ; Life Style ; Logistic Models ; Male ; Mass Media ; Medicine, Traditional ; Periodicals ; Prevalence ; Salts ; Seasons ; Vegetables

A woman aged 45 years was presented with hypokalemic metabolic alkalosis and hypomagnesemia associated with renal potassium and magnesium wasting. Her 24-hour urinary calcium excretion was strikingly low despite normocalcemia and normal creatinine clearance, which is one of characteristic findings of Gitelman's syndrome (GS). She was evaluated for the responses following Mg supplementation for 10 days, which showed marked increments in serum potassium and magnesium as well as improvements of the degree of renal potassium wasting and hypocalciuria. This amelioration of abnormal biochemical pictures in this patient after Mg supplementation proposes that the hypokalemia with renal potassium wasting and hypocalciuria may be caused by abnormal Mg metabolism.
Bartter's Disease/urine ; Bartter's Disease/therapy* ; Bartter's Disease/blood ; Calcium/urine* ; Case Report ; Female ; Food, Fortified ; Human ; Hypokalemia/therapy* ; Magnesium/blood* ; Middle Age ; Syndrome