Prior to folic acid fortification of the food supply in North America in 1998, a reduction in maternal folate stores during lactation was observed and was likely due to poor dietary folate intakes [64-67]. Since implementation of the fortification program, significant improvements in blood folate status of reproductive age women, including pregnant and lactating women, have been described [68, 69]. Dietary folate intakes from unfortified foods during lactation, however, remain suboptimal for approximately one third of women as demonstrated in a sample of well-nourished lactating Canadian women . On average in this study, natural food folate provided 283 ± 71 mcg/day folate, while folic acid from fortified foods supplied approximately 125 ± 35 mcg/day folic acid. The investigators concluded that without mandatory folic acid fortification, 98% of lactating women would not have met their requirements for folate from diet alone .
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