Contributions of enriched cereal-grain products, ready-to-eat cereals, and supplements to folic acid and vitamin B-12 usual intake and folate and vitamin B-12 status in US children: National Health and Nutrition Examination Survey (NHANES), 2003–20061234

Background: US children consume folic acid from multiple sources. These sources may contribute differently to usual intakes above the age-specific tolerable upper intake level (UL) for folic acid and to folate and vitamin B-12 status. Objective: We estimated usual daily folic acid intakes above the UL and adjusted serum and red blood cell folate, serum vitamin B-12, homocysteine, and methylmalonic acid (MMA) concentrations in US children by age group and by the following 3 major folic acid intake sources: enriched cereal-grain products (ECGP), ready-to-eat cereals (RTE), and supplements containing folic acid (SUP). Design: We analyzed data in 4 groups of children aged 1–3, 4–8, 9–13, and 14–18 y from the National Health and Nutrition Examination Survey (NHANES), 2003–2006 (n = 7161). Results: A total of 19–48% of children consumed folic acid from ECGP only. Intakes above the UL varied from 0–0.1% of children who consumed ECGP only to 15–78% of children who consumed ECGP+RTE+SUP. In children aged 1–8 y, 99–100% of those who consumed ≥200 μg folic acid/d from supplements exceeded their UL. Although