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On the basis of unfortified food sources, Canadians would struggle to consume adequate amounts of folate. When folate intakes from all food sources were considered, the overall prevalence of folate inadequacy was low across all age\/sex groups, with the exception of females &gt;70 years. However, &gt;10 % of supplement users were above the tolerable upper intake level, increasing to almost 18 % when overage factors were accounted for. In addition, between 20 and 52 % of supplement users had elevated erythrocyte folate concentrations, depending on the cut-off used. Results from this study suggest that insufficient dietary intakes of folate in Canadians have been ameliorated because of the fortification policy, although folate inadequacy still exists across all age groups. However, supplement users appear to be at an increased risk of folic acid (FA) overconsumption as well as elevated erythrocyte folate. As such, the general population should be informed of the potential risks of FA overconsumption resulting from supplement use. This study suggests a need for more careful assessment of the risks and benefits of food fortification, particularly fortification above mandated levels, and FA supplement use in the general population.<\/jats:p>","DOI":"10.1017\/s000711451600307x","type":"journal-article","created":{"date-parts":[[2016,9,9]],"date-time":"2016-09-09T06:57:39Z","timestamp":1473404259000},"page":"1236-1245","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":21,"title":["Folate intakes from diet and supplements may place certain Canadians at risk for folic acid toxicity"],"prefix":"10.1017","volume":"116","author":[{"given":"Adriana N.","family":"Mudryj","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"de Groh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold M.","family":"Aukema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,9,9]]},"reference":[{"key":"S000711451600307X_ref25","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.21.2351"},{"key":"S000711451600307X_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/132.9.2792"},{"key":"S000711451600307X_ref39","unstructured":"Health Canada (2008) Canadian Community Health Survey, Cycle 2.2, Nutrition (2004): income related household food security in Canada. http:\/\/www.hc-sc.gc.ca\/fn-an\/surveill\/nutrition\/commun\/income_food_sec-sec_alim-eng.php (accessed February 2016)."},{"key":"S000711451600307X_ref19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i734"},{"key":"S000711451600307X_ref51","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2009.28427"},{"key":"S000711451600307X_ref23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143738"},{"key":"S000711451600307X_ref15","unstructured":"Institute of Medicine (2000) Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. http:\/\/www.iom.edu\/Reports\/2000\/Dietary-Reference-Intakes-for-Thiamin-Riboflavin-Niacin-Vitamin-B6-Folate-Vitamin-B12-Pantothenic-Acid-Biotin-and-Choline.aspx (accessed February 2016)."},{"key":"S000711451600307X_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)32685-8"},{"key":"S000711451600307X_ref33","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2008.26947C"},{"key":"S000711451600307X_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62001-7"},{"key":"S000711451600307X_ref9","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-4-20"},{"key":"S000711451600307X_ref5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911113412001"},{"key":"S000711451600307X_ref49","doi-asserted-by":"publisher","DOI":"10.1139\/apnm-2015-0191"},{"key":"S000711451600307X_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/81.5.1213"},{"key":"S000711451600307X_ref52","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-014-0449-9"},{"key":"S000711451600307X_ref35","first-page":"154","article-title":"Impact of food fortification on folic acid intake in Canada (Letter to editor)","volume":"94","author":"Quinlivan","year":"2003","journal-title":"Can J Public Health"},{"key":"S000711451600307X_ref6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03430200091032"},{"key":"S000711451600307X_ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-007-0793-y"},{"key":"S000711451600307X_ref53","unstructured":"Health Canada (2010) Canadian Community Health Survey: Cycle 2.2: A guide to accessing and interpreting the data. http:\/\/www.hc-sc.gc.ca\/fn-an\/surveill\/nutrition\/commun\/cchs_guide_escc-eng.php (accessed February 2016)."},{"key":"S000711451600307X_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/88.3.763"},{"key":"S000711451600307X_ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2006.07.011"},{"key":"S000711451600307X_ref40","unstructured":"Health Canada (2012) Canadian Community Health Survey 2.2, Nutrition focus. http:\/\/www.hc-sc.gc.ca\/fn-an\/surveill\/nutrition\/commun\/cchs_focus-volet_escc-eng.php (accessed February 2016)."},{"key":"S000711451600307X_ref1","unstructured":"National Institutes of Health. 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