In most European countries, the average vitamin B9 (folate) intake does not meet national recommendations; the mean dietary folate intake of adults has been estimated at 291 micrograms/day for men and 247 micrograms/day for women (39).
In Germany, 79% of men and 86% of women do not meet their daily needs of vitamin B9 (folate) (40). This is partly due to an inadequate intake of dietary vitamin B9, but also because folate is destroyed to a large extends by storage, processing and heating of food.
The highest folate intake was reported in the Parisian area of France, whilst the lowest folate intakes were found in Swedish and Dutch populations.
These differences in vitamin B9 (folate) intake partly reflect traditional dietary habits among Europeans. A Mediterranean diet consisting of higher portions of vegetables, fruits and whole grains may help explain higher intakes of folate in France, Spain and Portugal. An overview of the nutrient intake for women by country and its variation worldwide is given by Stamm et al. 2013 (62).
In Europe, more than 90% of women of childbearing age are estimated to have intake below the recommended level (41).
A report has shown that only one in three European consumers know of the relationship between folic acid intake and the prevention of neural tube defects (42).
Likewise in the U.S.: despite the effectiveness of vitamin B9 (folic acid) supplementation in preventing neural tube defects, it appears that less than half of women in the U.S. who become pregnant follow the recommendation ─ either out of ignorance or because of unplanned pregnancy (43).
To decrease the incidence of neural tube defects, in many countries legislation has been implemented requiring the fortification of all enriched grain products with folic acid (44, 45).
Authored by Dr Peter Engel in 2010, reviewed and revised by Angelika Friedel on 29.06.2017