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C J Boushey

Publications and source records attributed to C J Boushey.

6 recordsLinked to original sources

Estimates of the effects of folic-acid fortification and folic-acid bioavailability for women.

OBJECTIVE: With the recent implementation of the folic-acid-fortification program, our objective was to estimate its benefits in adult women and account for the higher bioavailability of synthetic folic acid in fortification programs and supplements. METHODS: The study used a cross-sectional design. Dietary assessment data were collected with a quantitative food-frequency questionnaire, the Nutrition DISCovery program. Fortification was simulated with the use of fortification standards (140 microg/100 g of flour) and new bioavailability standards for synthetic folic acid. Data were collected from 289 women 18 to 89 y old. Subjects were recruited from participants in two health-screening events in autumn of 1997. Chi-square tests were used to estimate the differences between categoric variables, and F tests were used in analysis of variance for continuous outcome measures. Results were considered significant at P < 0.05. RESULTS: Estimated mean dietary intake of folate increased considerably with simulation of fortification (320 to 608 microg of dietary folate equivalents). Women in the lower quartiles for age (18 to 39 and 40 to 46 y) consumed more servings from the bread group than women did in the upper quartile (55 to 89 y). Thus, the improvement in folate intake with fortification was significantly greater for the younger than for the older women (P < 0.05). Despite the limitations of estimating folate intakes, these data suggest that most women met the new estimated average requirement. However, 61% of women of childbearing age had intakes of synthetic folic acid below the recommended level of 400 microg/d, and only those using supplements containing folic acid met the guideline. CONCLUSIONS: Based on this sample of well-educated, adult women, the current level of folic-acid fortification should improve the intakes of a large proportion of women, especially when accompanied by supplements containing folic acid. These improvements in folate intake might not be seen in groups with limited resources, however. Further, under existing standards and practices, many women will not meet current recommendations for prevention of neural-tube defects.

Adolescent↗

A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes.

OBJECTIVES: To determine the risk of elevated total homocysteine (tHcy) levels for arteriosclerotic vascular disease, estimate the reduction of tHcy by folic acid, and calculate the potential reduction of coronary artery disease (CAD) mortality by increasing folic acid intake. DATA SOURCES: MEDLINE search for meta-analysis of 27 studies relating homocysteine to arteriosclerotic vascular disease and 11 studies of folic acid effects on tHcy levels. STUDY SELECTION AND DATA EXTRACTION: Studies dealing with CAD, cerebrovascular disease, and peripheral arterial vascular disease were selected. Three prospective and six population-based case-control studies were considered of high quality. Five cross-sectional and 13 other case-control studies were also included. Causality of tHcy's role in the pathogenesis of vascular disease was inferred because of consistency across studies by different investigators using different methods in different populations. DATA SYNTHESIS: Elevations in tHcy were considered an independent graded risk factor for arteriosclerotic vascular diseases. The odds ratio (OR) for CAD of a 5-mumol/L tHcy increment is 1.6 (95% confidence interval [CI], 1.4 to 1.7) for men and 1.8 (95% CI, 1.3 to 1.9) for women. A total of 10% of the population's CAD risk appears attributable to tHcy. The OR for cerebrovascular disease (5-mumol/L tHcy increment) is 1.5 (95% CI, 1.3 to 1.9). Peripheral arterial disease also showed a strong association. Increased folic acid intake (approximately 200 micrograms/d) reduces tHcy levels by approximately 4 mumol/L. Assuming that lower tHcy levels decrease CAD mortality, we calculated the effect of (1) increased dietary folate, (2) supplementation by tablets, and (3) grain fortification. Under different assumptions, 13,500 to 50,000 CAD deaths annually could be avoided; fortification of food had the largest impact. CONCLUSIONS: A 5-mumol/L tHcy increment elevates CAD risk by as much as cholesterol increases of 0.5 mmol/L (20 mg/dL). Higher folic acid intake by reducing tHcy levels promises to prevent arteriosclerotic vascular disease. Clinical trials are urgently needed. Concerns about masking cobalamin deficiency by folic acid could be lessened by adding 1 mg of cobalamin to folic acid supplements.

Arteriosclerosis↗

Soft drink consumption among Yup'ik Eskimo teenagers.

Soft drink intake among Yup'ik Eskimo teenagers was assessed as part of a monitoring system for a nutrition education intervention project. Soft drink intakes were found to be three to four times greater than in the general US teenage population. Over half of the soft drinks consumed were in the form of sweetened non-carbonated beverages, e.g., Tang, Koolaid. At the end of two years of intervention, soft drink consumption decreased by 10% in the 10 intervention villages as a whole, while intakes decreased by 4% in the 4 control villages. Soda pop consumption alone decreased by 18% in the intervention villages and increased by 20% in control villages.

Adolescent↗