PANEL REVISES VITAMIN B RECOMMENDATIONS

WASHINGTON—Women who are considering pregnancy should consume 400 micrograms of folate, a B vitamin, from supplements or from cereal or other fortified foods—in addition to what they absorb naturally from their diets, a panel recommended here Tu esday.

And older Americans, who are less able to absorb vitamin B-12 from meat and dairy products, should use supplements or fortified foods to help meet the Recommended Dietary Allowance (RDA) of 2.4 micrograms per day, the panel said.

This is the first time that the Institute of Medicine (IOM), a federal advisory agency which has set dietary recommendations since 1941, has recommended that large groups of people help meet their daily nutritional needs through supplements or fortified f oods.

Studies have shown that women who consume supplements of folate before conceiving and during the first month of pregnancy can prevent serious birth defects of the brain and spine known as neural tube defects. These defects occur in about one birth per 1,0 00.

It is not clear whether women receive the same benefit from folate-rich foods alone, said committee chair Dr. Roy M. Pitkin, a professor emeritus of obstetrics and gynecology at the University of California at Los Angeles.

Some research has suggested that consuming high levels of folate and other B vitamins may reduce the risk of developing cardiovascular disease, cancers and various mental disorders, but the evidence is not solid enough to make recommendations about the am ount necessary to receive these potential health benefits, he said.

Since January, the federal Food and Drug Administration has required manufacturers to add folate to enriched breads, flour, corn meal, pasta, rice and other grain-based foods. Supplemental folate is also kno wn as folic acid.

The new, higher RDA for folate is 400 micrograms for non-pregnant, non-breast-feeding Americans older than 14. The revised RDA is 600 micrograms per day for pregnant women and 500 micrograms per day for women who are breast-feeding.

These recommendations can be met by eating foods high in folate, such as green leafy vegetables or orange juice, as well as through fortified foods or supplements, experts said.

"We always like to say, 'food first,' [but] women of childbearing age may need a supplement, especially during pregnancy and [breast-feeding]. At the same time it is important to recognize that it is possible to get adequate nutrition from food," said Helenbeth Reiss Reynolds, a nutritionist in Plymouth, Minn., and a spokesperson for the Chicago-based American Dietetic Association.

The IOM committee recommended that people eat no more than 1,000 micrograms, or 1 milligram, of folate daily, in large part because high levels may mask symptoms of vitamin B-12 deficiency.

If left untreated, this deficiency, known as pernicious anemia, can cause permanent nerve damage. It is rare in this country, but older Americans—10 to 30 percent of whom cannot absorb enough vitamin B-12 from meats and dairy products in their diets& #151;as well as vegetarian women who are taking extra folate because of potential pregnancy should make sure to meet their B-12 needs with supplements, said Dr. Robert Russell, a committee member and nutritionist from Tufts University in Boston.

Recommendations for the other B vitamins, such as niacin, thiamin, vitamin B-6 and riboflavin, have not changed substantially since the last recommendations were made in 1989. Unlike the 1989 recommendations, however, these recommendations also list amoun ts above which health problems might occur. For example, taking more than 3.5 milligrams of niacin may cause itching or flushing, Pitkin said.

Publication Date: 1998-04-08

Copyright 1998 by Simon & Schuster. All rights reserved. This copyright material may not be published, broadcast or redistributed in any manner.