Table 1.

Comparative analysis of strategies to improve folate intake

	Strengths	Weaknesses
Nutritional advice: natural folate sources	Overall improvement of population's nutritional status Diet should provide all nutrients needed (38)	Difficulty to change dietary habits Low amounts in foods and limited number of food sources (legumes, green leaf vegetables, etc.) Bioavailability and chemical stability of folates is questioned (39, 40)
Pharmacological supplementation	Target population specificity (e.g. women at childbearing age) (41, 42)Better dosage	Lower adherence Depends on socio-economical status (9)Potentially higher risk of toxicity when combined with fortification practices (10)
Mandatory fortification	Reaches all population groups No need to change dietary habits Better cost-effectiveness (28, 40)	Dosage is a function of serving size Risk of high intakes in untargeted population Different fortification ranges and laws across countries (43)
Voluntary fortification	Target consumption with marketing of products (e.g. breakfast cereals for children) (25)Consumption is a matter of food choice	Different fortification levels depending on manufacturers and food groups (25)Higher costs Potentially high or insufficient intakes depending on consumption patterns/dietary habits (16)