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Biomonitoring also gives us important 
information about nutrition:

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the foods we eat and how 
those foods affect our health.

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Remember the NHANES survey?

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In Section 2, we talked about 
how biomonitoring scientists use

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the NHANES survey results 
to gather exposure data,

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or information about the 
levels of chemicals in people’s bodies.

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Scientists also use NHANES results 
to gather data on nutritional biomarkers:

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the levels of certain
nutrients in our bodies.

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CDC publishes the findings in the

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National Report on Biochemical Indicators 
of Diet and Nutrition in the U.S. Population.

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The first version of the 
report was released in 2008,

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and it included 27 nutrition biomarkers.

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The second was published in 2012 
and included 58 biomarkers.

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Updates to the 2012 version 
occurred in 2020.

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Some of those biomarkers 
include fat- and water-soluble vitamins,

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iron-status indicators, and iodine.

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This information helps doctors, scientists, 
and public health officials find out

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if we’re getting too little or too 
much of certain nutrients.

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Based on biomonitoring research, 
public health officials make policy

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changes to help us get the 
nutrition we need.

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For example, folic acid is a nutrient 
that’s very important for

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pregnant women and infants.

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If pregnant women don’t get 
enough folic acid in their diet,

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their babies are more likely to 
develop a type of health problem

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called a neural tube defect.

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In 1998, the U.S. 
Food and Drug Administration,

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or FDA, started requiring food 
manufacturers to add folic acid

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to cereals and other grain-based foods — 
a process called folic acid fortification.

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To see how effective 
folic acid fortification was,

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biomonitoring scientists 
developed a more accurate

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way to test blood folate levels, 
or the amount of folic acid

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in a person’s blood.

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The test showed that blood 
folate levels increased 50%

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among all race and ethnicity groups 
after the new policy went into effect.

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However, 20% of women of childbearing age 
still have less than the recommended

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amount of folate in their blood, 
which means their future children

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could have a higher risk of 
neural tube defects.

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To learn more about folic acid 
and folate levels,

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see the National Report on Biochemical 
Indicators of Diet and Nutrition

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in the U.S. Population.

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Here’s another example.

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You’ve probably heard about 
trans fatty acids (TFAs),

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often known as “trans fats.”

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Consuming too many TFAs 
may put people at a higher

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risk of developing heart disease.

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In 2006, the U.S. 
Food and Drug Administration, or FDA,

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started requiring food packaging to 
include TFAs on the

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Nutrition Facts labels.

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Some state and local health 
departments also took steps to help

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people eat less of these fats.

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They required restaurants to limit 
their use of TFAs,

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and launched awareness 
campaigns to teach people about

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the health risks associated with TFAs.

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But did all these changes lead 
to people consuming less TFAs?

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Biomonitoring scientists turned to 
the NHANES survey data to find out.

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Scientists at the 
Environmental Health Laboratory

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used data from the 1999–2000 
and 2009–2010 NHANES

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surveys to compare TFA
levels in adult Americans’ blood.

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The results showed that TFA levels 
dropped by 54%,

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meaning that people consumed a 
lot fewer TFAs after the national

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and state policies went 
into effect in 2006.