Documentation: USDA National Fluoride Database of SelectedBeverages and FoodsIntroduction
Assessment of fluoride intake is paramount in understanding the mechanisms of fluoride metabolism specifically the prevention of dental caries, dental fluorosis, andskeletal fluorosis. The Institute of Medicine (IOM, 1997) specified Adequate Intakes (AI)of 0.01 mg/day for infants through 6 months, 0.05 mg/kg/day beyond 6 months of age,and 3 mg/day and 4 mg/day for adult women and men (respectively), to prevent dentalcaries. Upper limits (UL) of 0.10 mg/kg/day in children less than 8 years and 10 mg/dayfor those older than 8 years are recommended for prevention of dental fluorosis. Similar levels have been endorsed by the American Dental Association (ADA, 1994) and theAmerican Dietetic Association (ADA, 2000). Fluoride works primarily via topicalmechanisms to inhibit demineralization, to enhance remineralization, and to inhibitbacteria associated with tooth decay (Featherstone, 2000). Fluoride has an affinity for calcified tissues. Studies of exposure and bone mineral density, fractures andosteoporosis would benefit from a national fluoride database coupled with an intakeassessment tool (Phipps, 1995; Phipps
2000). Therefore, a database for fluorideis needed for epidemiologists and health researchers to estimate the intakes and toinvestigate the relationships between intakes and human health.The Nutrient Data Laboratory (NDL), Agriculture Research Service, US Department of Agriculture (USDA) coordinated the development of this USDA National FluorideDatabase of Selected Beverages and Foods subsequently described as the NationalFluoride Database--a critical element of the comprehensive multi-center NationalFluoride Database and Intake Study (NFDIAS). The National Fluoride Database will beincorporated into a computer-based fluoride assessment tool being developed by theUniversity of Minnesota, Nutrition Coordinating Center (NCC), as a module of theNutrition Data System for Research (NDS-R) software.The National Fluoride Database is a comprehensive, nationally representative databaseof the fluoride concentration in foods and beverages consumed in the United States. Itcontains fluoride values for beverages, water, and foods that are major fluoridecontributors. Water and water-based beverages are the chief source of dietary fluorideintake (Singer and Ophaug, 1984). Conventional estimates are that about 75% of dietary fluoride comes from water and water-based beverages. According to the 1992Fluoridation Census (CDC, 1993), about 63% of the population on U.S. public water systems are receiving water that is fluoridated naturally or by adding fluoride. Drinkingwater fluoride distributions may vary widely over geographical and geo-politicalboundaries (CDC, 1993). Variations occur with soil composition and with local politicaldecisions to fluoridate water. The use of wells of varying depths, commercial water products, home water purifiers, and filtration systems also increase variability of fluoridein drinking water and complicate estimates of intake (Brown and Aaron, 1991; Robinson
1991; Van Winkle
, 1995). These variations in fluoride in commercial foodsand beverages have been addressed in this National Fluoride Database.