Pulses are nutrient-dense foods that have for a long time been empirically known to have beneficial effects in human health. In the last decade, several studies have gathered evidence of the metabolic benefits of pulse intake. However, it remains unclear at what amounts these effects may be attained. This study aimed to systematically review the scientific outputs of the last two decades regarding health benefits of pulse consumption and the amounts necessary for positive outcomes to be achieved. A PubMed search including keywords [(“dietary pulses”, “pulses”, “legumes”, “grain legumes”, “bean”, “chickpea”, “pea”, “lentil”, “cowpea”, “faba bean”, “lupin”) and (“inflammation”, “inflammatory markers”, “C-reactive protein”, “blood lipids”, “cholesterol”, “cardiometabolic health”, “cardiovascular disease”, “diabetes”, “glycaemia”, “insulin”, “HOMA-IR”, “body weight”, “body fat”, “obesity”, “overweight”, “metabolome”, “metabolic profile”, “metabolomics”, “biomarkers”, “microbiome”, “microbiota”, “gut”)] was performed. Only English written papers referring to human dietary interventions, longer than one day, focusing on whole pulses intake, were included. Most of the twenty eligible publications reported improvements in blood lipid profile, blood pressure, inflammation biomarkers, as well as, in body composition, resulting from pulse daily amounts of 150 g (minimum-maximum: 54-360 g/day; cooked). Concerns regarding methodological approaches are evident and the biochemical mechanisms underlying such effects require further investigation.

Objective: To summarize the recommendations on folate intake and folic acid supplementation and fortification in the periconceptional period, aimed at prevention of neural tube defects (NTD), provided by official health organizations in different countries worldwide and WHO.Design: Information on recommendations for folate and folic acid intake in the periconceptional period was gathered from the websites of official national health organizations of several countries worldwide and from the WHO website.Setting: WHO, selected developed countries and emerging economies, totalling thirty-six countries worldwide (some European, BRICS, G8, Asian Tiger/Asian Dragon and Australia).Results: Recommendations differ between countries, although the majority (69·4 %) recommend a healthy diet plus a folic acid supplement of 400 µg/d from preconception (4–12 weeks) until the end of the first trimester of pregnancy (8–12 weeks). The same recommendation is issued by the WHO. Dosages for women at high risk of NTD are up to 4–5 mg/d (for 41·7 % of studied countries). The recommended intake for folate is in the range of 300–400 µg/d for women of childbearing age and 500–600 µg/d for pregnant women in different countries and WHO. Five countries emphasize the importance of a healthy diet rendering supplementation needless. By contrast, five others advise a healthy diet and supplementation plus mandatory fortification. Only one mentions the importance of ensuring an adequate folate status and refers to checking with a health-care provider on the need for supplements.Conclusions: Different recommendations regarding folate and folic acid, seeking NTD prevention, are available worldwide; however, most countries and WHO focus on a healthy diet and folic acid supplementation of 400 µg/d periconceptionally.

Objective: To assess maternal diet and nutritional adequacy prior to conception and during pregnancy.Design: Follow-up of a cohort of pregnant women with collection of questionnaire data throughout pregnancy and after delivery.Setting: Antenatal clinics at two public hospitals in Porto, Portugal.Subjects: Two hundred and forty-nine pregnant women who reported a gestational age below 13 weeks at the time they attended their first antenatal visit.Results: Intakes of energy and macronutrients were within recommended levels for most women. Pregnancy was accompanied by increases in the dietary intake of vitamins A and E, riboflavin, folate, Ca and Mg, but declines in the intake of alcohol and caffeine. The micronutrients with higher inadequacy prevalences prior to pregnancy were vitamin E (83 %), folate (58 %) and Mg (19 %). These three micronutrients, together with Fe, were also those with the highest inadequacy prevalences during pregnancy (91 %, 88 %, 73 % and 21 %, respectively, for folate, Fe, vitamin E and Mg). Ninety-seven per cent of the women reported taking supplements of folic acid during the first trimester, but the median gestational age at initiation was 6·5 (interquartile range 5, 9) weeks. Self-reported prevalences of Fe and Mg supplementation were high, and increased throughout pregnancy.Conclusion: The study identified low dietary intakes of vitamin E, folate and Mg both in the preconceptional period and during pregnancy, and low intake of Fe during pregnancy only. The low dietary intake of folate and the late initiation of supplementation indicate that current national guidelines are unlikely to be effective in preventing neural tube defects.