Details:

Alternative Title:
Am J Clin Nutr
Personal Author:
Crider, Krista S ; Qi, Yan Ping ; Devine, Owen ; Tinker, Sarah C ; Berry, Robert J
Crider, Krista S ; Qi, Yan Ping ; Devine, Owen ; Tinker, Sarah C ; Berry, Robert J Less -
Description:
Background:

The US CDC and the Institute of Medicine recommend that women capable of becoming pregnant consume ≥400 μg synthetic folic acid/d to prevent neural tube defects (NTDs). The United States has 3 sources of folic acid: fortified enriched cereal grain products (ECGPs), fortified ready-to-eat (RTE) cereals, and dietary supplements.

Objective:

Our objectives were as follows: 1) to estimate the usual daily folic acid intake and distributions of red blood cell (RBC) folate concentrations among women consuming folic acid from different sources; 2) to assess the usual daily total folic acid intake associated with optimal RBC folate concentrations for NTD prevention; 3) to predict NTD prevalence; and 4) to estimate the number of pre-ventable folate-sensitive NTDs.

Design:

NHANES data (2007–2012) for nonpregnant women of re-productive age (12–49 y) were used to estimate usual daily intakes of synthetic folic acid and natural food folate. We applied existing models of the relation between RBC folate concentrations and NTD risk to predict NTD prevalence.

Results:

Based on the distribution of overall RBC folate concentrations (4783 women), the predicted NTD prevalence was 7.3/10,000 live births [95% uncertainty interval (UI): 5.5–9.4/10,000 live births]. Women consuming folic acid from ECGPs as their only source had lower usual daily total folic acid intakes (median: 115 μg/d; IQR: 79–156 μg/d), lower RBC folate concentrations (median: 881 nmol/L; IQR: 704–1108 nmol/L), and higher predicted NTD prevalence (8.5/10,000 live births; 95% UI: 6.4–10.8/10,000 live births) compared with women consuming additional folic acid from diet or supplements. If women who currently consume folic acid from ECGPs only (48% of women) consumed additional folic acid sources, 345 (95% UI: 0–821) to 701 (95% UI: 242–1189) additional NTDs/y could be prevented.

Conclusions:

This analysis supports current recommendations and does not indicate any need for higher intakes of folic acid to achieve optimal NTD prevention. Ensuring 400 μg/d intake of folic acid prior to pregnancy has the potential to increase the number of babies born without an NTD.


Subjects:
[+]
Adolescent Adult Child Computer Simulation Erythrocytes Female Folic Acid Food Analysis Humans Middle Aged Models, Biological Neural Tube Defects Nutrition Surveys Pregnancy Prenatal Nutritional Physiological Phenomena Risk Factors United States Young Adult
Keywords:
[+]
Congenital Anomalies Folate Folic Acid Fortification Neural Tube Defects Public Health
Source:
Am J Clin Nutr. 107(6):1027-1034
Pubmed ID:
29767673
Pubmed Central ID:
PMC6980262
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:2a0e1058a8f24553e5faa4c2c1f8da04722cc4ee78ce4f457686a329c2f60a36
Download URL:
https://stacks.cdc.gov/view/cdc/84513/cdc_84513_DS1.pdf
File Type:

Supporting Files

• 	nihms-1004110-f0001.gif	gif
  	nihms-1004110-f0001.jpg	jpeg
  	nihms-1004110.nxml	xml
  	NIHMS1004110-supplement-Supplemental_Flow_Chart.docx	docx

More +