Update on the impact of voluntary folic acid fortification of corn masa flour on red blood cell folate concentrations—National Health and Nutrition Examination Survey, 2011–March 2020

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2024-03-08 DOI:10.1002/bdr2.2321

Arick Wang, Amy Fothergill, Lorraine F. Yeung, Krista S. Crider, Jennifer L. Williams

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引用次数: 0

Abstract

Background

Folic acid is a micronutrient that is effective at preventing neural tube defects (NTDs). In 2016, the FDA authorized the voluntary fortification of corn masa flour (CMF) with folic acid to reduce disparities in NTDs among infants of women who do not regularly consume other fortified cereal grains, in particular Hispanic women of reproductive age (WRA).

Methods

We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to March 2020 assessing the impact of voluntary fortification of CMF on the folate status of Hispanic WRA. We analyzed folic acid usual intake and red blood cell (RBC) folate concentrations among non-pregnant, non-lactating Hispanic WRA, comparing pre-fortification (2011–2016) to post-fortification (2017–March 2020) data. RBC folate concentrations were used to create model-based estimation of NTD rates.

Results

The proportion of Hispanic WRA with folic acid usual intakes <400 μg/d did not change (2011–2016: 86.1% [95% Confidence Interval, CI: 83.7–88.5]; 2017–March 2020: 87.8% [95% CI: 84.8–90.7]; p = .38) nor did the proportion of Hispanic WRA with RBC folate below optimal concentrations (<748 nmol/L, 2011–2016: 16.0% [95% CI: 13.7–18.2]; 2017–March 2020: 18.1% [95% CI: 12.1–24.0]; p = 0.49). Model-based estimates of NTD rates suggest further improvements in the folate status of Hispanic WRA might prevent an additional 157 (95% Uncertainty Interval: 0, 288) NTDs/year.

Conclusions

Voluntary fortification of CMF with folic acid has yet to have a significant impact on the folate status of WRA. Continued monitoring and further research into factors such as fortified product availability, community knowledge, and awareness of folic acid benefits would inform and improve future public health interventions.

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2011 年至 2020 年 3 月全国健康与营养调查：玉米面中自愿添加叶酸对红血球叶酸浓度影响的最新情况。

背景：叶酸是一种能有效预防神经管畸形（NTD）的微量营养素。2016 年，美国食品和药物管理局（FDA）授权对玉米麻酱粉（CMF）进行叶酸自愿强化，以减少不经常食用其他强化谷物的妇女，尤其是西班牙裔育龄妇女（WRA）的婴儿患 NTD 的差异：我们分析了 2011 年至 2020 年 3 月的美国国家健康与营养调查（NHANES）数据，评估了自愿强化 CMF 对西班牙裔育龄妇女叶酸状况的影响。我们比较了强化前（2011-2016 年）和强化后（2017 年至 2020 年 3 月）的数据，分析了非怀孕、非哺乳期西班牙裔 WRA 的叶酸常规摄入量和红血球（RBC）叶酸浓度。红细胞叶酸浓度被用于建立基于模型的NTD发病率估算：结果：叶酸通常摄入量占西语裔 WRA 的比例得出结论：自愿在 CMF 中添加叶酸尚未对 WRA 的叶酸状况产生重大影响。继续监测和进一步研究强化产品的可用性、社区知识和对叶酸益处的认识等因素，将为未来的公共卫生干预措施提供信息并加以改进。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.