Folic acid fortifi cation and women's folate levels in selected communities in Brazil - A first look

dc.contributor.authorChakraborty, Hrishikesh
dc.contributor.authorNyarko, Kwame A.
dc.contributor.authorGoco, Norman
dc.contributor.authorMoore, Janet
dc.contributor.authorMoretti-Ferreira, Danilo [UNESP]
dc.contributor.authorMurray, Jeffrey C.
dc.contributor.authorWehby, George L.
dc.contributor.institutionStatistics and Epidemiology, RTI International
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionNational Bureau of Economic Research
dc.description.abstractBackground: Several countries have implemented mandatory folic acid fortifi cation of wheat flour and selected grain products to increase the folate intake of reproductive-aged women. Brazil implemented a folic acid fortifi cation program in 2004. No previous studies have examined folate differences among Brazilian women following the mandate. Objective: We evaluate differences in serum and red blood cell (RBC) folate concentrations between two samples of women of childbearing age from selective communities in Brazil, one tested before (N = 116) and the other after the mandate (N = 240). Methods: We compared the baseline folate levels of women enrolled in a prevention study shortly before the fortifi cation mandate was implemented, to baseline levels of women from the same communities enrolled in the same study shortly after fortifi cation began. The participants were women enrolled in a folate supplementation clinical trial, at a hospital specializing in treating craniofacial anomalies in the city of Bauru from January 29, 2004 to April 27, 2005. We only compared baseline folate levels before the women received oral cleft prevention program (OCPP) folic acid supplements. Results: Women enrolled after the fortifi cation mandate had higher means of serum folate (20.3 versus 11.2 nmol/L; p < 0.001) and RBC folate (368.3 versus 177.6 nmol/L; p < 0.001) than women enrolled before the mandate. Differences in folate levels between the two groups remained after adjusting for several co-variables. Conclusions: The results suggest that serum and RBC folate levels among women of childbearing age increased after implementing the folic acid fortifi cation mandate in Brazil.en
dc.description.affiliationDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina
dc.description.affiliationDepartment of Health Management and Policy, College of Public Health, University of Iowa
dc.description.affiliationStatistics and Epidemiology, RTI International
dc.description.affiliationServiço de Aconselhamento Genético - IBB/UNESP, São Paulo State University
dc.description.affiliationDepartment of Pediatrics, Division of Neonatology, University of Iowa
dc.description.affiliationDepartments of Health Management and Policy, Economics, and Preventive and Community Dentistry, Public Policy Center, University of Iowa
dc.description.affiliationNational Bureau of Economic Research
dc.description.affiliationUnespServiço de Aconselhamento Genético - IBB/UNESP, São Paulo State University
dc.identifier.citationInternational Journal for Vitamin and Nutrition Research, v. 84, n. 5-6, p. 286-294, 2014.
dc.relation.ispartofInternational Journal for Vitamin and Nutrition Research
dc.rights.accessRightsAcesso restrito
dc.subjectCongenital anomalies
dc.subjectFolic acid
dc.subjectNeural tube defects
dc.titleFolic acid fortifi cation and women's folate levels in selected communities in Brazil - A first looken