Race-ethnicity differences in folic acid intake in women of childbearing age in the United States after folic acid fortification: findings from the National Health and Nutrition Examination Survey

Background: Neural tube defects are serious birth defects of the brain and spinal cord. Up to 70% of neural tube defects can be prevented by the consumption of folic acid by women before and early during pregnancy. Objective:Theobjectivewastoexaminefolicacidintakeinwomen of childbearing age in the United States. Design: We analyzed nutrient intake data reported by 1685 non- pregnant women aged 15-49 y who participated in the National Health and Nutritional Examination Survey, 2001-2002. Results: The adjusted geometric mean consumption of folic acid from fortified foods was 128 g/d (95% CI: 123, 134 g/d) in nonpregnant women. Eight percent (95% CI: 5.8%, 11.0%) of non- pregnant women reported consuming 400 g folic acid/d from fortified foods. This proportion was lower among non-Hispanic black women (5.0%) than among non-Hispanic white (8.9%) or Hispanic (6.8%) women. A smaller percentage of non-Hispanic black (19.1%) and Hispanic (21%) women than of non-Hispanic white women (40.5%) consumed 400 g folic acid from supple- ments, fortified foods, or both, in addition to food folate, as recom- mended by the Institute of Medicine to reduce the frequency of neural tube defects. Conclusions: Most nonpregnant women of childbearing age in the United States reported consuming less than the recommended amountoffolicacid.Theproportionwithlowdailyfolicacidintake wassignificantlyhigherinnon-HispanicblackandHispanicwomen thaninnon-Hispanicwhitewomen.Atthepresentleveloffolicacid fortification, most women need to take a folic acid-containing di- etary supplement to achieve the Institute of Medicine recommendation. Am J Clin Nutr 2007;85:1409-16.