March 14, 2006

Folate deficiency still seen in US minorities

By Will Boggs, MD

NEW YORK (Reuters Health) - Racial and ethnic differences
in blood levels of folate persist despite the fortification of
food with folic acid in the US, according to a new report.

"Even after the US cereals and grains were fortified with
folic acid in 1998, women in racial and ethnic minority groups
had lower serum folate levels than women who were non-Hispanic
whites," Dr. Jean M. Lawrence from Kaiser Permanente Southern
California, Pasadena, told Reuters Health.

"Our study results suggest that Latina, black or Pacific
Islander women, as well as women who are overweight and obese,
may be particularly at risk of having lower folate levels," she

Lawrence and here colleagues used data from the Kaiser
Permanente Medical Care Program to investigate whether folate
values varied by race, ethnicity, body mass index, and maternal
age among 9421 pregnant women who started prenatal care.

Folate levels were the highest among women who consistently
used vitamins and were progressively lower among women who had
just started taking vitamins, were former vitamin users or did
not take vitamins, the investigators report in the American
Journal of Obstetrics & Gynecology.

Women who were underweight or normal weight had the highest
average folate levels, the researchers note, and values were
lower for overweight women and lowest for obese women.

Folate deficiency is linked to an increased risk of having
a baby with a neural tube defect like spina bifida. "While it
is very important for women to take prenatal vitamins when they
are pregnant, the point of this study is to identify groups of
women who may be at risk for neural tube defects because they
are not taking folic acid when they become pregnant," Lawrence

"In our study, only 35 percent of the women reported that
they were taking vitamins when they learned they were pregnant,
while 25 percent of the women started taking vitamins when they
learned they were pregnant," she commented.

How much folic acid should a woman of childbearing age
take? "Until the optimal folate level is identified that
confers maximum protection against neural tube defects,"
Lawrence advised, "health care professionals and women's health
advocates should continue to encourage women who can become
pregnant to take a vitamin containing 400 micrograms of folic
acid every day."

SOURCE: American Journal of Obstetrics & Gynecology,
February 2006.