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Serum and red blood cell folate concentrations, race, and education: findings from the third National Health and Nutrition Examination Survey^1,2

Background: Little is known about the relations between race or ethnicity, educational attainment, and serum and red blood cell folate concentrations.

Objective: We examined the relation between educational attainment and serum and red blood cell folate concentrations in 8457 white, African American, and Mexican American men and women aged 17 y.

Design: We performed a cross-sectional analysis using data from Phase 1 of the third National health and Nutrition Examination Survey (1988–1991).

Results: White men had significantly higher adjusted serum and red blood cell folate concentrations (16.9 and 502.6 nmol/L, respectively) than did African American men (15.6 and 423.3 nmol/L, respectively) or Mexican American men (16.0 and 457.0 nmol/L, respectively); white women had significantly higher concentrations (18.4 and 515.9 nmol/L, respectively) than did African American women (16.3 and 415.4 nmol/L, respectively) or Mexican American women (15.9 and 455.7 nmol/L, respectively). For the entire sample, rank correlation coefficients between educational attainment and serum and red blood cell folate were 0.11 and 0.12, respectively, and were larger in white participants than in other participants. No significant linear trends between adjusted serum or red blood cell folate and educational attainment were found. Among participants with >12 y of education, the mean adjusted concentrations of serum folate were 15% and 18% lower and those of red blood cell were 18% and 22% lower in African American men and women than in white men and women, respectively.

Conclusions: African Americans and Mexican Americans could benefit most from public health programs to boost folate intakes by encouraging increased intake of folate-rich foods and vitamin supplements.

Key Words: Education • ethnic group • folic acid • health surveys • third National Health and Nutrition Examination Survey • NHANES III • African Americans • Mexican Americans

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