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Status of plasma folate after folic acid fortification of the food supply in pregnant African American women and the influences of diet, smoking, and alcohol consumption^1,2,3

¹ From the Laboratory of Membrane Biochemistry and Biophysics, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD (KDS, RJP, SB, MM, and NS); the Food Composition Laboratory, Beltsville Human Nutrition Research Center, US Department of Agriculture, Beltsville, MD (RJP and VPF); the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (HR); and the Departments of Obstetrics & Gynecology, School of Medicine (JJ, MB-A, JEW, RJS, and JHH) and Psychology (JHH), Wayne State University, Detroit, MI

ABSTRACT

Background:African American women and socioeconomically challenged women are at risk of compromised folate status and, thus, of folate-related birth defects. Data are limited on circulating folate concentrations in pregnant African American women after folic acid fortification of the food supply was implemented.

Objective:The objective was to determine the influence of smoking and alcohol consumption on plasma 5-methyltetrahydrofolic acid (5-MTHFA) concentrations in pregnant African American women.

Design:Alcohol consumption, smoking exposure, and other characteristics of pregnant African American women reporting to an inner-city antenatal clinic were assessed. At 24 wk of gestation, blood samples and food-frequency intake data were collected. Plasma 5-MTHFA concentrations were determined by liquid chromatography–mass spectrometry for 116 subjects and examined in a correlational study design.

Results:Dietary folate and markers of alcohol consumption were positively associated, whereas exposure to smoke was negatively associated with plasma 5-MTHFA. More than one-half of the participants in this population failed to meet the recommended dietary allowance for dietary folate equivalents of 600 µg/d during pregnancy.

Conclusions:Most inner-city African American women are not meeting the recommended dietary allowance for dietary folate during pregnancy, and smoking may further compromise their folate status. Programs to reduce smoking and raise awareness about the importance of folate and multivitamin supplementation during pregnancy need to target this population.

Key Words: 5-Methyltetrahydrofolic acid • folate • folic acid • fortification • African American women • pregnancy • nutrition • smoking • alcohol • electrospray mass spectrometry • human plasma • polyunsaturated fatty acids

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