| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
ORIGINAL RESEARCH COMMUNICATION |
1 From the National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
Background: Mandatory folic acid fortification of cereal-grain products was introduced in the United States in 1998 to decrease the risk that women will have children with neural tube defects.
Objective: The objective was to determine the effect of folic acid fortification on concentrations of serum and red blood cell (RBC) folate, serum vitamin B-12, and plasma total homocysteine (tHcy) and methylmalonic acid (MMA) in the US population.
Design: Blood was collected from a nationally representative sample of 
7300 participants aged 
3 y in the National Health and Nutrition Examination Survey (NHANES) during 1999–2000 and was analyzed for these B vitamin–status indicators. The results were compared with findings from the prefortification survey NHANES III (1988–1994).
Results: The reference ranges (5th–95th percentiles) were 13.1–74.3 nmol/L for serum folate, 347–1167 nmol/L for RBC folate, and 179–738 pmol/L for serum vitamin B-12. For plasma tHcy and MMA, the reference ranges for serum vitamin B-12–replete participants with normal serum creatinine concentrations were 3.2–10.7 µmol/L and 60–210 nmol/L, respectively. The prevalence of low serum folate concentrations (<6.8 nmol/L) decreased from 16% before to 0.5% after fortification. In elderly persons, the prevalence of high serum folate concentrations (>45.3 nmol/L) increased from 7% before to 38% after fortification; 3% had marginally low serum vitamin B-12 concentrations (<148 pmol/L) and 7% had elevated plasma MMA concentrations (>370 nmol/L). Seventy-eight percent of the US population had plasma tHcy concentrations <9 µmol/L.
Conclusions: Every segment of the US population appears to benefit from folic acid fortification. Continued monitoring of B vitamin concentrations in the US population is warranted.
Key Words: Nutrition survey • age • sex • race • ethnic groups • National Health and Nutrition Examination Survey • NHANES
Related articles in AJCN:
This article has been cited by other articles:
|
|
 |
|
  G. M. Lindzon, A. Medline, K.-J. Sohn, F. Depeint, R. Croxford, and Y.-I. Kim Effect of folic acid supplementation on the progression of colorectal aberrant crypt foci Carcinogenesis, September 1, 2009; 30(9): 1536 - 1543. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. J. Piyathilake, M. Macaluso, R. D. Alvarez, W. C. Bell, D. C. Heimburger, and E. E. Partridge Lower Risk of Cervical Intraepithelial Neoplasia in Women with High Plasma Folate and Sufficient Vitamin B12 in the Post-Folic Acid Fortification Era Cancer Prevention Research, July 1, 2009; 2(7): 658 - 664. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Q. Yang, R. M. Bostick, J.M. Friedman, and W. D. Flanders Serum Folate and Cancer Mortality Among U.S. Adults: Findings from the Third National Health and Nutritional Examination Survey Linked Mortality File Cancer Epidemiol. Biomarkers Prev., May 1, 2009; 18(5): 1439 - 1447. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Marian and G. Sacks Micronutrients and Older Adults Nutr Clin Pract, April 1, 2009; 24(2): 179 - 195. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Molloy, P. N. Kirke, J. F. Troendle, H. Burke, M. Sutton, L. C. Brody, J. M. Scott, and J. L. Mills Maternal Vitamin B12 Status and Risk of Neural Tube Defects in a Population With High Neural Tube Defect Prevalence and No Folic Acid Fortification Pediatrics, March 1, 2009; 123(3): 917 - 923. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Lemos, I. Kathmann, E. Giovannetti, J. A.M. Belien, G. L. Scheffer, C. Calhau, G. Jansen, and G. J. Peters Cellular folate status modulates the expression of BCRP and MRP multidrug transporters in cancer cell lines from different origins Mol. Cancer Ther., March 1, 2009; 8(3): 655 - 664. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. H Allen How common is vitamin B-12 deficiency? Am. J. Clinical Nutrition, February 1, 2009; 89(2): 693S - 696S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Selhub, M. S. Morris, P. F Jacques, and I. H Rosenberg Folate-vitamin B-12 interaction in relation to cognitive impairment, anemia, and biochemical indicators of vitamin B-12 deficiency Am. J. Clinical Nutrition, February 1, 2009; 89(2): 702S - 706S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Green Is it time for vitamin B-12 fortification? What are the questions? Am. J. Clinical Nutrition, February 1, 2009; 89(2): 712S - 716S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Kerr, B. Livingstone, C. J. Bates, I. Bradbury, J. M. Scott, M. Ward, K. Pentieva, M. A. Mansoor, and H. McNulty Folate, Related B Vitamins, and Homocysteine in Childhood and Adolescence: Potential Implications for Disease Risk in Later Life Pediatrics, February 1, 2009; 123(2): 627 - 635. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. C. Tangney, Y. Tang, D. A. Evans, and M. C. Morris Biochemical indicators of vitamin B12 and folate insufficiency and cognitive decline Neurology, January 27, 2009; 72(4): 361 - 367. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Y. Tsai, C. M. Loria, J. Cao, Y. Kim, D. Siscovick, P. J. Schreiner, and N. Q. Hanson Clinical Utility of Genotyping the 677C>T Variant of Methylenetetrahydrofolate Reductase in Humans Is Decreased in the Post-Folic Acid Fortification Era J. Nutr., January 1, 2009; 139(1): 33 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. P. Leamon, J. A. Reddy, R. Dorton, A. Bloomfield, K. Emsweller, N. Parker, and E. Westrick Impact of High and Low Folate Diets on Tissue Folate Receptor Levels and Antitumor Responses Toward Folate-Drug Conjugates J. Pharmacol. Exp. Ther., December 1, 2008; 327(3): 918 - 925. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B. Dowd and A. E Aiello Did national folic acid fortification reduce socioeconomic and racial disparities in folate status in the US? Int. J. Epidemiol., October 1, 2008; 37(5): 1059 - 1066. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-I. Kim Folic Acid Supplementation and Cancer Risk: Point Cancer Epidemiol. Biomarkers Prev., September 1, 2008; 17(9): 2220 - 2225. [Full Text] [PDF]
|
|
|
|
|
|
H. Refsum and A D. Smith Are we ready for mandatory fortification with vitamin B-12? Am. J. Clinical Nutrition, August 1, 2008; 88(2): 253 - 254. [Full Text] [PDF]
|
|
|
|
|
|
L. Hao, Q.-H. Yang, Z. Li, L. B Bailey, J.-H. Zhu, D. J Hu, B.-L. Zhang, J D. Erickson, L. Zhang, J. Gindler, et al. Folate status and homocysteine response to folic acid doses and withdrawal among young Chinese women in a large-scale randomized double-blind trial Am. J. Clinical Nutrition, August 1, 2008; 88(2): 448 - 457. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Nguyen, R. Grajeda, P. Melgar, J. Marcinkevage, R. Flores, and R. Martorell Weekly May Be as Efficacious as Daily Folic Acid Supplementation in Improving Folate Status and Lowering Serum Homocysteine Concentrations in Guatemalan Women J. Nutr., August 1, 2008; 138(8): 1491 - 1498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Q.-H. Yang, L. D Botto, M. Gallagher, J. Friedman, C. L Sanders, D. Koontz, S. Nikolova, J D. Erickson, and K. Steinberg Prevalence and effects of gene-gene and gene-nutrient interactions on serum folate and serum total homocysteine concentrations in the United States: findings from the third National Health and Nutrition Examination Survey DNA Bank Am. J. Clinical Nutrition, July 1, 2008; 88(1): 232 - 246. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. G. Luebeck, S. H. Moolgavkar, A. Y. Liu, A. Boynton, and C. M. Ulrich Does Folic Acid Supplementation Prevent or Promote Colorectal Cancer? Results from Model-Based Predictions Cancer Epidemiol. Biomarkers Prev., June 1, 2008; 17(6): 1360 - 1367. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Ueland and S. Hustad Homocysteine and Folate Status in an Era of Folic Acid Fortification: Balancing Benefits, Risks, and B-vitamins Clin. Chem., May 1, 2008; 54(5): 779 - 781. [Full Text] [PDF]
|
|
|
|
|
|
C. M. Pfeiffer, J. D. Osterloh, J. Kennedy-Stephenson, M. F. Picciano, E. A. Yetley, J. I. Rader, and C. L. Johnson Trends in Circulating Concentrations of Total Homocysteine among US Adolescents and Adults: Findings from the 1991-1994 and 1999-2004 National Health and Nutrition Examination Surveys Clin. Chem., May 1, 2008; 54(5): 801 - 813. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Hung, C. M. Abratte, W. Wang, R. Li, D. J. Moriarty, and M. A. Caudill Ethnicity and Folate Influence Choline Status in Young Women Consuming Controlled Nutrient Intakes J. Am. Coll. Nutr., April 1, 2008; 27(2): 253 - 259. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Kotsopoulos, K.-J. Sohn, and Y.-I. Kim Postweaning Dietary Folate Deficiency Provided through Childhood to Puberty Permanently Increases Genomic DNA Methylation in Adult Rat Liver J. Nutr., April 1, 2008; 138(4): 703 - 709. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A D. Smith, Y.-I. Kim, and H. Refsum Is folic acid good for everyone? Am. J. Clinical Nutrition, March 1, 2008; 87(3): 517 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H. Lichtenstein, H. Rasmussen, W. W. Yu, S. R. Epstein, and R. M. Russell Modified MyPyramid for Older Adults J. Nutr., January 1, 2008; 138(1): 5 - 11. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Hoey, H. McNulty, N. Askin, A. Dunne, M. Ward, K. Pentieva, J. Strain, A. M Molloy, C. A Flynn, and J. M Scott Effect of a voluntary food fortification policy on folate, related B vitamin status, and homocysteine in healthy adults Am. J. Clinical Nutrition, November 1, 2007; 86(5): 1405 - 1413. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. K. Kant and B. I. Graubard Ethnicity Is an Independent Correlate of Biomarkers of Micronutrient Intake and Status in American Adults J. Nutr., November 1, 2007; 137(11): 2456 - 2463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M Pfeiffer, C. L Johnson, R. B Jain, E. A Yetley, M. F. Picciano, J. I Rader, K. D Fisher, J. Mulinare, and J. D Osterloh Trends in blood folate and vitamin B-12 concentrations in the United States, 1988 2004 Am. J. Clinical Nutrition, September 1, 2007; 86(3): 718 - 727. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M Ulrich Folate and cancer prevention: a closer look at a complex picture Am. J. Clinical Nutrition, August 1, 2007; 86(2): 271 - 273. [Full Text] [PDF]
|
|
|
|
|
|
A D. Smith Reply to RJ Berry et al Am. J. Clinical Nutrition, July 1, 2007; 86(1): 268 - 269. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Chattopadhyay, R. Tamari, S. H. Min, R. Zhao, E. Tsai, and I. D. Goldman Commentary: A Case for Minimizing Folate Supplementation in Clinical Regimens with Pemetrexed Based on the Marked Sensitivity of the Drug to Folate Availability Oncologist, July 1, 2007; 12(7): 808 - 815. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Q.-H. Yang, H. K Carter, J. Mulinare, R. Berry, J. Friedman, and J D. Erickson 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, 2001-2002 Am. J. Clinical Nutrition, May 1, 2007; 85(5): 1409 - 1416. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-K. Kuo, K.-C. Liao, S. G. Leveille, J. F. Bean, C.-J. Yen, J.-H. Chen, Y.-H. Yu, and T.-Y. Tai Relationship of Homocysteine Levels to Quadriceps Strength, Gait Speed, and Late-Life Disability in Older Adults J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2007; 62(4): 434 - 439. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Fazili, C. M. Pfeiffer, and M. Zhang Comparison of Serum Folate Species Analyzed by LC-MS/MS with Total Folate Measured by Microbiologic Assay and Bio-Rad Radioassay Clin. Chem., April 1, 2007; 53(4): 781 - 784. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. D Stark, R. J Pawlosky, R. J Sokol, J. H Hannigan, and N. Salem Jr Maternal smoking is associated with decreased 5-methyltetrahydrofolate in cord plasma Am. J. Clinical Nutrition, March 1, 2007; 85(3): 796 - 802. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A D. Smith Folic acid fortification: the good, the bad, and the puzzle of vitamin B-12 Am. J. Clinical Nutrition, January 1, 2007; 85(1): 3 - 5. [Full Text] [PDF]
|
|
|
|
|
|
M. S. Morris, P. F Jacques, I. H Rosenberg, and J. Selhub Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification Am. J. Clinical Nutrition, January 1, 2007; 85(1): 193 - 200. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Poo-Prieto, D. B. Haytowitz, J. M. Holden, G. Rogers, S. F. Choumenkovitch, P. F. Jacques, and J. Selhub Use of the Affinity/HPLC Method for Quantitative Estimation of Folic Acid in Enriched Cereal-Grain Products J. Nutr., December 1, 2006; 136(12): 3079 - 3083. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. G.K. Bentley, W. C. Willett, M. C. Weinstein, and K. M. Kuntz Population-Level Changes in Folate Intake by Age, Gender, and Race/Ethnicity after Folic Acid Fortification Am J Public Health, November 1, 2006; 96(11): 2040 - 2047. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Clarke Vitamin B12, folic acid, and the prevention of dementia. N. Engl. J. Med., June 29, 2006; 354(26): 2817 - 2819. [Full Text] [PDF]
|
|
|
|
|
|
L. A Houghton, K. L Sherwood, R. Pawlosky, S. Ito, and D. L O'Connor [6S]-5-Methyltetrahydrofolate is at least as effective as folic acid in preventing a decline in blood folate concentrations during lactation. Am. J. Clinical Nutrition, April 1, 2006; 83(4): 842 - 850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. I. Rader and B. O. Schneeman Prevalence of Neural Tube Defects, Folate Status, and Folate Fortification of Enriched Cereal-Grain Products in the United States Pediatrics, April 1, 2006; 117(4): 1394 - 1399. [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ulrich and J. D. Potter Folate supplementation: too much of a good thing? Cancer Epidemiol. Biomarkers Prev., February 1, 2006; 15(2): 189 - 193. [Full Text] [PDF]
|
|
|
|
|
|
B. Beagle, T. L. Yang, J. Hung, E. A. Cogger, D. J. Moriarty, and M. A. Caudill The Glycine N-Methyltransferase (GNMT) 1289 C->T Variant Influences Plasma Total Homocysteine Concentrations in Young Women after Restricting Folate Intake J. Nutr., December 1, 2005; 135(12): 2780 - 2785. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. H Rosenberg Science-based micronutrient fortification: which nutrients, how much, and how to know? Am. J. Clinical Nutrition, August 1, 2005; 82(2): 279 - 280. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
