Near elimination of folate deficiency anemia by mandatory folic acid fortification in older US asults: REasons for Geographic and Racial Differences in Stroke study (REGARDS) 2004-2007 Pubblico
Odewole, Oluwaseun Anike Temitope (2012)
Abstract
ABSTRACT
Prevalence of Folate deficiency and Folate Deficiency Anemia in the
REasons for Geographic and Racial Differences in Stroke study
(REGARDS)
By: Oluwaseun A. Odewole
BACKGROUND: The US implemented mandatory folic acid
fortification in 1998. While several studies have documented the
resulting decrease in anemia and folate deficiency, none has
determined the prevalence of folate deficiency anemia
post-fortification.
OBJECTIVE: We aim to determine the prevalence of folate deficiency and folate deficiency anemia within a sample of the REGARDS cohort.
METHODS: REGARDS is a prospective cohort (collected from January 2003 to October 2007) comprised of 42% black and 58%white participants. We measured mean serum folate concentrations on a sample of 1,547 REGARDS participants who were 45 years and older and had baseline hemoglobin and red cell mean corpuscular volume (MCV) measurements. Folate deficiency was defined as serum folate concentrations <3.0 ng/mL and anemia was defined using both the WHO definition and age, sex, race specific criteria. Folate deficiency anemia was defined as the presence of both folate deficiency and anemia.
RESULTS: Mean hemoglobin level was 13.6g/dL and the prevalence of anemia by WHO definition in the sample was 15.9%. Mean serum folate was 14.6 ng/mL and two (0.13%) participants were found to be folate deficient. Both participants are African American females with markedly elevated C reactive protein levels and macrocytosis but had normal serum B12 levels. Of these two participants, only one had folate deficiency with anemia. Overall, the prevalence of folate deficiency anemia in the sample was 0.06%.
CONCLUSION: There is almost no folate deficiency anemia in our sample of REGARSDS participants from the post-fortification era. Thus, in addition to being instrumental in the decline of neural tube defects, our data suggests that folic acid fortification has also resulted in nearly eliminating the prevalence of folate deficiency anemia in the US in particular among those over age 50.
Table of Contents
Table of Contents
BACKGROUND...1
MANUSCRIPT...4
Student contribution...5
Abstract...6
Introduction...8
Methods...9
Results...11
Discussion...13
References...16
Tables...20
Table 1: Characteristics of study participants,
REGARDS 2003-2007...20
Table 2: Hematologic Parameters of study participants, REGARDS
2003-2007...21
Table 3: Characteristics of folate deficient participants, REGARDS
2003-2007...22
PUBLIC HEALTH IMPLICATIONS AND RECOMENDATIONS...23
REFERENCES...25
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