scholarly journals Folate status in the US population 20 y after the introduction of folic acid fortification

2019 ◽  
Vol 110 (5) ◽  
pp. 1088-1097 ◽  
Author(s):  
Christine M Pfeiffer ◽  
Maya R Sternberg ◽  
Mindy Zhang ◽  
Zia Fazili ◽  
Renee J Storandt ◽  
...  
Keyword(s):  
Folic Acid ◽  
White Women ◽  
Geometric Mean ◽  
Age Groups ◽  
The United States ◽  
Reproductive Age ◽  
Serum Folate ◽  
Folate Status ◽  
Cereal Grain ◽  
The Us

ABSTRACT Background Enriched cereal-grain products have been fortified in the United States for >20 y to improve folate status in women of reproductive age and reduce the risk of folic acid–responsive neural tube birth defects (NTDs). Objectives Our objectives were to assess postfortification changes in folate status in the overall US population and in women aged 12–49 y and to characterize recent folate status by demographic group and use of folic acid–containing supplements. Methods We examined cross-sectional serum and RBC folate data from the NHANES 1999–2016. Results Serum folate geometric means increased from 2007–2010 to 2011–2016 in persons aged ≥1 y (38.7 compared with 40.6 nmol/L) and in women (35.3 compared with 37.0 nmol/L), whereas RBC folate showed no significant change. Younger age groups, men, and Hispanic persons showed increased serum and RBC folate concentrations, whereas non-Hispanic black persons and supplement nonusers showed increased serum folate concentrations. The folate insufficiency prevalence (RBC folate <748 nmol/L; NTD risk) in women decreased from 2007–2010 (23.2%) to 2011–2016 (18.6%) overall and in some subgroups (e.g., women aged 20–39 y, Hispanic and non-Hispanic black women, and supplement nonusers). After covariate adjustment, RBC folate was significantly lower in all age groups (by ∼10–20%) compared with persons aged ≥60 y and in Hispanic (by 8.2%), non-Hispanic Asian (by 12.1%), and non-Hispanic black (by 20.5%) compared with non-Hispanic white women (2011–2016). The 90th percentile for serum (∼70 nmol/L) and RBC (∼1800 nmol/L) folate in supplement nonusers aged ≥60 y was similar to the geometric mean in users (2011–2014). Conclusions Blood folate concentrations in the US population overall and in women have not decreased recently, and folate insufficiency rates are ∼20%. Continued monitoring of all age groups is advisable given the high folate status particularly in older supplement users.

scholarly journals Impact of Voluntary Folic Acid Fortification of Corn Masa Flour on RBC Folate Concentrations in the U.S. (NHANES 2011–2018)

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 827-827
Author(s):  
Arick Wang ◽  
Charles Rose ◽  
Yan Ping Qi ◽  
Jennifer Williams ◽  
Christine Pfeiffer ◽  
...  
Keyword(s):  
Folic Acid ◽  
The United States ◽  
Reproductive Age ◽  
Fortified Foods ◽  
Folic Acid Fortification ◽  
Folate Status ◽  
Funding Sources ◽  
Cereal Grain ◽  
The Us ◽  
Corn Masa

Abstract Objectives Surveillance data have highlighted continued disparities in neural tube defects (NTDs) among infants of Hispanic women of reproductive age (HWRA) in the United States. Starting in 2017, the US Food and Drug Administration implemented voluntary folic acid fortification of corn masa flour to reduce the risk of NTDs. We assessed folate status, using red blood cell (RBC) folate concentrations, in HWRA (aged 12–49 y) before (2011–2016) and after (2017–2018) voluntary fortification of corn masa, stratified by acculturation factors (i.e., primary language spoken at home, length of time residing in the US). Methods Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 with available RBC folate concentrations for HWRA were analyzed. Additional analyses were conducted among HWRA whose only folic acid source was fortified foods (enriched cereal grain products (ECGP) only), including usual intake and NTD prevalence estimations based on previously published models. Results Overall, RBC folate concentrations (adjusted geometric means) among HWRA remained similar from 2011–2016 to 2017–2018, though RBC folate significantly increased in 2017–2018 among lesser acculturated HWRA consuming ECGP only. Concentrations for those who were born outside the US and resided in the US &lt; 15 y increased from 894 nmol/L (95% CI: 844–946) in 2011–2016 to 1018 nmol/L (95% CI: 982–1162; p &lt; 0.001) in 2017–2018. Primarily Spanish speaking HWRA who consumed ECGP only increased from 941 nmol/L (95% CI: 895–990) in 2011–2016 to 1034 nmol/L (95% CI: 966–1107; p = 0.03) in 2017–2018. We observed no significant changes in the proportion at risk of NTD (&lt;748 nmol/L) and no changes in Bayesian model-based estimated NTD rates. Conclusions This early analysis following voluntary corn masa fortification found an increase in RBC folate concentrations in lesser acculturated groups relying on fortified foods as their primary folic acid source, though HWRA overall had no significant increase in folate concentrations. These early data suggests that there is remaining risk among Hispanics for folate sensitive NTDs; continued monitoring of folate status with NHANES will help assess the long-term efficacy of voluntary fortification. Funding Sources No funding sources outside of salaries.

scholarly journals Folate status and concentrations of serum folate forms in the US population: National Health and Nutrition Examination Survey 2011–2

2015 ◽  
Vol 113 (12) ◽  
pp. 1965-1977 ◽  
Author(s):  
Christine M. Pfeiffer ◽  
Maya R. Sternberg ◽  
Zia Fazili ◽  
David A. Lacher ◽  
Mindy Zhang ◽  
...  
Keyword(s):  
Folic Acid ◽  
National Health ◽  
Geometric Mean ◽  
Population Data ◽  
Serum Folate ◽  
Nutrition Examination Survey ◽  
Folate Status ◽  
Supplement Use ◽  
Health And Nutrition ◽  
Nationally Representative

Serum and erythrocyte (RBC) total folate are indicators of folate status. No nationally representative population data exist for folate forms. We measured the serum folate forms (5-methyltetrahydrofolate (5-methylTHF), unmetabolised folic acid (UMFA), non-methyl folate (sum of tetrahydrofolate (THF), 5-formyltetrahydrofolate (5-formylTHF), 5,10-methenyltetrahydrofolate (5,10-methenylTHF)) and MeFox (5-methylTHF oxidation product)) by HPLC–MS/MS and RBC total folate by microbiologic assay in US population ≥ 1 year (n approximately 7500) participating in the National Health and Nutrition Examination Survey 2011–2. Data analysis for serum total folate was conducted including and excluding MeFox. Concentrations (geometric mean; detection rate) of 5-methylTHF (37·5 nmol/l; 100 %), UMFA (1·21 nmol/l; 99·9 %), MeFox (1·53 nmol/l; 98·8 %), and THF (1·01 nmol/l; 85·2 %) were mostly detectable. 5-FormylTHF (3·6 %) and 5,10-methenylTHF (4·4 %) were rarely detected. The biggest contributor to serum total folate was 5-methylTHF (86·7 %); UMFA (4·0 %), non-methyl folate (4·7 %) and MeFox (4·5 %) contributed smaller amounts. Age was positively related to MeFox, but showed a U-shaped pattern for other folates. We generally noted sex and race/ethnic biomarker differences and weak (Spearman's r< 0·4) but significant (P< 0·05) correlations with physiological and lifestyle variables. Fasting, kidney function, smoking and alcohol intake showed negative associations. BMI and body surface area showed positive associations with MeFox but negative associations with other folates. All biomarkers showed significantly higher concentrations with recent folic acid-containing dietary supplement use. These first-time population data for serum folate forms generally show similar associations with demographic, physiological and lifestyle variables as serum total folate. Patterns observed for MeFox may suggest altered folate metabolism dependent on biological characteristics.

scholarly journals 1483. Maternal Tdap Vaccination During Pregnancy and Immune Response: A Comparison Between Infants Born to Mothers Primed with Acellular or Whole Cell Pertussis Vaccines

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S743-S743
Author(s):  
Fiona Havers ◽  
Tami Skoff ◽  
Marcia Rench ◽  
Monica Epperson ◽  
Jarad Schiffer ◽  
...  
Keyword(s):  
Cord Blood ◽  
Geometric Mean ◽  
Severe Infection ◽  
The United States ◽  
Reproductive Age ◽  
Whole Cell ◽  
Primary Series ◽  
Gestational Age At Delivery ◽  
Antibody Levels ◽  
Lower Birthweight

Abstract Background Acellular pertussis (aP) vaccines replaced whole cell pertussis (wP) vaccines for the recommended childhood primary series in the United States in 1997. As women primed with aP vaccines in childhood enter reproductive age, it is unknown how maternal aP-priming will impact pertussis protection conferred to infants through Tdap (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis) vaccination during pregnancy. Methods Infants born at term to women who had been vaccinated with Tdap at 27-36 weeks’ gestation and ≥ 14 days prior to delivery were included. Geometric mean concentrations (GMC) of pertussis-specific antibodies (measured in IU/mL) in umbilical cord blood of infants born to women born after 1997 (aP vaccine primed) were compared with those born to women born before 1992 (wP vaccine primed). Results 253 and 506 neonates born to aP- and wP-primed women, respectively, were included. Compared with wP-primed women, aP-primed women were younger (19.3 v. 24.5 years), more likely to be Hispanic or non-Hispanic black and to have infants with lower birthweight (3264 v. 3392 grams, p&lt; 0.01 for all). Gestation at Tdap receipt, gestational age at delivery, and interval between Tdap administration and delivery were not statistically different. Antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) were significantly lower among neonates born to aP-primed versus wP-primed mothers (PT: 17.3 v. 36.4, GMC ratio 0.475 (0.408 – 0.552) (Figure); FHA: 104.6 v. 121.4, GMC ratio 0.861 (0.776 – 0.958)). No significant differences were observed between the aP and wP-primed groups for anti- fimbriae (FIM) or anti-pertactin (PRN) antibodies ((FIM: 469.6 v. 577.2, GMC ratio 0.81 (CI 0.65 – 1.01); PRN 338.8 v. 292.6, GMC ratio 1.16 (CI 0.99 – 1.35)). Figure. Distribution of anti-PT antibody levels in cord blood in infants born to women who were primed with whole cell pertussis compared with acellular pertussis vaccines in childhood.* Conclusion The type of pertussis vaccine a woman received during childhood significantly impacted her response to Tdap vaccination during pregnancy; the largest reduction was in anti-PT antibodies thought to be most important in preventing severe infection in infants. These findings suggest that infants born to aP-primed women who received Tdap during pregnancy may have less passive protection against pertussis during the first months of life than those born to wP-primed women. Disclosures All Authors: No reported disclosures

scholarly journals Exploring Attitudes About the Legality of Self-Managed Abortion in the US: Results from a Nationally Representative Survey

2021 ◽  
Author(s):  
Sarah Raifman ◽  
M. Antonia Biggs ◽  
Lauren Ralph ◽  
Katherine Ehrenreich ◽  
Daniel Grossman
Keyword(s):  
Multinomial Logistic Regression ◽  
Public Attitudes ◽  
The United States ◽  
Public Affairs ◽  
Policy Implications ◽  
Reproductive Age ◽  
Factors Associated ◽  
The Us ◽  
The Law ◽  
Nationally Representative

Abstract Introduction Twenty-four states have at least one law in place that could be used to prosecute people for self-managed abortion (SMA), or the termination of a pregnancy outside of the formal healthcare system. We investigated factors associated with public attitudes about SMA legality and legal access to abortion more generally. Methods In August 2017, we surveyed a nationally representative sample of English- and Spanish-speaking women ages 18–49 years in the United States (US) using Ipsos Public Affairs’ KnowledgePanel. Unadjusted and adjusted multinomial logistic regression estimates identify characteristics associated with believing that SMA should not be against the law, compared to should be against the law, with weighting to account for sampling into the panel. Results Overall, 76% (95% CI: 74.3%-77.1%) and 59% (95% CI: 57.3%-60.4%) of participants (n = 7,022, completion rate 50%) reported that abortion and SMA, respectively, should not be against the law; 1% and 19% were unsure. Among those living in a state with at least one law that could be used to prosecute an individual for SMA, the majority (55%, 95% CI: 52.7%-57.9%) believed SMA should not be against the law. Factors associated with believing SMA should not be against the law, compared to should be against the law, included prior abortion experience and higher levels of education and income. Conclusion Most reproductive age women in the US believe that SMA should not be criminalized. There is more uncertainty about SMA legality than about the legality of abortion more generally. Policy Implications US laws that criminalize SMA are not supported by the majority of the people living in their jurisdictions.

Intergenerational Transfers and Public Expenditure on the Elderly in Modern Britain

1988 ◽  
Vol 8 (2) ◽  
pp. 129-146 ◽  
Author(s):  
Paul Johnson ◽  
Jane Falkingham
Keyword(s):  
Social Services ◽  
Elderly Population ◽  
Public Expenditure ◽  
Age Groups ◽  
The Elderly ◽  
The United States ◽  
Generational Conflict ◽  
The Us ◽  
Families With Children ◽  
Poor Children

ABSTRACTIn the United States, much attention has recently been directed to the issue of whether the welfare system has become over-generous to the retired population, at the expense of families with children. The proportion of the US elderly population living in poverty has fallen significantly in the last fifteen years while the number of poor children has increased rapidly, and it has been suggested that this lack of investment in the next generation of workers may have disastrous longterm consequences for the U.S. economy. This paper considers whether similar trends are evident in Britain. It reviews data on the poverty and income of the elderly population, and finds little unequivocal evidence of relative economic gain over the last two decades, although it is clear that many children have suffered from the recent rise in unemployment-induced poverty. It also looks at direct public expenditure on the elderly through both the pension and the health and personal social services systems, and finds no evidence of a transfer of public resources away from children and towards the elderly population. The paper concludes that the British welfare state has been remarkably neutral in its allocation of resources between generations, and that, in the British context, any discussion of inter-generational conflict for welfare resources establishes a false dichotomy, because economic inequality within broad age groups is much greater than inequality between age groups.

scholarly journals Consumption of Folic Acid–Fortified Bread Improves Folate Status in Women of Reproductive Age in Chile

2003 ◽  
Vol 133 (10) ◽  
pp. 3166-3169 ◽  
Author(s):  
Eva Hertrampf ◽  
Fanny Cortés ◽  
J. David Erickson ◽  
Marisol Cayazzo ◽  
Wilma Freire ◽  
...  
Keyword(s):  
Folic Acid ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Folate Status

scholarly journals Serum homocysteine and folate concentrations among a US cohort of adolescents before and after folic acid fortification

2012 ◽  
Vol 15 (10) ◽  
pp. 1818-1826 ◽  
Author(s):  
Daniel A Enquobahrie ◽  
Henry A Feldman ◽  
Deanna H Hoelscher ◽  
Lyn M Steffen ◽  
Larry S Webber ◽  
...  
Keyword(s):  
Folic Acid ◽  
Cardiovascular Health ◽  
Serum Folate ◽  
Vitamin B ◽  
Serum Concentrations ◽  
Folic Acid Fortification ◽  
Serum Homocysteine ◽  
Cereal Grain ◽  
Before And After ◽  
Average Serum

AbstractObjectiveWe assessed serum homocysteine (tHcy) and folate concentrations among US adolescents before and after fortification of cereal-grain products with folic acid, and associations with demographic, behavioural and physiological factors.DesignObservational study conducted among participants of a randomized trial.SettingThe Child and Adolescent Trial for Cardiovascular Health (CATCH) study.SubjectsAdolescents (n2445) in grades 8 (pre-fortification, mean age 14 years) and 12 (post-fortification, mean age 18 years).ResultsAverage serum concentrations of tHcy, folate and vitamin B6increased by 17 %, 16 % and 14 %, respectively, while serum concentrations of vitamin B12decreased by 11 % post-fortification. Folic acid fortification provided, on average, an additional intake of 118 μg folate/d. Male sex (P< 0·0001) and white race (P= 0·0008) were associated with significantly greater increases in tHcy concentration, while increases in BMI (P= 0·006) and serum folate concentration (P< 0·0001) were associated with significant decreases in tHcy concentration. Female sex (P< 0·0001), non-smoking (P< 0·0001), use of multivitamins (P< 0·0001) and higher dietary intake of folate (P= 0·001) were associated with significantly greater increases in serum folate concentrations. From grade 8 to grade 12, the upward age trend in serum tHcy concentration was uninterrupted in its course (P> 0·50); whereas serum folic acid concentration showed a downward trend that incurred a discrete jump upward (17 % higher;P< 0·0001) with fortification. These trends differed significantly for malesv. females (P< 0·001 for interaction).ConclusionsFortification had a significant impact on improving folate status but not serum tHcy concentrations among US adolescents.

scholarly journals Obesity trends in populations of the Russian Federation and the United States of America. Thirty-year long dynamics

2018 ◽  
Vol 17 (4) ◽  
pp. 67-73 ◽  
Author(s):  
V. G. Vilkov ◽  
S. A. Shalnova ◽  
A. D. Deev ◽  
Yu. A. Balanova ◽  
S. E. Efstifeeva ◽  
...  
Keyword(s):  
Russian Federation ◽  
Age Groups ◽  
The United States ◽  
Men And Women ◽  
The Us ◽  
Obesity Trends ◽  
Prevalence Of Obesity ◽  
The Mean ◽  
And Gender ◽  
Gender Categories

Aim. To evaluate the dynamics of obesity and mean body mass index (BMI) in Russia and USA in various age and gender categories during 1975-2014.Material and methods. By a repeat analysis of one-moment studies of Russian and US population in 1975-1982 and 2007-2014, the values of obesity and BMI were assessed in men and women age 25-64 y. o. Into analysis, the data was included from Russian part of the Lipid Clinics study and multicenter ESSE-RF study (Epidemiology of cardiovascular diseases and risk factors in various regions of Russian Federation). American data acquired from the studies NHANES (National Health And Nutrition Examination Survey), open access. Total number of observations 48974.Results. In the 80s of XX century in all age groups of women the mean BMI levels were lower in USA comparing to Russia, in men there were no significant differences. For the following 30 years in Russia the situation improved for men and women <45 y. o. — differences with USA changed modality, and currently BMI in Russia is lower than in USA.Conclusion. Russia was below the US 30 years ago by the mean BMI in females of all ages, with no differences for males. For the following 30 years in the US there was significant increase of BMI in all age strata of men and women, and in Russia dynamics was the same, but lesser. Comparison of the prevalence of obesity in men 30 years ago showed some predominance of obesity in American males, especially young, but not statistically significant. Russian women had higher prevalence of obesity regardless of age. Currently, obesity in young age is more prevalent in men and women of USA, and >45 years old — in Russia.

scholarly journals Prevalence of hypotension in populations of the Russian Federation and the United States of America according to 30-year follow-up

2020 ◽  
Vol 19 (3) ◽  
pp. 2497
Author(s):  
V. G. Vilkov ◽  
S. A. Shalnova ◽  
Yu. A. Balanova ◽  
S. E. Evstifeeva ◽  
A. E. Imaeva ◽  
...  
Keyword(s):  
United States ◽  
Adult Population ◽  
Age Groups ◽  
The United States ◽  
Cross Sectional ◽  
Men And Women ◽  
National Medical ◽  
Health And Nutrition ◽  
The Us ◽  
The Usa

Aim. To study the prevalence of hypotension according to several criteria in the Russia and the USA.Material and methods. We used data of Russian population studies performed in 1975-1982 and ESSE-RF study performed in 2012-2014 at the National Medical Research Center for Therapy and Preventive Medicine. A comparison was made with the data of cross-sectional stu - dies of the US population — National Health and Nutrition Examination Survey (NHANES): NHANES II (1976-1980) and Continuous NHANES (2007-2012). We analyzed age, sex, and systolic and diastolic blood pressure. The prevalence of individuals with hypotension was calculated in men and women of five age groups using four different criteria for hypertension.Results. The prevalence of hypotension in studies of different years according to different criteria was as follows: in the Russia — 0,3-9,0% in men and 2-15% in women; in the USA — 5-30% in men and 8-45% in women. In age group >30 years, the prevalence of hypotension in Russia, by most criteria, decreased approximately by 50% in men and did not change in women. In the United States, according to all criteria, the prevalence in men and women has increased 2-3 times.Conclusion. The prevalence of hypotension in the adult population ranges from decimal percentages to 45% and varies many times depending on the selected criterion.

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