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Folic Acid Intake Among U.S. Women Aged 15–44 Years, National Health and Nutrition Examination Survey, 2003–2006

      Background

      In 1998, the IOM recommended all women capable of becoming pregnant consume 400 μg of folic acid daily to prevent neural tube defects (NTDs).

      Purpose

      This paper aims to describe how different sources of folic acid contribute to achieving the recommended usual daily intake.

      Methods

      Data on 2617 nonpregnant U.S. women aged 15–44 years from the 2003–2004 and 2005–2006 National Health and Nutrition Examination Surveys were analyzed in 2009. The usual daily folic acid intake from diet and supplements accounting for measurement error; the proportion of women consuming the recommended usual intake; and the adjusted associations of recommended intake with multiple characteristics were estimated.

      Results

      Overall, 24% of nonpregnant U.S. women of childbearing age consumed the recommended usual intake (95% CI=20%, 27%). Intake was highest among non-Hispanic white women (30%), followed by Mexican-American (17%) and non-Hispanic black women (9%). Among women who used supplements with folic acid, 72% (95% CI=65%, 79%) consumed the recommended usual intake. Use of supplements was the strongest determinant (unadjusted prevalence ratio [PR]: 10.2, 95% CI=7.1, 14.7) of recommended intake, mediating associations of other characteristics. Among the 68% of women who did not use supplements, consumption of cereals with folic acid and having diabetes were the strongest determinants of recommended usual intake (PRs=20.2 and 0.10, respectively).

      Conclusions

      Given that consumption of folic acid is an important public health goal to prevent NTDs, an evaluation of strategies, beyond recommendations that women consume supplements, is needed.
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