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Session: From the Womb to the World: Impact of Prenatal and Perinatal Exposures on Offspring Outcomes (Oral 21)

(OR21-01-23) Racial Disparities in Folate Status and NTD Risk Among Nonpregnant Women of Reproductive Age: NHANES 1999-2018

Monday, July 24, 2023
4:00 PM – 4:12 PM ET
Location:  Constitution B
ECRAC

    Presenting Author(s)

  • Derek C. Miketinas, PhD, RDN

    Assistant Professor
    Texas Woman's University
    Houston, Texas, United States

    Disclosure(s): ingredion: Grant/Research Support (Ongoing)
    Mead Johnson: Grant/Research Support (Ongoing)
    Reckitt Benckiser: Grant/Research Support (Ongoing)

    • Co-Author(s)

  • Hanqi Luo, PhD

    Assistant Research Professor
    Emory University
    Oakland, California, United States

  • TB

    Tonya Bender, MS

    Global Nutrition Science Reckitt|Mead Johnson, Evansville, IN

  • AB

    Ariana D. Bailey, PhD

    Sr. Scientist
    Global Nutrition Science Reckitt|Mead Johnson, Evansville, IN
    Henderson, Kentucky, United States

  • LB

    Lauren R. Brink, PhD, RD

    Principal Scientist
    Global Nutrition Science Reckitt|Mead Johnson, Evansville, IN
    Evansville, Indiana, United States

Disclosure(s):
Derek C. Miketinas, PhD, RDN: ingredion: Grant/Research Support (Ongoing)
Mead Johnson: Grant/Research Support (Ongoing)
Reckitt Benckiser: Grant/Research Support (Ongoing)
Objectives: The objective of this study was to evaluate folate status measured by RBC folate, and usual folate intake among nonpregnant women of reproductive age in the US.

Methods: This secondary analysis of the NHANES 1999-2018 included nonpregnant women of reproductive age (20-44y) who provided at least 1 reliable dietary recall and had RBC folate values (n = 9,007). RBC folate was assessed using a variety of laboratory methods, and older values were adjusted to account for methodological differences and to align with the latest methods. Neural tube defect (NTD) risk was defined as RBC folate < 748 nmol/L. Dietary folate intake (mcg Dietary Folate Equivalent [DFE]) was assessed using the NCI method and the prevalence of inadequate dietary folate intake (% < Estimated Average Requirement) from foods and supplements was assessed using the cut-point approach.

Results: Mean [SE] RBC folate for the total sample was 1119[8.4] nmol/L, and 18.6[0.5]% of women were at risk for NTD. Mean RBC folate did not change over time (p = .23) and neither did the proportion of women at risk for NTD (p = .25). Non-Hispanic Black women had significantly lower RBC folate (p < .001) compared to all other race/ethnicities, corresponding to a greater risk (36.3%) for NTD compared to Mexican Americans (17.3%), Other Hispanics (20.8%), and Non-Hispanic Whites (14.6%). NTD risk among Non-Hispanic Black women was consistent from 29.6% in 1999 – 2000 to 35.4% in 2017- 2018 (p trend = .85). From 1999-2018, usual folate intake among Non-Hispanic Black women increased from 451[66] to 548[32] mcg DFE/d and the percentage of those with inadequate intake consequently decreased from 60.1% to 24.3% (p for trends < .001). Non-Hispanic Black women’s folate intake from foods and beverages only increased from 263[14] to 408[13] mcg DFE/d (p trend < .001) while their supplemental folate remained stable (p = .35).

Conclusions: Serum RBC folate status among nonpregnant women of reproductive age remained relatively stable over the past 2 decades. Despite increased usual folate intake from foods and beverages over the same period, Non-Hispanic Black women were at greatest risk for NTD based on RBC folate status.

Funding Sources: Funded by Reckitt|Mead Johnson Nutrition