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Biochemical indicators of B vitamin status in the US population after folic acid fortification: results from the National Health and Nutrition Examination Survey 1999-2000.
Am J Clin Nutr. 2005 Aug; 82(2):442-50.AJ

Abstract

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 approximately 7300 participants aged > or = 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 mumol/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 micromol/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.

Authors+Show Affiliations

National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. cpfeiffer@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16087991

Citation

Pfeiffer, Christine M., et al. "Biochemical Indicators of B Vitamin Status in the US Population After Folic Acid Fortification: Results From the National Health and Nutrition Examination Survey 1999-2000." The American Journal of Clinical Nutrition, vol. 82, no. 2, 2005, pp. 442-50.
Pfeiffer CM, Caudill SP, Gunter EW, et al. Biochemical indicators of B vitamin status in the US population after folic acid fortification: results from the National Health and Nutrition Examination Survey 1999-2000. Am J Clin Nutr. 2005;82(2):442-50.
Pfeiffer, C. M., Caudill, S. P., Gunter, E. W., Osterloh, J., & Sampson, E. J. (2005). Biochemical indicators of B vitamin status in the US population after folic acid fortification: results from the National Health and Nutrition Examination Survey 1999-2000. The American Journal of Clinical Nutrition, 82(2), 442-50.
Pfeiffer CM, et al. Biochemical Indicators of B Vitamin Status in the US Population After Folic Acid Fortification: Results From the National Health and Nutrition Examination Survey 1999-2000. Am J Clin Nutr. 2005;82(2):442-50. PubMed PMID: 16087991.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biochemical indicators of B vitamin status in the US population after folic acid fortification: results from the National Health and Nutrition Examination Survey 1999-2000. AU - Pfeiffer,Christine M, AU - Caudill,Samuel P, AU - Gunter,Elaine W, AU - Osterloh,John, AU - Sampson,Eric J, PY - 2005/8/10/pubmed PY - 2005/9/2/medline PY - 2005/8/10/entrez SP - 442 EP - 50 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 82 IS - 2 N2 - 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 approximately 7300 participants aged > or = 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 mumol/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 micromol/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. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/16087991/Biochemical_indicators_of_B_vitamin_status_in_the_US_population_after_folic_acid_fortification:_results_from_the_National_Health_and_Nutrition_Examination_Survey_1999_2000_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn.82.2.442 DB - PRIME DP - Unbound Medicine ER -