Presented at the 7th International Conference on Neural Tube Defects, November 6–9, 2011, Austin, Texas.
Article first published online: 29 MAY 2012
Copyright © 2012 Wiley Periodicals, Inc.
Birth Defects Research Part A: Clinical and Molecular Teratology
Special Issue: Papers from the 7th International Neural Tube Defects Conference
Volume 94, Issue 10, pages 749–755, October 2012
How to Cite
Tinker, S. C., Hamner, H. C., Berry, R. J., Bailey, L. B. and Pfeiffer, C. M. (2012), Does obesity modify the association of supplemental folic acid with folate status among nonpregnant women of childbearing age in the United States?. Birth Defects Research Part A: Clinical and Molecular Teratology, 94: 749–755. doi: 10.1002/bdra.23024
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
- Issue published online: 16 OCT 2012
- Article first published online: 29 MAY 2012
- Manuscript Accepted: 5 APR 2012
- Manuscript Revised: 27 MAR 2012
- Manuscript Received: 15 FEB 2012
- folic acid;
- folate status;
Obesity is associated with an increased risk of having a pregnancy affected by a neural tube defect (NTD). It is not clear whether the amount of folic acid required by obese women to protect against NTDs is the same as that for nonobese women.
We analyzed data from the National Health and Nutrition Examination Survey, representative of the noninstitutionalized civilian U.S. population, to assess whether body mass index (BMI; normal weight, overweight, and obese categories) modified the association between supplemental folic acid intake and folate status. We estimated the geometric mean concentration among nonpregnant women of childbearing age (15–44 years) during the postfortification period of: serum folate (2003–2008); red blood cell (RBC) folate (2007–2008); and plasma total homocysteine (tHcy; 2003–2006), adjusted for age, race and ethnicity, and total dietary folate expressed as dietary folate equivalents for strata of supplement use and BMI.
BMI was inversely associated with serum folate among women who did not use supplements containing folic acid; no differences between women in different BMI categories were observed among supplement users. Regardless of supplement use, obese women had the highest RBC folate concentrations. There were no differences in tHcy by BMI, regardless of supplement use.
These results do not support a straightforward modification of the relationship between supplemental folic acid intake and folate status by BMI. In this population, BMI may affect the body distribution of folate, as reflected by lower serum and higher RBC folate levels in obese women who do not use supplements. Birth Defects Research (Part A) 2012. © 2012 Wiley Periodicals, Inc.