Original Article

Does obesity modify the association of supplemental folic acid with folate status among nonpregnant women of childbearing age in the United States?†‡

  1. Sarah C. Tinker1,*,
  2. Heather C. Hamner1,
  3. Robert J. Berry1,
  4. Lynn B. Bailey2,
  5. Christine M. Pfeiffer3

Article first published online: 29 MAY 2012

DOI: 10.1002/bdra.23024

Issue

Birth Defects Research Part A: Clinical and Molecular Teratology

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

Additional Information

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

Author Information

  1. 1

    National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA

  2. 2

    Department of Foods and Nutrition, University of Georgia College of Family and Consumer Sciences, Athens, GA

  3. 3

    National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA

*1600 Clifton Road NE, Mail-Stop E86, Atlanta, GA 30333

  1. †

    Presented at the 7th International Conference on Neural Tube Defects, November 6–9, 2011, Austin, Texas.

  2. ‡

    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.

Publication History

  1. Issue published online: 16 OCT 2012
  2. Article first published online: 29 MAY 2012
  3. Manuscript Accepted: 5 APR 2012
  4. Manuscript Revised: 27 MAR 2012
  5. Manuscript Received: 15 FEB 2012

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Keywords:

  • folic acid;
  • folate status;
  • obesity;
  • NHANES

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

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