Baseline investigations of folate status in Aboriginal and non-Aboriginal West Australians prior to the introduction of mandatory fortification

Authors

  • Susannah J. Maxwell,

    1. Department of Health, Office of Population Health Genomics, Perth, Western Australia, Australia
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  • Kate J. Brameld,

    1. Department of Health, Peel and Rockingham Kwinana Mental Health Service, Perth, Western Australia, Australia
    2. Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University of Technology, Bentley, Western Australia, Australia
    3. School of Population Health, University of Western Australia, Crawley, Western Australia, Australia
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  • Caroline Bower,

    1. Western Australian WA Register of Developmental Anomalies, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia
    2. Telethon Institute for Child Health, Centre for Child Health Research, The University of Western Australia, Crawley, Western Australia, Australia
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  • Heather D'Antoine,

    1. Menzies School of Health, Charles Darwin University, Darwin, Northern Territory, Australia
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  • Siobhan Hickling,

    1. School of Population Health, University of Western Australia, Crawley, Western Australia, Australia
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  • Julia Marley,

    1. The Rural Clinical School of Western Australia, The University of Western Australia, Crawley, Western Australia, Australia
    2. Kimberley Aboriginal Medical Services Council Inc, Broome, Western Australia, Australia
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  • Peter O'Leary

    Corresponding author
    1. Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University of Technology, Bentley, Western Australia, Australia
    2. School of Pathology & Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia
    3. School of Women's & Infants' Health, University of Western Australia, Crawley, Western Australia, Australia
    • Department of Health, Office of Population Health Genomics, Perth, Western Australia, Australia
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Correspondence: Prof Peter O'Leary, Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Email: peter.oleary@curtin.edu.au

Abstract

Objective

In September 2009, Australia implemented mandatory folic acid fortification of wheat flour for bread-making to reduce the incidence of neural tube defects. Our study aimed to establish baseline folate status data in Aboriginal and non-Aboriginal Western Australians.

Methods

Patients who presented at a health service or collection centre for blood tests were invited to participate. One hundred and ninety-one Aboriginals and 159 non-Aboriginals were recruited between April 2008 and September 2009. Participants completed a five-minute questionnaire and had blood taken for red blood cell (RBC) folate and serum vitamin B12. Data were analysed using SPSS (version 17.0.2, SPSS Inc., Chicago, IL, USA).

Results

Ten per cent (95% confidence intervals (CI): 5, 19) of the Aboriginal women participants and 26% (95% CI: 16, 40) of men had RBC folate concentrations below 250 ng/mL, the cut-off associated with folate deficiency. None of the non-Aboriginal women (95% CI: 0, 4) and 4% of the non-Aboriginal men (95% CI: 2, 12) had RBC folate concentrations below 250 ng/mL. All participants were vitamin B12 replete. None of the 96 Aboriginal and 8% of non-Aboriginal women aged 16–44 reported consumption of supplements with a daily intake of >400 μg folic acid during the previous week.

Conclusions and implications

This study established a baseline of RBC folate, folate consumption and supplement use in Aboriginal and non-Aboriginal groups. We identified 10% of Aboriginal women and none of non-Aboriginal women participants with low folate concentrations. The higher prevalence of folate deficiency in Aboriginal participants suggests they are more likely to benefit from a universal program of folate fortification.

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