Women from Racial and Ethnic Minority Groups Should Be Encouraged to Consume Vitamin Supplements Containing Folic Acid.

PASADENA, Calif. -- A Kaiser Permanente Southern California research study shows that, even after the U.S. cereals and grains were fortified with folic acid in 1998, women in racial and ethnic minority groups had lower serum folate levels than women who were non-Hispanic White. In addition, women who were obese or overweight had lower serum folate levels than women who were of healthy weight. Study participants who didn't take vitamin supplements containing folic acid were eight times more likely to have the lower serum folate levels when compared with women who took supplements.

The study is published in the February 2006 edition of the American Journal of Obstetrics and Gynecology.

"Until the optimal folate level is identified that confers maximum protection against neural tube defects, health care providers and women's health advocates should continue to encourage women who can become pregnant to take a vitamin containing 400 micrograms of folic acid every day. Our study results suggests that Latinas, black or Pacific Islander women as well as women who are overweight and obese may be particularly at risk of having lower serum folate levels," said Jean M. Lawrence, Sc.D., M.P.H., M.S.S.A., an epidemiologist with the Kaiser Permanente Southern California Department of Research and Evaluation, the study's lead author.

The U.S. Food and Drug Administration mandated that cereals and grain products be fortified with folic acid by January of 1998. Folic acid is used by the body to create new cells. Women who consume 400 micrograms of folic acid prior to becoming pregnant are less likely to have infants with neural tube defects (NTD) than women who consume less than 400 micrograms of folic acid.

"Lower folic acid consumption has been associated with an increased risk of neural tube defects such as spina bifida," said Joe Mulinare, MD, medical epidemiologist of the CDC's program on birth defects and developmental disabilities. This large study is important in that it identifies some populations that could perhaps benefit from additional folic acid consumption, even after fortification in 1998."

Neural tube defects include spina bifida or open spine; anencephaly, the incomplete development of the brain, spinal cord and protective coverings; and encephalocele, when the end of the neural tube fails to close. These conditions annually affect about 3000 pregnancies and 2200 births in the U.S. and the number of pregnancies affected by these conditions have decreased significantly since cereals and grains were fortified with folic acid.

In addition to Dr. Lawrence, the study's other authors are Diana B. Petitti, MD, MPH, and Vicki Chiu, MS, of the Department of Research and Evaluation, Kaiser Permanente Southern California; and Margaret L. Watkins, BSN, MPH, and J David Erickson, DDS, Ph.D, both of the federal Centers for Disease Control and Prevention.

Kaiser Permanente is America's leading integrated health plan. Founded in 1945, it is a nonprofit, group practice prepayment program with Southern California headquarters in Pasadena, California. Kaiser Permanente serves the health care needs of 3.1 million members in Southern California. Today it encompasses the nonprofit Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the for-profit Southern California Permanente Medical Group. Kaiser Permanente's Southern California Region includes more than 47,530 technical, administrative and clerical employees and caregivers, and more than 5,200 physicians representing all specialties.