Folate status in Aboriginal people before and after mandatory fortification of flour for bread-making in Australia
Abstract
Background: Mandatory fortification of wheat flour for bread-making was introduced in Australia in September 2009, to assist in the prevention of neural tube defects (NTD). NTD are twice as common in Aboriginal compared with non-Aboriginal infants, and folate levels are lower in the Aboriginal population. Aims: This study was undertaken to compare folate status and NTD in the Aboriginal population before and after fortification. Methods: Postfortification, 95 Aboriginal men and nonpregnant women aged 16–44 years in metropolitan and regional Western Australia (WA) completed a rapid dietary assessment tool and had blood taken to measure red cell folate. Measures were compared with prefortification values obtained in an earlier study using the same methods. Data on NTD in Aboriginal infants were obtained from the WA Register of Developmental Anomalies. Results: No participant was folate deficient. The mean red cell folate increased after fortification to 443 ng/mL for males and 567 ng/mL for females. The mean difference between red cell folate after fortification compared with before was 129 ng/mL for males (95% CI 81–177); t = 5.4; P < 0.0001) and 186 ng/mL for females (95% CI 139–233); t = 7.9; P < 0.0001). Most participants ate fortified shop-bought bread at least weekly, resulting in an estimated additional folate intake per day of 178 (males) and 145 (females) dietary folate equivalents. NTD prevalence fell by 68% following fortification (prevalence ratio 0.32 (CI 0.15–0.69)). Conclusions: The population health intervention of mandatory fortification of wheat flour for bread-making has had the desired effect of increasing folate status and reducing NTD in the Australian Aboriginal population.
Citation
Source Title
ISSN
School
Collection
Related items
Showing items related by title, author, creator and subject.
-
Maxwell, S.; Brameld, Kate; Bower, C.; D'antoine, H.; Hickling, S.; Marley, J.; O'Leary, Peter (2013)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 ...
-
Parkinson, B.; Goodall, S.; Norman, Richard (2013)Background - Economic evaluation of mandatory health programmes generally do not consider the utility impact of a loss of consumer choice upon implementation, despite evidence suggesting that consumers do value having the ...
-
Jacoby, P.; Watson, K.; Bowman, J.; Taylor, A.; Riley, T.; Smith, D.; Lehmann, Deborah (2007)Go to ScienceDirect® Home Skip Main Navigation Links Brought to you by: The University of Western Australia Library Login: + Register Athens/Institution Login Not Registered? - User Name: Password: ...