National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia 30333, USA.
Am J Prev Med. 2010 May;38(5):534-42. doi: 10.1016/j.amepre.2010.01.025. Epub 2010 Mar 28.
In 1998, the IOM recommended all women capable of becoming pregnant consume 400 microg of folic acid daily to prevent neural tube defects (NTDs).
This paper aims to describe how different sources of folic acid contribute to achieving the recommended usual daily intake.
Data on 2617 nonpregnant U.S. women aged 15-44 years from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Surveys were analyzed in 2009. The usual daily folic acid intake from diet and supplements accounting for measurement error; the proportion of women consuming the recommended usual intake; and the adjusted associations of recommended intake with multiple characteristics were estimated.
Overall, 24% of nonpregnant U.S. women of childbearing age consumed the recommended usual intake (95% CI=20%, 27%). Intake was highest among non-Hispanic white women (30%), followed by Mexican-American (17%) and non-Hispanic black women (9%). Among women who used supplements with folic acid, 72% (95% CI=65%, 79%) consumed the recommended usual intake. Use of supplements was the strongest determinant (unadjusted prevalence ratio [PR]: 10.2, 95% CI=7.1, 14.7) of recommended intake, mediating associations of other characteristics. Among the 68% of women who did not use supplements, consumption of cereals with folic acid and having diabetes were the strongest determinants of recommended usual intake (PRs=20.2 and 0.10, respectively).
Given that consumption of folic acid is an important public health goal to prevent NTDs, an evaluation of strategies, beyond recommendations that women consume supplements, is needed.
1998 年，IOM 建议所有可能怀孕的女性每天摄入 400 微克叶酸以预防神经管缺陷（NTDs）。
本文旨在描述不同来源的叶酸如何有助于达到推荐的日常摄入量。
对 2003-2004 年和 2005-2006 年国家健康和营养调查中 2617 名年龄在 15-44 岁之间的未怀孕美国女性的数据进行了分析。考虑到测量误差，分析了饮食和补充剂中叶酸的日常通常摄入量；摄入推荐日常摄入量的女性比例；以及推荐摄入量与多种特征的调整关联。
总体而言，24%的育龄美国女性摄入了推荐的日常摄入量（95%CI=20%，27%）。非西班牙裔白人女性的摄入量最高（30%），其次是墨西哥裔美国女性（17%）和非西班牙裔黑人女性（9%）。在使用含叶酸补充剂的女性中，72%（95%CI=65%，79%）摄入了推荐的日常摄入量。使用补充剂是推荐摄入量的最强决定因素（未调整的流行率比[PR]：10.2，95%CI=7.1，14.7），介导了其他特征的关联。在 68%不使用补充剂的女性中，食用含叶酸的谷物和患有糖尿病是推荐日常摄入量的最强决定因素（PRs=20.2 和 0.10）。
鉴于叶酸的摄入是预防 NTDs 的一个重要公共卫生目标，需要对策略进行评估，而不仅仅是建议女性服用补充剂。
