Black Andrew P, Vally Hassan, Morris Peter, Daniel Mark, Esterman Adrian, Smith Fiona, O'Dea Kerin
School of Population Health, Division of Health Sciences, University of South Australia; Bulgarr Ngaru Medical Aboriginal Corporation, Grafton, New South Wales.
Aust N Z J Public Health. 2014 Jun;38(3):241-6. doi: 10.1111/1753-6405.12235.
To evaluate the impact of a fruit and vegetable (F&V) subsidy program for disadvantaged Aboriginal children in Australia, implemented alongside the introduction of mandatory folic acid fortification of bread-making flour.
A before-and-after evaluation was undertaken of a F&V subsidy program at three Aboriginal community-controlled health services in New South Wales. The program provided a weekly box of subsidised F&V linked to preventive health services and nutrition promotion for families. In this analysis, red blood cell (RBC) folate was assessed together with self-reported dietary intake at baseline and 12 months later in a cohort of 125 children (aged 0-17 years).
No children had low RBC folate at baseline or at follow-up; however, 33 children (26%) exceeded the reference range of RBC folate at baseline and 38 children (30%) exceeded the reference range at follow-up. Mean RBC folate levels increased substantially in children at follow-up (mean RBC folate z-score increased +0.55 (95%CI 0.36-0.74). Change in F&V intake (p=0.196) and mean bread intake (p=0.676) were not statistically significant predictors for change in RBC folate levels.
RBC folate levels increased among these disadvantaged Aboriginal children following mandatory folic acid fortification and participation in a subsidised F&V program. Even before mandatory folic acid fortification, none of these children had low RBC folate.
The effect on health of mandatory fortification of foods with folate is not clear, hence, ongoing population-based monitoring of folate levels to assess the impact of mandatory folic acid fortification is important.
评估一项针对澳大利亚弱势原住民儿童的果蔬补贴计划的影响，该计划是在面包制作面粉强制添加叶酸的同时实施的。
对新南威尔士州三个由原住民社区控制的健康服务机构实施的果蔬补贴计划进行了前后评估。该计划每周为家庭提供一盒补贴的果蔬，与预防保健服务和营养促进相关。在本分析中，对125名儿童（0至17岁）队列在基线和12个月后的红细胞（RBC）叶酸水平以及自我报告的饮食摄入量进行了评估。
在基线或随访时，没有儿童红细胞叶酸水平低；然而，33名儿童（26%）在基线时红细胞叶酸水平超过参考范围，38名儿童（30%）在随访时超过参考范围。随访时儿童的平均红细胞叶酸水平大幅增加（平均红细胞叶酸z评分增加+0.55（95%CI 0.36 - 0.74））。果蔬摄入量的变化（p = 0.196）和平均面包摄入量的变化（p = 0.676）不是红细胞叶酸水平变化的统计学显著预测因素。
在强制添加叶酸和参与补贴的果蔬计划后，这些弱势原住民儿童的红细胞叶酸水平有所增加。即使在强制添加叶酸之前，这些儿童中也没有红细胞叶酸水平低的情况。
食物强制添加叶酸对健康的影响尚不清楚，因此，持续进行基于人群的叶酸水平监测以评估强制添加叶酸的影响很重要。
