Press Release

Blood folate levels up in American women: Potential for reduction in birth defects

As the first sign that the nation's effort to fortify foods with folic acid to prevent birth defects is succeeding, the Centers for Disease Control and Prevention announced today new findings showing that folate levels of American women of child-bearing age are on the rise. These increased folate levels, mostly due to food fortification, will potentially reduce women's risk of having a baby born with a birth defect of the spine or brain (spina bifida or anencephaly).

As reported in the October 27 issue of the Morbidity Mortality Weekly Report, the CDC's 1999 National Health and Nutrition Examination Survey found that the average level of folic acid in the blood almost tripled from 6.3 to 16.2 nanograms per milliliter and red blood cell folate concentrations, a better measure of long-term folate status, show an average increase from 181 to 315 ng/mL RBC.

Similar increases in folate levels were shown for women who were not pregnant and therefore less likely to use a supplement containing folic acid; for those who were taking a vitamin/mineral supplement; and for those who had not used supplements.

"This is an important step toward reducing the risk of a life-threatening and disabling birth defect in the U.S.," said CDC Director Jeffrey P. Koplan, M.D.. M.P.H.

To prevent neural tube defects, the U.S. Public Health Service recommended in 1992 that women of childbearing age increase daily consumption of the vitamin folic acid. Since then, national efforts have been implemented to increase the use of dietary supplements containing folic acid. In 1996, the U.S. Food and Drug Administration mandated that all enriched cereal grain products be fortified with folic acid by January1998.

Food fortification was determined to be the best strategy for increasing blood folate levels since the critical period for adequate folic acid intake is in the first weeks of pregnancy, before most women know they are pregnant and begin taking prenatal vitamins. Since many pregnancies are unintended or not recognized in the early stages, women are more likely to consume folic acid from food than from supplements.

Much of the increase in folic acid is likely the result of food fortification since the number of women using supplements was similar in the two surveys.

"Efforts to increase folate levels are working due to sound public health research and action," said Jane Henney, FDA Commissioner.

In addition to food fortification, CDC is working with the March of Dimes and the National Council on Folic Acid to conduct a national campaign to educate women of reproductive age on the need to consume folic acid daily before and during pregnancy. The campaign stresses that folic acid can be obtained from fortified foods or by consuming a multivitamin supplement daily. Information about this campaign can be obtained at www.cdc.gov/nceh/cddh/folic.

The National Health and Nutrition Examination Survey, a nationally representative sample of the nation's civilian, noninstitutionalized population, is conducted by CDC and consists of an interview in the home as well as a standardized physical examination and laboratory tests. Serum and red blood cell folate were measured by CDC's environmental health laboratory.

CDC protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES