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Vol. 58, No. 3, 2011
Issue release date: August 2011
Section title: Original Paper
Ann Nutr Metab 2011;58:188–196
(DOI:10.1159/000329726)

Efficacy of Flour Fortification with Folic Acid in Women of Childbearing Age in Iran

Abdollahi Z. · Elmadfa I. · Djazayery A. · Golalipour M.J. · Sadighi J. · Salehi F. · Sadeghian Sharif S.
aNutrition Department, Ministry of Health and Medical Education, bDepartment of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Science, cInstitute for Health Sciences Research, Academic Center for Education, Culture and Research, and dEndocrine Research Center, Shahid Beheshti University of Medical Science, Tehran, and eGorgan Congenital Malformations Research Center, Gorgan University of Medical Sciences, Gorgan, Iran; fDepartment of Nutritional Science, University of Vienna, Vienna, Austria

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/8/2010 10:50:52 AM
Accepted: 5/30/2011 9:50:50 AM
Published online: 7/9/2011

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 2

ISSN: 0250-6807 (Print)
eISSN: 1421-9697 (Online)

For additional information: http://www.karger.com/ANM

Abstract

Background: Flour fortification with folic acid is one of the main strategies for improving folate status in women of childbearing age. No interventional trial on the efficacy of folic acid fortification has been conducted so far in Iran. Objectives: To study the effects of flour fortification with folic acid on any reduction in neural tube defects (NTDs) and folate status of women of childbearing age. Methods: In a longitudinal hospital-based study, 13,361 postpartum women were studied after admission for childbirth before and after fortification. In addition, two cross-sectional surveys were conducted before (2006) and after flour fortification (2008). The cluster sampling method was used and 580 women, 15–49 years old, were studied as a representative sample of Golestan province in the north of Iran. Fasting blood samples were collected to measure serum vitamin B12, folate and plasma homocysteine. Sociodemographic data, health characteristics and dietary intake were determined. Results: The mean daily intakes of folate from natural food before and after flour fortification were 198.3 and 200.8 µg/day, respectively. The total folate intake increased significantly from 198.3 to 413.7 µg/day after fortification (p < 0.001). Folate intake increased by an average of 226 µg/day from fortified bread. The mean serum folate level increased from 13.6 to 18.1 nmol/l; folate deficiency decreased from 14.3 to 2.3% (p < 0.001). The incidence rate of NTDs declined by 31% (p < 0.01) in the post-fortification period (2.19 per 1,000 births; December 2007 to December 2008) compared to the pre-fortification period (3.16 per 1,000 births; September 2006 to July 2007). Conclusions: Implementation of mandatory flour fortification with folic acid can lead to a significant increase in serum folate and a significant decrease in NTDs.


  

Author Contacts

Ibrahim Elmadfa
Department of Nutritional Sciences
University of Vienna, Althanstrasse 14
AT–1090 Vienna (Austria)
Tel. +43 1 427 754 911, E-Mail ibrahim.elmadfa@univie.ac.at

  

Article Information

Received: April 8, 2010
Accepted after revision: May 30, 2011
Published online: July 9, 2011
Number of Print Pages : 9
Number of Figures : 3, Number of Tables : 2, Number of References : 29

  

Publication Details

Annals of Nutrition and Metabolism (Journal of Nutrition, Metabolic Diseases and Dietetics)

Vol. 58, No. 3, Year 2011 (Cover Date: August 2011)

Journal Editor: Koletzko B. (Munich)
ISSN: 0250-6807 (Print), eISSN: 1421-9697 (Online)

For additional information: http://www.karger.com/ANM


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/8/2010 10:50:52 AM
Accepted: 5/30/2011 9:50:50 AM
Published online: 7/9/2011

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 2

ISSN: 0250-6807 (Print)
eISSN: 1421-9697 (Online)

For additional information: http://www.karger.com/ANM


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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