Large -scale wheat flour folic acid fortification program increases plasma folate levels among women of reproductive age in urban Tanzania.
Large -scale wheat flour folic acid fortification program increases plasma folate levels among women of reproductive age in urban Tanzania.
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DOI：
10.1371/journal.pone.0182099
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Fawzi W
中科院分区：
文献类型：
--
作者：
Noor RA;Abioye AI;Ulenga N;Msham S;Kaishozi G;Gunaratna NS;Mwiru R;Smith E;Dhillon CN;Spiegelman D;Fawzi W
坦桑尼亚普遍存在维生素和矿物质缺乏问题，已知至少缺乏维生素A、铁、叶酸和锌，特别是对产妇健康、认知发展以及国家的经济潜力造成持久的负面影响。叶酸缺乏与育龄妇女的显著不良健康影响有关，包括神经管缺陷的风险较高。包括坦桑尼亚在内的几个国家已经实施了小麦和玉米粉的强制性强化，但这些计划在发展中国家的有效性的证据仍然有限。我们通过检测18-49岁育龄妇女的叶酸水平来评估坦桑尼亚食品强化计划的有效性。一项前瞻性队列研究，纳入了600名非妊娠女性，同时开始食物强化，并随访1年。在基线、6个月和12个月时收集血液样本、饮食摄入量和强化食品消费数据。使用叶酸结合蛋白的竞争性测定法测定血浆叶酸水平。使用单变量和多变量线性回归，我们比较了从基线开始的6个月和12个月的血浆叶酸水平的变化。我们还使用对数二项回归评估了随访期间叶酸缺乏的相对风险。基线时，这些女性的平均（±SE）强化前血浆叶酸水平为5.44 ng/ml（±2.30）。这些水平在6个月[差异：4.57 ng/ml（±2.89）]和12个月[差异：4.27 ng/ml（±4.18）]时显著改善。基于血浆叶酸截止水平4 ng/ml，基线时叶酸缺乏的患病率为26.9%，12个月时为5%。血浆叶酸水平较基线水平升高1 ng/ml与12个月时叶酸缺乏风险降低25%相关[（RR = 0.75; 95% CI = 0.67-0.85，P<0.001）]。在叶酸缺乏的情况下，叶酸的食物强化计划导致育龄妇女叶酸状况的显着改善。
There is widespread vitamin and mineral deficiency problem in Tanzania with known deficiencies of at least vitamin A, iron, folate and zinc, resulting in lasting negative consequences especially on maternal health, cognitive development and thus the nation’s economic potential. Folate deficiency is associated with significant adverse health effects among women of reproductive age, including a higher risk of neural tube defects. Several countries, including Tanzania, have implemented mandatory fortification of wheat and maize flour but evidence on the effectiveness of these programs in developing countries remains limited. We evaluated the effectiveness of Tanzania’s food fortification program by examining folate levels for women of reproductive age, 18–49 years. A prospective cohort study with 600 non-pregnant women enrolled concurrent with the initiation of food fortification and followed up for 1 year thereafter. Blood samples, dietary intake and fortified foods consumption data were collected at baseline, and at 6 and 12 months. Plasma folate levels were determined using a competitive assay with folate binding protein. Using univariate and multivariate linear regression, we compared the change in plasma folate levels at six and twelve months of the program from baseline. We also assessed the relative risk of folate deficiency during follow-up using log-binomial regression. The mean (±SE) pre–fortification plasma folate level for the women was 5.44-ng/ml (±2.30) at baseline. These levels improved significantly at six months [difference: 4.57ng/ml (±2.89)] and 12 months [difference: 4.27ng/ml (±4.18)]. Based on plasma folate cut-off level of 4 ng/ml, the prevalence of folate deficiency was 26.9% at baseline, and 5% at twelve months. One ng/ml increase in plasma folate from baseline was associated with a 25% decreased risk of folate deficiency at 12 months [(RR = 0.75; 95% CI = 0.67–0.85, P<0.001]. In a setting where folate deficiency is high, food fortification program with folic acid resulted in significant improvements in folate status among women of reproductive age.
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影响因子：
158.5
作者：
CZEIZEL, AE;DUDAS, I
通讯作者：
DUDAS, I
影响因子：
3.5
作者：
Filmer, D;Pritchett, LH
通讯作者：
Pritchett, LH
影响因子：
168.9
作者：
Black, Robert E.;Victora, Cesar G.;Uauy, Ricardo
通讯作者：
Uauy, Ricardo
DOI：
10.3945/jn.114.206078
发表时间：
2015-04
期刊：
The Journal of nutrition
影响因子：
--
作者：
Haddad L;Achadi E;Bendech MA;Ahuja A;Bhatia K;Bhutta Z;Blössner M;Borghi E;Colecraft E;de Onis M;Eriksen K;Fanzo J;Flores-Ayala R;Fracassi P;Kimani-Murage E;Nago Koukoubou E;Krasevec J;Newby H;Nugent R;Oenema S;Martin-Prével Y;Randel J;Requejo J;Shyam T;Udomkesmalee E;Reddy KS
通讯作者：
Reddy KS
影响因子：
3.6
作者：
Barkley, Jonathan S.;Wheeler, Kathleen S.;Pachon, Helena
通讯作者：
Pachon, Helena