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Folate Intake and Food-Related Behaviors in Nonpregnant, Low-Income Women of Childbearing Age

https://doi.org/10.1016/j.jada.2008.05.004Get rights and content

Abstract

Information about folate intake among low-income women of childbearing age remains limited. This report presents results from a cross-sectional study of folate intake and food-related behaviors in a sample of low-income, nonpregnant women of childbearing age in California. One hundred fifty-seven nonpregnant, low-income (≤185% federal poverty level) women of childbearing age (18 to 45 years) were evaluated for usual intake of natural food folate and synthetic folic acid, as well as specific food-related behaviors. Eighty-five percent of participants met the Recommended Dietary Allowance for folate, but only 37% met the current synthetic folic acid recommendation for reducing the risk of neural tube defects. Intake of naturally occurring food folate and intake of synthetic folic acid from supplements were positively associated with overall healthful food-related behaviors. Nutrition education that includes information about folic acid may be one way to improve folate intake and other healthful food behaviors among low-income women of childbearing age.

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Study Participants

Participants were recruited by trained FSNE staff in four California counties/regions, representing urban and rural settings: Fresno, San Diego, Sonoma, and Shasta/Trinity (combined because one staff administers the program in these two counties). Eligible subjects were 18- to 45-year-old, nonpregnant, low-income (≤185% of federal poverty level) women. Each participant had to be able to read English or Spanish and be the primary food purchaser/preparer in her household. Women were excluded if

Results

Mean age of participants was 31.6 years (range, 18 to 45). Ethnicities included Hispanic (n=89), white (n=56), Native American/Alaskan Native (n=6), Asian/Pacific Islander (n=2), and mixed ethnicity (n=4). All participants from Fresno (n=39) and San Diego (n=41) were Hispanic and completed the surveys in Spanish, whereas the participants from Shasta/Trinity (n=36) and Sonoma (n=41) represented multiple ethnicities and completed the surveys in English. Forty percent of participants received food

Discussion

This study investigated folate intake and food-related behaviors of low-income, nonpregnant women of childbearing age. Although mean intakes were adequate and 85% of participants achieved the RDA for total folate, 63% did not meet the recommended 400 μg of synthetic folic acid per day to reduce neural tube defect risk. This is consistent with a previous study in which 58% of low-income women of childbearing age in California had folic acid intakes less than current recommendations (7).

E. R. Cena is a dietetic intern, University of California, San Francisco, Medical Center; at the time of the study, she was a graduate student researcher, Department of Nutrition, University of California, Davis.

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    A third hypothesis for this study was that providing nutrition education to food stamp recipients would result in positive dietary changes because they would be better equipped for spending their food budget on healthful choices and, in this case, folate-rich foods. It has been shown that simply receiving food stamps without any accompanying nutrition education has no influence on folate intake (13). Similar findings have been reported for other nutrients (29).

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E. R. Cena is a dietetic intern, University of California, San Francisco, Medical Center; at the time of the study, she was a graduate student researcher, Department of Nutrition, University of California, Davis.

A. B. Joy is cooperative extension specialist, Department of Nutrition, University of California, Davis; at the time of the study, she was director, University of California Food Stamp Nutrition Education Program, Department of Nutrition, University of California, Davis.

K. Heneman is assistant project scientist, Department of Nutrition, University of California, Davis; at the time of the study, she was a post-doctoral scholar, Department of Nutrition, University of California, Davis.

S. Zidenberg-Cherr is a cooperative extension specialist, Department of Nutrition, University of California, Davis.

G. Espinosa-Hall is program manager, nutrition and physical activity, Shasta County Public Health, Redding, CA; at the time of the study, she was a nutrition, family, and consumer sciences advisor, University of California Cooperative Extension–Shasta and Trinity Counties, Redding.

L. Garcia is county director and a nutrition, family, and consumer sciences advisor, University of California Cooperative Extension–Sonoma County, Santa Rosa.

C. Schneider is a nutrition, family, and consumer sciences advisor, University of California Cooperative Extension–Fresno County, Fresno.

P. C. Wooten Swanson is a nutrition, family, and consumer sciences advisor, University of California Cooperative Extension–San Diego County, San Diego.

M. Hudes is a senior statistician, Department of Nutritional Sciences and Toxicology, University of California, Berkeley.

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