Abstract
BackgroundThe benefits of folic acid for prevention of congenital anomalies are well known. For the Inuit of Canada, where vitamin use is low and access to folate-rich foods limited, fortification is likely a major source of intake. We sought to determine whether red blood cell folate (RBCF) levels of Inuit women reached accepted target levels.MethodsThe Inuit Health Survey, 2007–2008, included evaluation of RBCF levels among 249 randomly selected non-pregnant women of reproductive age. Using descriptive statistics and linear regression analyses, RBCF levels were assessed and compared across several socio-demographic variables to evaluate the characteristics associated with RBCF status.ResultsMean (SD) RBCF levels of 935.5 nmol/L (± 192) reached proposed target levels (> 906 nmol/L); however, 47% of women had lower than target levels. In bivariate analysis, non-smoking, higher education, higher income, food security, increased body mass index, and vitamin use were each significantly associated with higher RBCF. Increased levels of smoking had a negative association with RBCF levels (− 5.8 nmol/L per cigarette smoked per day (p = 0.001)). A total of 6.8% of women reported taking vitamin supplements, resulting in a 226 nmol/L higher RBCF level on average compared to non-users (p < 0.001).ConclusionWhile mean levels of folate reached target levels, this was largely driven by the small number of women taking vitamin supplements. Our results suggest that folate status is often too low in Inuit women of childbearing years. Initiatives to improve food security, culturally relevant education on folate-rich traditional foods, vitamin supplements, and smoking cessation/reduction programs may benefit Inuit women and improve birth outcomes.
Highlights
An adequate maternal blood folate level during the periconceptional period significantly reduces the likelihood of a neural tube defect at birth (Czeizel and Dudas 1992)
It has been previously observed that Inuit, residing in Canada’s Northern regions of Baffin Island, Nunavut and Nunavik, had nearly twice the rate of total birth defects compared to non-Inuit in other parts of the country (Arbour et al 2004), increased rates which persist in more recent assessments, especially for congenital heart defects (Public Health Agency of Canada 2013)
With a measured mean red blood cell folate (RBCF) level of 935.5 ± 192 nmol/L, our findings suggest that at the population level, the average Inuit woman of childbearing age has a sufficient folate/folic acid intake to reach target levels
Summary
An adequate maternal blood folate level during the periconceptional period significantly reduces the likelihood of a neural tube defect at birth (Czeizel and Dudas 1992). For this reason, Canada introduced mandatory folic acid fortification of cereal and grain products in November 1998 as a public health measure to reduce the incidence of neural tube defects (Public Health Agency of Canada 1998). It has been previously observed that Inuit, residing in Canada’s Northern regions of Baffin Island, Nunavut and Nunavik, had nearly twice the rate of total birth defects compared to non-Inuit in other parts of the country (Arbour et al 2004), increased rates which persist in more recent assessments, especially for congenital heart defects (Public Health Agency of Canada 2013). We sought to determine whether red blood cell folate (RBCF) levels of Inuit women reached accepted target levels
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
