Folate deficiency epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Epidemiology and Demographics
- The prevalence of folate deficiency is quite variable across the world.
- The deficiency is more commonly seen in countries without folic acid fortification of cereal-grain products. Surveys conducted in several countries show that without fortification, folate deficiency can be a public health problem. The primary age groups affected include preschool children, pregnant women and older people. In the US, folate deficiency was present in school-age children (2.3% of the folate-deficient population), adults (24.5%), and older people (10.8%) before folic acid fortification was introduced.
- In 1998, the FDA has required folic acid fortification of all enriched cereal-grain products in the U.S to to explore the changes in serum and erythrocyte folate status of the adult U.S. population following folic acid fortification of enriched cereal-grain products.
- Subsequent surveys have shown that serum and RBC folate concentrations have increased in the general population of all age and sex groups.[1]
DEMOGRAPHICS
Each year in the United States
- There are 3,000 pregnancies affected by neural tube defects (NTDs) caused by the incomplete closing of the spine and skull.
- About 1,300 babies are born without a neural tube defect since folic acid fortification.
- Many, but not all, neural tube defects could be prevented if women took 400 mcg of folic acid daily, before and during early pregnancy.
- Folate deficiency complicates between 1% and 4% of pregnancies in the United States and affects approximately one-third of pregnancies worldwide.27
Hispanic/Latina Women
- Have the highest rate among women having a child affected by these birth defects.
- Have lower blood folate levels and are less likely to consume foods fortified with folic acid.
- Are less likely to have heard about folic acid, or take vitamins containing folic acid before pregnancy.
Use of Supplements Containing Folic Acid Among Women of Childbearing Age — United States
2007 Survey Data
Among all women of childbearing age:
- 40% reported taking folic acid daily.
- 81% reported awareness of folic acid.
- 12% reported knowing that folic acid should be taken before pregnancy.
Women of childbearing age who were aware of folic acid reported hearing about it from:
- Health care provider (33%)
- Magazine or newspaper (31%)
- Radio or television (23%)
- Women aged 18-24 years were more likely to hear about folic acid from a magazine or newspaper (25%) or school or college (22%) than from their health care provider (17%). Whereas 37% of women aged 25-34 years and 36% of women 35-45 years reported hearing about folic acid from their health care provider.
Among women who reported not taking a vitamin or mineral supplement on a daily basis, the most common reasons were:
- “Forgetting” (33%)
- “No need” (18%)
- “No reason” (14%)
- “Already get balanced nutrition” (12%)
2005 Survey Data
Among all women of childbearing age:
- 33% reported taking folic acid daily.
- 84% reported awareness of folic acid.
- 7% reported knowing that folic acid should be taken before pregnancy.
Among women who reported not taking a vitamin or mineral supplement on a daily basis, the most common reasons were:
- Forgetting to take supplements (28%)
- Perceiving they do not need them (16%)
- Believing they get needed nutrients and vitamins from food (9%)
When asked, “For what specific need would you start taking a vitamin or mineral supplement?” The most common reported needs were:
- Being sick or in poor health (20%)
- A doctor’s recommendation (20%)
- The need for energy (9%)
- Being pregnant (8%)
- Being deficient in any vitamins or minerals (7%)
- Balancing the diet (6%)
- Keeping bones strong (6%)
- In addition, 11% cited no specific need that would motivate them to begin taking a vitamin or supplement. Among women who reported not consuming a vitamin or mineral supplement daily, 31% indicated they had received a doctor’s recommendation.
Economic Cost
- The annual medical care and surgical costs for people with spina bifida exceed $200 million.
- The total lifetime cost of care for a child born with spina bifida is estimated to be $791,900.
Incidence
- The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
- In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
Prevalence
- The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
- In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
- The prevalence of [disease/malignancy] is estimated to be [number] cases annually.
Case-fatality rate/Mortality rate
- In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
- The case-fatality rate/mortality rate of [disease name] is approximately [number range].
Age
- Patients of all age groups may develop [disease name].
- The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
- [Disease name] commonly affects individuals younger than/older than [number of years] years of age.
- [Chronic disease name] is usually first diagnosed among [age group].
- [Acute disease name] commonly affects [age group].
Race
- There is no racial predilection to [disease name].
- [Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
- The prevalence has reported to be higher in African and Asian population.
Gender
- [Disease name] affects men and women equally.
- [Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
Region
- The majority of [disease name] cases are reported in [geographical region].
- [Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
Developed Countries
Developing Countries
References
- ↑ Dietrich M, Brown CJ, Block G (2005). "The effect of folate fortification of cereal-grain products on blood folate status, dietary folate intake, and dietary folate sources among adult non-supplement users in the United States". J Am Coll Nutr. 24 (4): 266–74. PMID 16093404.