title: Socio-demographic and lifestyle factors associated with folate status among non-supplement-consuming Canadian women of childbearing age.
abstract: OBJECTIVE
  Mandatory folic acid fortification was implemented in Canada in 1998 to reduce the risk of neural tube defects (NTD). Our objective was to assess the relationship between socio-demographic factors and folate status in non-supplement-consuming Canadian women of childbearing age.
  
  
  METHODS
  Data on demographic factors, lifestyle factors, physical measures and red blood cell (RBC) folate concentration were collected from 1,008 non-supplement-consuming women aged 15-49 years in the Canadian Health Measures Survey (2007-2009). RBC folate ³906 nmol/L was used as a cut-off for optimal folate status for protection from NTD.
  
  
  RESULTS
  Approximately 75% of non-supplement consuming women had an RBC folate concentration ³906 nmol/L. Young age (15-19 years), White ethnicity, less than secondary education, lowest income adequacy, smoking and high body mass index were associated with a higher prevalence of lower folate status. After adjustment, only young age (adjusted odds ratio [OR] 1.99-95% confidence interval [CI]: 1.25-3.18) was associated with lower folate status. Less than secondary education (adjusted OR 5.66, 95% CI: 1.10-29.04) and lowest income adequacy (adjusted OR 4.77, 95% CI: 1.06-21.49) were associated with lower folate status in women aged 15-24 and 25-49 years, respectively.
  
  
  CONCLUSIONS
  Many risk factors for lower folate status identified before food fortification was implemented were not associated with folate status in our representative sample of non-supplement-consuming Canadian women. However, younger women, women aged 15-24 with less than secondary education and women aged 25-49 with low income adequacy remain at risk of lower folate status, supporting the continued promotion of folic acid supplement use to women of childbearing age.
authors.forename: Yipu
authors.initials: Y
authors.lastname: Shi
authors.forename: Margaret
authors.initials: M
authors.lastname: De Groh
authors.affiliation: Health Canada. amanda.macfarlane@hc-sc.gc.ca.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: MacFarlane
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood*; D005494:Folic Acid Deficiency / Q000097:blood* / Q000453:epidemiology; D005527:Food, Fortified; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D015999:Multivariate Analysis; D009436:Neural Tube Defects / Q000517:prevention & control; D018673:Nutrition Policy; D009752:Nutritional Status; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D005492:Folic Acid
keywords: Canadian Health Measures Survey; Folate; folic acid; fortification; neural tube defects