Knowledge of folic acid and neural tube defects among inner-city residents: have they heard about it?

A randomized trial has documented a causal link between periconceptional consumption of folic acid and incidence of neural tube defects (1). In response, the Centers for Disease Control and Prevention (Atlanta, Ga) recommends that women who have had a pregnancy affected by neural tube defect consume daily, under the supervision of a physician, a pill supplement containing 4 mg folic acid while planning to become pregnant again (2). In 1992, the US Public Health Service recommended that all women of childbearing age consume 0.4 mg folic acid daily (3). In 1994, the US Food and Drug Administration (FDA) approved a claim about the connection between folic acid and neural tube defects for inclusion on labels of dietary supplements containing this vitamin (4). Furthermore, FDA ruled that cereal products such as enriched flour, breads, cornmeal, rice, and pasta be fortified with 100 to 140 [[micro]gram] folic acid per serving beginning January 1, 1998 (5).

In spite of these recommendations, little attention has been paid to nutrition and health education as a way to increase folic acid consumption and prevent neural [TABULAR DATA FOR TABLE 1 OMITTED] tube defects. Thus, it is important to document the knowledge of folic acid and neural tube defects in different populations, particularly low-income groups who are usually the last to receive information relevant to better health and nutrition decisions (6-14).

The specific aims of this inner-city study were to assess the knowledge of good food sources of folic acid, neural tube defects, and the relationship between periconceptional consumption of folic acid and neural tube defects.

METHODS

Survey

This study was approved by the human subject review committees of the University of Connecticut and the Hispanic Health Council. A household-to-household survey of food and nutrition knowledge, attitudes, and behaviors was conducted in the 5 predominantly Latino neighborhoods of inner-city Hartford, Conn. Data were collected between January 1 and September 30, 1997. The criterion for selecting the neighborhoods was that, according to census data, at least half of its residents identified themselves as Latino. Sample size estimations (15) indicated that 500 respondents were needed to obtain a representative assessment of the nutrition knowledge, attitudes, and practices of the population living in these neighborhoods. The …