Folate and iron status of South African non-pregnanat rural women of childbearing age, before and after fortification of foods

Abstract

Objective: To assess the effect of fortification of staple foods on the folate and iron status of women of childbearing age. Design: A prospective cohort study was undertaken. Setting: Dikgale Demographic Surveillance Site, a rural area in the Capricorn district of Limpopo Province. Subjects. Non-pregnant women of childbearing age, 18 - 44 years (N=80). Outcome measures: Serum folate, ferritin, vitamin B12, red blood cell folate and full blood count. Results: The prevalence of low serum folate (<3ng/ml) in the study population was 27.6% before fortification; after fortification, none of the women had low serum folate. Low red cell folate (<164 ng/ml) was observed in 26.4% of subjects before fortification, and in 1.9% of subjects after fortification. The prevalence of vitamin B12 deficiency (<145 pg/ml) was 6.3% during phase 1 of the study and increased to 11.3% during phase 2. Low haemoglobin levels were present in 7.5% of women before fortification, and in 5% of women after fortification. The percentage of women with low ferritin levels was similar before and after fortification (25%). Conclusion: The study shows a significant improvement in folate status in women of childbearing age approximately 9 months after fortification of maize and wheat foodstuffs in South Africa, whereas no improvement in iron status as measured by serum ferritin was observed.