Table 5.
Adjusted red blood cell (RBC) folate concentrations of U.S. Hispanic women of reproductive age (12–49 years), who were enriched cereal grain product (ECGP)a only consumers from NHANES 2011–2018, stratified by acculturation factors and pre- and post-implementation of corn masa fortification.
| Time Period | n | Adjusted Geometric Mean b of RBC Folate, nmol/L (95% CI) | p Value (within Time Periods) | p Value (between Time Periods) | % with RBC Folate Concentration < 748 nmol/L c (95% CI) | p Value (within Time Periods) | p Value (between Time Periods) | Adjusted Odds Ratio d of Having an RBC Folate Concentration < 748 nmol/L (95% CI) | |
|---|---|---|---|---|---|---|---|---|---|
| Time spent in U.S | |||||||||
| U.S Born | 2011–2016 | 499 | 950 (918, 982) | REF | 19.9 (16.2, 23.5) | REF | REF | ||
| Born outside U.S, been in U.S ≥ 15 years | 164 | 975 (916, 1037) | 0.47 | 20.3 (13.6, 27.0) | 0.92 | 1.22 (0.70, 2.12) | |||
| Born outside U.S, been in U.S < 15 years | 216 | 894 (844, 946) | 0.07 | 27.7 (19.9, 35.5) | 0.08 | 1.86 (1.00, 3.44) | |||
| U.S Born | 2017–2018 | 143 | 918 (812, 1037) | REF | 0.60 | 25.2 (18.0, 32.5) | REF | 0.19 | REF |
| Born outside U.S, been in U.S ≥15 years | 59 | 1039 (929, 1162) | 0.14 | 0.33 | 14.8 (5.4, 24.2) | 0.09 | 0.35 | 0.40 (0.10, 1.50) | |
| Born outside U.S, been in U.S <15 years | 49 | 1018 (982, 1057) | 0.11 | <0.001 | 22.8 (13.7, 31.9) | 0.69 | 0.42 | 0.39 (0.12, 1.25) | |
| Primary language spoken at home | |||||||||
| Primarily English | 2011–2016 | 365 | 936 (900, 972) | REF | 21.2 (17.4, 25.1) | REF | REF | ||
| Equal Spanish and English | 181 | 952 (893, 1015) | 0.65 | 23.1 (16.6, 29.6) | 0.62 | 1.17 (0.71, 1.92) | |||
| Primarily Spanish | 361 | 941 (895, 990) | 0.85 | 22.6 (17.6, 27.6) | 0.66 | 1.35 (0.84, 2.17) | |||
| Primarily English | 2017–2018 | 99 | 879 (776, 996) | REF | 0.35 | 28.8 (16.6, 41.1) | REF | 0.24 | REF |
| Equal Spanish and English | 59 | 958 (848, 1082) | 0.34 | 0.93 | 25.3 (15.9, 34.6) | 0.66 | 0.71 | 0.36 (0.06, 2.19) | |
| Primarily Spanish | 104 | 1034 (966, 1107) | 0.03 | 0.03 | 15.8 (10.0, 21.5) | 0.06 | 0.08 | 0.26 (0.06, 1.05) | |
| Masa consumption | |||||||||
| No | 2011–2016 | 435 | 946 (913, 981) | REF | 22.1 (17.9, 26.3) | REF | REF | ||
| Yes | 479 | 936 (909, 964) | 0.65 | 21.7 (18.1, 25.4) | 0.89 | 1.05 (0.71, 1.54) | |||
| No | 2017–2018 | 124 | 942 (834, 1063) | REF | 0.94 | 26.7 (18.2, 35.2) | REF | 0.34 | REF |
| Yes | 141 | 953 (892, 1018) | 0.87 | 0.64 | 19.4 (13.4, 25.3) | 0.17 | 0.51 | 0.51 (0.12, 2.14) |
a Abbreviations: enriched cereal grain product (ECGP), National Health and Nutrition Examination Survey (NHANES), red blood cell (RBC); b Geometric means adjusted for age, education, poverty-income ratio (PIR), body mass index (BMI), and ethnicity; c Associated with NTD rate of ≥9 per 10,000 live births; d Odds ratios adjusted for age, education, PIR, BMI, and ethnicity; p-values determined using Student’s t-test. “Between time periods” examined differences pre- and post-fortification within the subpopulation; “Within time periods” examined differences between the subpopulation and reference group within the pre- or post-fortification time periods.