Low proportions of folic acid deficiency after introduction of mandatory folic acid fortification in remote areas of northern Queensland, Australia: a secondary health data analysis

<b>Background:</b> Australia implemented mandatory folic acid fortification of bread-making flour in 2009. <b>Objective:</b> To assess the impact of folic acid fortification in remote vs. regional urban areas and Indigenous vs. non-Indigenous populations in northern Queensland. <b>Methods:</b> Routinely collected data on folic acid measurements in remote areas and two regional urban centres in northern Queensland between 2004 and 2015 were analysed (<i>n</i> = 13,929) dichotomously (folic deficient vs. non-deficient). <b>Results:</b> Overall prevalence of folic acid deficiency was 3.2% (235/7282) in urban centres compared with 7.2% (480/6647) in remote areas (<i>p</i> p n = 481) in 2004–2008 to 1.5% (<i>n</i> = 126) in 2010–2015 (<i>p</i> p <b>Conclusions:</b> Substantial declines of folic acid deficiency to low and comparable proportions in former high-risk populations indicate that mandatory folic acid fortification of flour has had a population-wide benefit in northern Queensland.