Is Moderate Hyperhomocysteinemia Due to Folic Acid Depletion Rather than Insufficient Dietary Intake?

The UK Department of Health recently recommended that flour be fortified with folic acid, at 2400 μg/kg. The objectives of the present paper were: to determine the consequence of this on folic acid intake of adolescents; to determine the level of fortification necessary to achieve an intake of 400 μg/d in adolescent girls (the amount recommended periconceptionally); to estimate the consequence of fortification on folic acid intake of high flour consumers; and to report on folate intake of adolescents. Dietary intake of folate and flour were determined by analysis of an existing database of the diets of 379 English adolescents. The folic acid intake that would result from white flour fortification with folic acid at 2400 μg/kg was determined and the level of folic acid fortification necessary to achieve an intake of 400 μg/d in girls from this source was also calculated. Without flour fortification, 6·9 % of girls failed to reach the UK lower reference nutrient intake for total folate. Fortification of white flour with folic acid at 2400 μg/kg would result in an additional folic acid intake of 191(SEM 6) μg/d in girls. To ensure 97 % of girls received 400 μg/d from white flour, white flour would need to be fortified at a level of 10 430 μg/kg, resulting in intakes of 1260 μg/d from flour in the highest (97·5 centile) female white flour consumers and 1422 μg/d from flour in the highest (97·5 centile) male white flour consumers.

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Fortification of bakery and corn masa–based foods in Mexico and dietary intake of folic acid and folate in Mexican national survey data

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz224 ◽

2019 ◽

Vol 110 (6) ◽

pp. 1434-1448

Author(s):

Manuela A Orjuela ◽

Fabiola Mejia-Rodriguez ◽

Amado D Quezada ◽

Tania G Sanchez-Pimienta ◽

Teresa Shamah-Levy ◽

...

Keyword(s):

Folic Acid ◽

Dietary Intake ◽

Nutrient Content ◽

Folate Intake ◽

Nutrient Concentrations ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Nutrition Survey ◽

The Impact ◽

Corn Masa

ABSTRACT Background In Mexico, wheat and corn flour fortification with folic acid (FA) was implemented in 2001 and mandated in 2008, but without direct enforcement. Current Mexican nutrient-content tables do not account for FA contained in bakery bread and corn masa–based foods, which are dietary staples in Mexico. Objective The objective of this study was to examine the impact of FA fortification of dietary staples on the proportion of the population consuming below the Estimated Average Requirement (EAR) for folate or above the Tolerable Upper Intake Level (UL) for FA. Methods We measured FA and folate content in dietary staples (bakery bread and tortillas) using microbial assays and MS, and we recalculated FA intake from 24-h recall dietary intake data collected in the 2012 Mexican National Health and Nutrition Survey (Encuesta Nacional de Salud y Nutrición) utilizing estimates from our food measurements, using nutrient concentrations from tortillas to approximate nutrient content of other corn masa–derived foods. The revised FA intake estimates were used to examine population-level intake of FA and dietary folate equivalent (DFE) accounting for geographic differences in FA content with statistical models. Results FA content in dietary staples was variable, whereas use of FA-fortified flour in corn masa tortillas increased with population size in place of residence. Accounting for dietary staples’ FA fortification increased population estimates for FA and DFE intake, resulting in a lower proportion with intake below the EAR and a higher proportion with intake above the UL. Despite accounting for FA-fortified staple foods, 9–33% of women of childbearing age still have intake below the EAR, whereas up to 12% of younger children have intake above the UL. Conclusions Unregulated FA fortification of dietary staples leads to unpredictable total folate intake without adequately impacting the intended target. Our findings suggest that monitoring, evaluation, and enforcement of mandatory fortification policies are needed. Without these, alternate strategies may be needed in order to reach women of childbearing age while avoiding overexposing children.

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Adequately Diversified Dietary Intake and Iron and Folic Acid Supplementation during Pregnancy Is Associated with Reduced Occurrence of Symptoms Suggestive of Pre-Eclampsia or Eclampsia in Indian Women

PLoS ONE ◽

10.1371/journal.pone.0119120 ◽

2015 ◽

Vol 10 (3) ◽

pp. e0119120 ◽

Cited By ~ 26

Author(s):

Sutapa Agrawal ◽

Jasmine Fledderjohann ◽

Sukumar Vellakkal ◽

David Stuckler

Keyword(s):

Folic Acid ◽

Dietary Intake ◽

Folic Acid Supplementation ◽

Indian Women ◽

Acid Supplementation ◽

Iron And Folic Acid

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Folate Transporters Are Found Throughout the Colon of Humans and Their mRNA Expression Appears to Be Unaffected by Low Dose Folic Acid Supplementation

Current Developments in Nutrition ◽

10.1093/cdn/nzab059_010 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1309-1309

Author(s):

Colleen Farrell ◽

Siya Khanna ◽

Md. Tozammel Hoque ◽

Nancy Basset ◽

Aneta Plaga ◽

...

Keyword(s):

Folic Acid ◽

Dietary Intake ◽

Terminal Ileum ◽

Low Dose ◽

Healthy Adults ◽

Folate Intake ◽

Mrna Levels ◽

Plasma Folate ◽

Descending Colon ◽

Folate Transporters

Abstract Objectives A large depot of folate resides in the colon and can exceed dietary intake. Little is known about the capacity of the colon to absorb folate. We aimed to determine the expression of key folate transporters, reduced folate carrier (RFC) and proton-coupled folate transporter (PCFT), throughout the colon of healthy adults and the impact of low dose folic acid (FA) supplementation. Methods In this 16 wk open-labelled randomized control trial, healthy adults (n = 25) from a colonoscopy waiting list were randomized to receive daily a multivitamin plus a 400 μg FA (400FA, n = 12) or no FA supplement (0FA, n = 13). Subjects were provided with low FA bread and pasta and instructions how to follow a low FA containing diet. Six 24-hr diet recalls were administered throughout the study and blood samples were collected at baseline, 8 and 16 wk. At colonoscopy (16 wk), 4 tissue biopsies were collected from the terminal ileum, cecum, ascending and descending colon. Blood folates were determined by microbial assay; mRNA levels of folate transporters were assessed using qPCR. Results One subject was removed from analysis due to missing data (0FA). No group differences in age, sex, BMI, dietary intake, vitamin B12, red blood cell (RBC) and plasma folate levels at baseline were observed. Mean ± SD FA supplement adherence was 92 ± 12% and 96 ± 9% at 8 and 16 wk, respectively. Subjects in the 400FA group had higher total folate intake (P < 0.05) and higher RBC and plasma folate levels (P < 0.01) at 8 and 16 wk compared to 0FA subjects. RBC values at 16 wk were 1764 ± 636 and 865 ± 190 nmol/L in the 400FA and 0FA group, respectively. RFC and PCFT were detected in terminal ileum and colon biopsies (n = 96) and their mRNA levels in each section did not differ between groups. However, expression of RFC was markedly higher than PCFT across all biopsy sections (P < 0.05) and highest in the terminal ileum, compared to the cecum, ascending and descending colon in both groups (P < 0.05). Conclusions We demonstrated expression of folate transporters, RFC and PCFT, throughout the human colon suggesting their potential contribution to overall folate absorption. mRNA expressions were not affected by a low dose FA supplement. A deeper understanding of how FA and folate status affect colonic transporter regulation may inform future revisions of folate intake recommendations. Funding Sources Natural Sciences and Engineering Research Council.

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Intake of fruits, vegetables, folic acid and related nutrients and risk of breast cancer in postmenopausal women

Public Health Nutrition ◽

10.1079/phn19980024 ◽

1998 ◽

Vol 1 (3) ◽

pp. 147-156 ◽

Cited By ~ 39

Author(s):

Barbara Thorand ◽

Lenore Kohlmeier ◽

Naal Simonsen ◽

Carry Croghan ◽

Michael Thamm

Keyword(s):

Breast Cancer ◽

Folic Acid ◽

Dietary Intake ◽

Total Energy ◽

Postmenopausal Women ◽

Energy Intake ◽

Alcohol Intake ◽

Population Based ◽

Total Energy Intake ◽

High Intake

AbstractObjective:To determine the role of fruit and vegetable consumption and dietary intake of folic acid and related nutrients such as methionine, cysteine and alcohol in the aetiology of breast cancer.Design:Population based case-control study.Setting:Part of the European Community Multicentre Study on Antioxidants, Myocardial Infarction, and Cancer of the Breast (EURAMIC) in Berlin, Germany.subjects:As part of the EURAMIC study, dietary intake data were collected in 43 postmenopausal women diagnosed with breast cancer between 191 and 1992 in Berlin, Germany, and compared to 106 population-based controls.Results:Odds ratios (ORs) adjusted for major risk factors of breast cancer but not for total energy intake showed a non-significant inverse association between a high intake of vegetables (OR=0.76, 95% CI=0.48–1.20) and fruits (OR=0.74, 95% CI=0.48–1.15) and breast cancer. Once results were adjusted for total energy intake the associations became much weaker (vegetables: OR=0.86, 95% CI=0.51–1.46; fruits: OR=0.82, 95% CI=0.51–1.32). For all nutrients, the effect of energy adjustment was more profound and the inverse associations disappeared when results were adjusted for energy intake (total folate—not energy adjusted: OR=0.79, 95% CI=O.51–1.21; energy adjusted: OR=1.14, 95% CI=0.73–1.79; folate equivalents-not energy adjusted: OR=0.81, 95% CI= 0.53–1.23; energy adjusted: OR=1.16, 95% CI=0.78–1.74; methionine—not energy adjusted: OR=0.60, 95% CI=0.35–1.03; energy adjusted: OR=1.29, 95% CI=0.76–2.19; cysteine—not energy adjusted: OR=0.52, 95% CI=0.29–0.94; energy adjusted: OR=1.22, 95% CI=0.75–1.97). Alcohol intake was inversely associated with breast cancer in a non-significant way, possibly due to the relatively low alcohol intake of the study population.Conclusions:The results of this study do not provide firm evidence that a high intake of fruits and vegetables, folic acid, methionine or cysteine reduces the risk of getting breast cancer.

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Voluntary fortification of breakfast cereals with folic acid: contribution to dietary intake in Australia

International Journal of Food Sciences and Nutrition ◽

10.3109/09637486.2016.1146234 ◽

2016 ◽

Vol 67 (3) ◽

pp. 225-231 ◽

Cited By ~ 2

Author(s):

Devina Japar ◽

Maria V. Chandra-Hioe ◽

Ashok Shrestha ◽

Jayashree Arcot

Keyword(s):

Folic Acid ◽

Dietary Intake ◽

Breakfast Cereals

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