scholarly journals Folic Acid Fortification and Women’s Folate Levels in Selected Communities in Brazil - A First Look

2014 ◽  
Vol 84 (5-6) ◽  
pp. 286-294 ◽  
Author(s):  
Hrishikesh Chakraborty ◽  
Kwame A. Nyarko ◽  
Norman Goco ◽  
Janet Moore ◽  
Danilo Moretti-Ferreira ◽  
...  
Keyword(s):  
Folic Acid ◽  
Folate Intake ◽  
Serum Folate ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Folate Supplementation ◽  
Folic Acid Fortification ◽  
Folic Acid Supplements ◽  
Two Samples ◽  
Reproductive Aged Women

Abstract. Background: Several countries have implemented mandatory folic acid fortification of wheat flour and selected grain products to increase the folate intake of reproductive-aged women. Brazil implemented a folic acid fortification program in 2004. No previous studies have examined folate differences among Brazilian women following the mandate. Objective: We evaluate differences in serum and red blood cell (RBC) folate concentrations between two samples of women of childbearing age from selective communities in Brazil, one tested before (N = 116) and the other after the mandate (N = 240). Methods: We compared the baseline folate levels of women enrolled in a prevention study shortly before the fortification mandate was implemented, to baseline levels of women from the same communities enrolled in the same study shortly after fortification began. The participants were women enrolled in a folate supplementation clinical trial, at a hospital specializing in treating craniofacial anomalies in the city of Bauru from January 29, 2004 to April 27, 2005. We only compared baseline folate levels before the women received oral cleft prevention program (OCPP) folic acid supplements. Results: Women enrolled after the fortification mandate had higher means of serum folate (20.3 versus 11.2 nmol/L; p < 0.001) and RBC folate (368.3 versus 177.6 nmol/L; p < 0.001) than women enrolled before the mandate. Differences in folate levels between the two groups remained after adjusting for several co-variables. Conclusions: The results suggest that serum and RBC folate levels among women of childbearing age increased after implementing the folic acid fortification mandate in Brazil.

scholarly journals Folate status in women of childbearing age in the Urban Metropolitan Region of Chile: results from the National Health Survey 2016–2017

2020 ◽  
pp. 1-8
Author(s):  
Dolores Busso ◽  
Guadalupe Echeverría ◽  
Alvaro Passi-Solar ◽  
Fernanda Morales ◽  
Marcelo Farías ◽  
...  
Keyword(s):  
Folic Acid ◽  
Folate Deficiency ◽  
National Health Survey ◽  
Reproductive Age ◽  
Metropolitan Region ◽  
Serum Folate ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Women Of Reproductive Age ◽  
Folic Acid Fortification

Abstract Objective: To analyse serum folate levels in women of childbearing age in the Metropolitan Region (MR) of Chile. Design: Cross-sectional design as part of the 2016–2017 National Health Survey (Encuesta Nacional de Salud, ENS 2016–2017), using a household-based multistage stratified random sample. Serum folate levels measured by electrochemiluminescence immunoassay in fasting venous blood samples were classified as deficient (<4·4 ng/ml), normal (4·4–20 ng/ml) or supraphysiological (>20 ng/ml). Setting: The MR of Chile. Participants: Women of reproductive age (15–49 years, n 222) from the MR participated in the ENS 2016–2017. Results: The mean, median and range of serum folate were 14·2 (se 0·4), 13·9 and 2·1–32·2 ng/ml, respectively. Folate deficiency was detected in 0·9 % of women, while 7·0 % had supraphysiological levels of the vitamin. No significant effects of age, educational level, marital status, parity, smoking status or nutritional status on serum folate levels were detected by univariate or multivariate analyses. Intake of folic acid supplements showed a significant association with serum folate levels, but only 1·2 % of women used supplements. Conclusions: Folate deficiency in women of reproductive age living in the MR of Chile is almost inexistent according to the ENS 2016–2017, suggesting that the current population-wide mandatory folic acid fortification of flour is an effective and equitable measure to prevent folate deficiency. These results support the option of maintaining current folic acid fortification in Chile, particularly based on the low adherence to supplementation regimes evidenced in other populations.

Folate Nutritional Status among Psoriasis Patients not Exposed to Antifolate Drug

2020 ◽  
Vol 16 (4) ◽  
pp. 543-553
Author(s):  
Luciana Y. Tomita ◽  
Andréia C. da Costa ◽  
Solange Andreoni ◽  
Luiza K.M. Oyafuso ◽  
Vânia D’Almeida ◽  
...  
Keyword(s):  
Folic Acid ◽  
Linear Regression ◽  
Multiple Linear Regression Model ◽  
Folate Intake ◽  
Serum Folate ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Folic Acid Fortification ◽  
Plasma Folate ◽  
Psoriasis Severity

Background: Folic acid fortification program has been established to prevent tube defects. However, concern has been raised among patients using anti-folate drug, i.e. psoriatic patients, a common, chronic, autoimmune inflammatory skin disease associated with obesity and smoking. Objective: To investigate dietary and circulating folate, vitamin B12 (B12) and homocysteine (hcy) in psoriatic subjects exposed to the national mandatory folic acid fortification program. Methods: Cross-sectional study using the Food Frequency Questionnaire, plasma folate, B12, hcy and psoriasis severity using the Psoriasis Area and Severity Index score. Median, interquartile ranges (IQRs) and linear regression models were conducted to investigate factors associated with plasma folate, B12 and hcy. Results: 82 (73%) mild psoriasis, 18 (16%) moderate and 12 (11%) severe psoriasis. 58% female, 61% non-white, 31% former smokers, and 20% current smokers. Median (IQRs) were 51 (40, 60) years. Only 32% reached the Estimated Average Requirement of folate intake. Folate and B12 deficiencies were observed in 9% and 6% of the blood sample respectively, but hyperhomocysteinaemia in 21%. Severity of psoriasis was negatively correlated with folate and B12 concentrations. In a multiple linear regression model, folate intake contributed positively to 14% of serum folate, and negative predictors were psoriasis severity, smoking habits and saturated fatty acid explaining 29% of circulating folate. Conclusion: Only one third reached dietary intake of folate, but deficiencies of folate and B12 were low. Psoriasis severity was negatively correlated with circulating folate and B12. Stopping smoking and a folate rich diet may be important targets for managing psoriasis.

scholarly journals Absorption of Folic Acid from Different Delivery Forms: A Randomized, Crossover Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 970-970
Author(s):  
Prasad Devarshi ◽  
Ryan Grant ◽  
Meredith Wilcox ◽  
Moneka Ali ◽  
Lisa Sanders ◽  
...  
Keyword(s):  
Folic Acid ◽  
Crossover Study ◽  
Water Soluble ◽  
Serum Folate ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Maximum Serum ◽  
Study Product ◽  
To Receive ◽  
Randomized Crossover Study

Abstract Objectives Folate, or folic acid, is a water-soluble B vitamin that plays a role in single carbon transfer reactions, which are involved in the synthesis and metabolism of nucleotides and amino acids. It has been established that adequate folic acid intake helps decrease the prevalence of neural tube defects during conception and early pregnancy. The objective of this study was to assess the bioavailability of folic acid from Prenatal Multi Gummies and Folic Acid tablets in women of childbearing age. Methods Eleven healthy, adult, premenopausal women of childbearing age (18–44 years) were recruited for a single-blind, randomized, crossover study. Each participant was randomly assigned to receive a single dose (2 gummies or 2 tablets) of Prenatal Multi Gummies or Folic Acid tablets (containing ∼800 µg folic acid) and then crossed over to receive the other study product after a wash-out period of ∼7 days. The study product was consumed along with a low folic acid breakfast meal. Blood samples were collected for the analysis of serum folate at t = −0.5, 1, 2, 4, 6 and 8 hours where t = 0 is the time of study product consumption. Results The mean serum folate total area under the curve (AUC0–8 hours) was 239.67 ± 24.50 h × ng/mL for the Prenatal Multi Gummies and 255.23 ± 30.17 h × ng/mL for the Folic Acid tablets. For both study products, the dose-adjusted net incremental AUC was significantly greater than 0 h × ng/mL (P ≤ 0.001). The maximum serum folate concentration (Cmax) was 47.69 ± 5.65 ng/mL for the Prenatal Multi Gummies and 52.45 ± 5.86 ng/mL for the Folic Acid tablets, and the median time to maximum serum concentration (Tmax) was 1.00 h for each product (interquartile limits for both included 1.00 to 1.08 hours). Conclusions In conclusion, folic acid contained in the Prenatal Multi Gummies and Folic Acid tablets was absorbed from both the Prenatal Multi Gummies and the Folic Acid tablets. Funding Sources This study was funded by Pharmavite LLC.

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

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.

scholarly journals Not all cases of neural-tube defect can be prevented by increasing the intake of folic acid

2008 ◽  
Vol 102 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Helmut B. Heseker ◽  
Joel B. Mason ◽  
Jacob Selhub ◽  
Irwin H. Rosenberg ◽  
Paul F. Jacques
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Target Population ◽  
Folate Intake ◽  
Vulnerable Groups ◽  
Childbearing Age ◽  
Floor Effect ◽  
Folic Acid Fortification ◽  
Beneficial Effects ◽  
Relative Decline

Some countries have introduced mandatory folic acid fortification, whereas others support periconceptional supplementation of women in childbearing age. Several European countries are considering whether to adopt a fortification policy. Projections of the possible beneficial effects of increased folic acid intake assume that the measure will result in a considerable reduction in neural-tube defects (NTD) in the target population. Therefore, the objective of the present study is to evaluate the beneficial effects of different levels of folic acid administration on the prevalence of NTD. Countries with mandatory fortification achieved a significant increase in folate intake and a significant decline in the prevalence of NTD. This was also true for supplementation trials. However, the prevalence of NTD at birth declined to approximately five cases at birth per 10 000 births and seven to eight cases at birth or abortion per 10 000 births. This decline was independent of the amount of folic acid administered and apparently reveals a ‘floor effect’ for folic acid-preventable NTD. This clearly shows that not all cases of NTD are preventable by increasing the folate intake. The relative decline depends on the initial NTD rate. Countries with NTD prevalence close to the observed floor may have much smaller reductions in NTD rates with folic acid fortification. Additionally, potential adverse effects of fortification on other vulnerable population groups have to be seriously considered. Policy decisions concerning national mandatory fortification programmes must take into account realistically projected benefits as well as the evidence of risks to all vulnerable groups.

Folate Status in Women of Childbearing Age Residing in Southern California after Folic Acid Fortification

2001 ◽  
Vol 20 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Marie A. Caudill ◽  
Thia Le ◽  
Sheniz A. Moonie ◽  
Setareh Torabian Esfahani ◽  
Edward A Cogger
Keyword(s):  
Folic Acid ◽  
Southern California ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Folic Acid Fortification ◽  
Folate Status
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