scholarly journals Folate and Vitamin B12 Status in Women of Reproductive Age in Rural Areas in Haryana, Northern India (P10-117-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Reena Das ◽  
Mona Duggal ◽  
Manmeet Kaur ◽  
Hari Kishan Senee ◽  
Gursharan Singh Dhanjal ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Wheat Flour ◽  
Rural Areas ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Reproductive Age ◽  
Serum Folate ◽  
Women Of Reproductive Age ◽  
B12 Deficiency

Abstract Objectives To conduct a household and biomarker survey to assess the baseline prevalence of folate deficiency and insufficiency and vitamin B12 deficiency in women of reproductive age prior to the start of a wheat flour fortification program in the Ambala District in Haryana, India. Methods A multistage cluster probability household and biomarker survey was conducted. Participants were women of reproductive age (18–49 y) who were not pregnant and resided in rural areas of two subdistricts in Ambala District in Haryana. Venous blood samples were collected among 866 women. Plasma, serum, and red blood cells (RBC) were separated by centrifugation, processed, and stored at <-80ºC until analysis. RBC and serum folate concentrations were measured using microbiologic assay and serum vitamin B12 was measured via chemiluminescence. Serum folate deficiency was defined as serum folate <7 nmol/L and RBC folate deficiency and insufficiency were defined as RBC folate <305 nmol/L and <748 nmol/L, respectively. Vitamin B12 deficiency was defined as vitamin B12 <200 pg/mL and vitamin B12 marginal deficiency was defined as vitamin B12 ≥200 and <300 pg/mL. Results The geometric mean concentrations for serum folate, RBC folate, and serum vitamin B12 were 12.3 (95% confidence interval [CI]: 11.8, 12.9) nmol/L, 544 (95% CI: 516, 573) nmol/L, and 190 (95% CI: 176, 206) pg/mL, respectively. The prevalence of folate deficiency was 11.3% (95% CI: 9.2, 13.9) for serum folate and 9.7% (95% CI: 7.8, 12.0) for RBC folate, and the prevalence of RBC folate insufficiency was 78.6% (95% CI: 74.8, 82.5). A total of 58.3% (95% CI: 54.2, 62.5) of women were vitamin B12 deficient (<200 pg/mL) and an additional 22.9% (95% CI: 19.7, 26.1) were marginally deficient for vitamin B12. Conclusions The magnitude of folate insufficiency and vitamin B12 deficiency in this Northern Indian population is a substantial public health concern. The findings from the survey help establish the baseline for a planned wheat flour fortification program aimed at reducing these micronutrient deficiencies. Funding Sources Centers for Disease Control and Prevention.

scholarly journals Vitamin B12 Status and Metabolic Health in Women of Reproductive Age in Southern India

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 646-646
Author(s):  
Heather Guetterman ◽  
Krista Crider ◽  
Amy Fothergill ◽  
Beena Bose ◽  
Christina Johnson ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Metabolic Health ◽  
Reproductive Age ◽  
Whole Body ◽  
Women Of Reproductive Age ◽  
Metabolic Outcomes ◽  
B12 Deficiency ◽  
Stage 1

Abstract Objectives To examine the burden of metabolic outcomes and associations of vitamin B12 status with metabolic health in women of reproductive age (WRA), as part of a population-based biomarker survey in Chittoor, India. Methods Participants (980 WRA; 15–40y nonpregnant or lactating) were assessed for glycated hemoglobin (HbA1c; nephelometry) and serum vitamin B12 concentrations (chemiluminescence). Anthropometric measurements and systolic (SBP) and diastolic (DBP) blood pressures were collected in triplicate. Bioelectrical impedance analysis was used to evaluate whole body (WF%) and trunk (TF%) fat among women ≤ 18y. We defined elevated HbA1c as ≤ 6.5% and ≤ 5.7-&lt; 6.5%, and hypertension as stage 1 (SBP 130–139 or DBP 80–89 mmHg) and stage 2 (SBP ≤ 140 or DBP ≤ 90 mmHg). Vitamin B12 was natural logarithmically transformed prior to analyses; vitamin B12 deficiency was defined as &lt; 148 pmol/L. Linear and binomial regression models were used to examine associations of vitamin B12 status with metabolic outcomes. Results A total of 23.3% of adult WRA were overweight (body mass index (BMI): 25.0 to &lt; 30.0 kg/m2) and 9.7% had obesity (≤30.0 kg/m2). Waist circumference (WC; ≤88.9 cm) and waist-hip ratio (WHR; ≤0.85) were elevated in 13.4% and 20.1% of adult WRA. One-fourth of WRA had elevated HbA1c (≤6.5%: 5.0%; ≤5.7-&lt; 6.5%: 20.0%), and 18.6% had hypertension (stage 1: 16.4%; stage 2: 2.2%); 48.3% of WRA were vitamin B12 deficient. Higher continuous vitamin B12 concentrations were associated with lower BMI (β [standard error (SE)] -0.65 [0.28]) and WF% (-1.01 [0.50]); lower risk of elevated WC (risk ratio (RR) [95% confidence interval] 0.64 [0.49–0.85]); and higher risk of HbA1c ≤ 5.7% (1.19 [1.00–1.41]). Vitamin B12 deficiency was associated with higher BMI (β [SE] 0.98 [0.34], p = 0.004), WC (1.96 [0.76]), WF% (1.75 [0.59]), and TF% (2.03 [0.73]); and higher risk of having overweight (RR: 1.31 [1.09–1.58]), elevated WC (1.85 [1.32–2.60]), and WHR (1.38 [1.07–1.78]). Conclusions The burden of adverse metabolic outcomes was substantial in this population, and vitamin B12 deficiency was associated with central adiposity and overweight. Evaluating the role of vitamin B12 in the development of metabolic outcomes in future studies could inform screening and interventions to improve vitamin B12 status and metabolic health in WRA. Funding Sources Centers for Disease Control and Prevention.

scholarly journals Prevalence of iron, folate, and vitamin B12 deficiencies in 20 to 49 years old women: Ensanut 2012

2015 ◽  
Vol 57 (5) ◽  
pp. 385 ◽  
Author(s):  
Teresa Shamah-Levy ◽  
Salvador Villalpando ◽  
Fabiola Mejía-Rodríguez ◽  
Lucía Cuevas-Nasu ◽  
Elsa Berenice Gaona-Pineda ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Urban Areas ◽  
Age Groups ◽  
Vitamin B12 Deficiency ◽  
Reproductive Age ◽  
Serum Folate ◽  
Women Of Reproductive Age ◽  
Nutrition Survey ◽  
B12 Deficiency

 Objective. To describe the prevalence of iron, folate, and B12 deficiencies in Mexican women of reproductive age from the National Health and Nutrition Survey (Ensanut) 2012.Materials and methods. Data came from a  ationalprobabilistic survey, representative from rural and urban areas,and different age groups. Blood samples were obtained from 4 263, 20 to 49 years old women for serum ferritin, vitamin B12 and serum folate oncentrations. The prevalence of deficiencies, was assessed using adjusted logistic regression models. Results. The deficiency of folate was 1.9% (95%CI1.3-2.8), B12 deficiency was 8.5% (95%CI 6.7-10.1) and iron deficiency was 29.4% (95%CI 26.5-32.2). No differences were found when compared with 2006, 24.8% (95%CI 22.3-27.2).Conclusions. The vitamin B12 deficiency is still a problem for women of reproductive age and their offspring in Mexico,while folate deficiency disappeared as a problem. Iron deficiency needs prevention and fortification strategies. 

scholarly journals Prevalence and possible factors associated with anaemia, and vitamin B12and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018007 ◽  
Author(s):  
Sajid Soofi ◽  
Gul Nawaz Khan ◽  
Kamran Sadiq ◽  
Shabina Ariff ◽  
Atif Habib ◽  
...  
Keyword(s):  
National Level ◽  
Serum Vitamin ◽  
Folate Deficiency ◽  
Reproductive Age ◽  
Serum Folate ◽  
Health Concern ◽  
Vitamin B ◽  
Women Of Reproductive Age ◽  
Factors Associated ◽  
Weekly Intake

ObjectiveTo determine the prevalence and possible factors associated with anaemia, and vitamin B12and folate deficiencies in women of reproductive age (WRA) in Pakistan.MethodsA secondary analysis was conducted on data collected through the large-scale National Nutrition Survey in Pakistan in 2011. Anaemia was defined as haemoglobin levels <12 g/dL, vitamin B12deficiency as serum vitamin B12levels of <203 pg/mL (150 pmol/L) and folate deficiency as serum folate levels <4 ng/mL (10 nmol/L).ResultsA total of 11 751 blood samples were collected and analysed. The prevalence of anaemia, vitamin B12deficiency and folate deficiency was 50.4%, 52.4% and 50.8%, respectively. After adjustment, the following factors were positively associated with anaemia: living in Sindh province (RR 1.07; 95% CI 1.04 to 1.09) P<0.00, food insecure with moderate hunger (RR 1.03; 95% CI 1.00 to 1.06) P=0.02, four or more pregnancies (RR 1.03; 95% CI 1.01 to 1.05) P<0.00, being underweight (RR 1.03; 95% CI 1.00 to 1.05) P=0.02, being overweight or obese (RR 0.95; 95% CI 0.93 to 0.97) P<0.00 and weekly intake of leafy green vegetables (RR 0.98; 95% CI 0.95 to 1.00) P=0.04. For vitamin B12deficiency, a positive association was observed with rural population (RR 0.81; 95% CI 0.66 to 1.00) P=0.04, living in Khyber Pakhtunkhwa province (RR 1.25; 95% CI 1.11 to 1.43) P<0.00 and living in Azad Jammu and Kashmir (RR 1.50; 95% CI 1.08 to 2.08) P=0.01. Folate deficiency was negatively associated with daily and weekly intake of eggs (RR 0.89; 95% CI 0.81 to 0.98) P=0.02 and (RR 0.88; 95% CI 0.78 to 0.99) P=0.03.ConclusionsIn Pakistan, anaemia, and vitamin B12and folate deficiencies are a severe public health concern among WRA. Our findings suggest that further research is needed on culturally appropriate short-term and long-term interventions within communities and health facilities to decrease anaemia, and vitamin B12and folate deficiencies among Pakistani women.

Low serum vitamin B12 is associated with recurrent pregnancy loss in Syrian women

2008 ◽  
Vol 46 (9) ◽  
Author(s):  
Ulrich Hübner ◽  
Ahmad Alwan ◽  
Muhidin Jouma ◽  
Mohammad Tabbaa ◽  
Heike Schorr ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Methylmalonic Acid ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Serum Folate ◽  
Functional Markers ◽  
Unexpected Result ◽  
Recurrent Abortion ◽  
B12 Deficiency ◽  
Low Serum

Abstract: Hyperhomocysteinemia and B-vitamin deficiency are associated with recurrent abortion. Recent studies have not investigated functional markers of vitamin B12 deficiency, such as methylmalonic acid.: A total of 43 consecutive Syrian women with unexplained recurrent abortion and 32 pregnant controls were enrolled in the study. Serum folate, vitamin B12, methylmalonic acid and plasma homocysteine were determined.: Vitamin B12 was significantly decreased in patients with recurrent abortion compared to controls (mean concentrations 197 vs. 300 pg/mL, p=0.004). The lowest mean serum vitamin B12 (172 pg/mL) was observed in primary aborters. Homocysteine was elevated in aborters in comparison to controls (8.3 vs. 7.1 μmol/L, p=0.093). Folate and methylmalonic acid did not differ significantly between the study groups. A highly significant correlation between homocysteine and methylmalonic acid and vitamin B12 was observed only in patients but not in controls (p<0.001 and p=0.002, respectively). In the logistic regression model, only serum vitamin B12 emerged with a significant odds ratio.: The results confirm low serum vitamin B12 in recurrent abortion patients. However, methylmalonic acid did not support that functional vitamin B12 plays a role in this group. This unexpected result might be due to a decrease of the metabolically inert vitamin B12 fraction (holohaptocorrin) or confounding factors. Further studies are necessary to investigate the role of vitamin B12 deficiency in recurrent abortion.Clin Chem Lab Med 2008;46:1265–9.

Serum Folate of Less than 7.0 ng/mL is a Marker of Malnutrition

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S87-S87
Author(s):  
S N Mattox ◽  
D Kozman ◽  
G Singh
Keyword(s):  
Vitamin B12 ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Normal Serum ◽  
Serum Folate ◽  
Folate Supplementation ◽  
B12 Deficiency ◽  
The Difference

Abstract Introduction/Objective To identify clinical/laboratory factors associated with folate deficiency in tertiary care patients. Methods We reviewed the medical records of 1019 patients with serum folate &lt;7.0 ng/mL, 301 patients with serum folate of 15 ng/mL, and 300 patients with serum folate &gt; 23 ng/mL. Results Serum prealbumin levels were subnormal in 54.8% of patients with serum folate &lt;7.0 ng/mL. Vitamin B12, hemoglobin, and serum albumin levels were significantly lower in the &lt;7.0 ng/mL folate group. In 62.4% of patients with serum folate &lt;7.0 ng/mL, 1 or more markers of malnutrition were present. The low-folate group had a significantly higher prevalence of gastrointestinal (GI) disorders, sepsis, and abnormal serum creatinine level. There were no significant differences in the 2 groups regarding diabetes; behavioral/neurological disorders, including drug and alcohol abuse; bariatric surgery; or a diagnosis of malnutrition. The average body mass index (BMI) for the &lt;7.0 ng/mL and 15 ng/mL folate groups was significantly different (28.89 and 28.31, respectively), although the difference does not appear to be clinically meaningful. Conclusion The prevalence of folate deficiency depends on what is considered a normal serum folate level. Approximately 10% of tertiary care patients have levels &lt;7.0 ng/mL and exhibit other markers of malnutrition. It is recommended that patients with GI disorders, chronic kidney disease, and sepsis be routinely tested for serum folate levels, before administration of vitamin supplements. Patients with serum folate levels &lt;7.0 ng/mL should be evaluated for malnutrition, despite BMI &gt; 25. Folate supplementation should be administered only after excluding coexisting vitamin B12 deficiency.

scholarly journals Total Homocysteine, Vitamin B12, and Total Antioxidant Status in Vegetarians

2001 ◽  
Vol 47 (6) ◽  
pp. 1094-1101 ◽  
Author(s):  
Wolfgang Herrmann ◽  
Heike Schorr ◽  
Kathrin Purschwitz ◽  
Fausi Rassoul ◽  
Volker Richter
Keyword(s):  
Vitamin B12 ◽  
Antioxidant Status ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Total Antioxidant Status ◽  
Serum Folate ◽  
Gas Chromatography Mass Spectrometry ◽  
Animal Products ◽  
Total Antioxidant ◽  
B12 Deficiency

Abstract Background: Decreasing or eliminating animal products from the diet decreases the intake of some essential nutrients, such as vitamin B12, which may lead to hyperhomocysteinemia. We investigated vitamin B12-dependent metabolism and oxidative stress in groups with various or no intake of meat or animal products. Methods: We investigated 44 high meat eaters, 19 low meat eaters, 34 lacto-ovo/lacto vegetarians, and 7 vegan vegetarians. Homocysteine (HCY) was assayed by HPLC, methylmalonic acid (MMA) by capillary gas chromatography–mass spectrometry, serum folate and vitamin B12 with a chemiluminescence immunoassay, and total antioxidant status (TAS) by a Randox method. Results: The mean serum HCY concentration of vegetarians was significantly increased, and in vegans the median concentration exceeded 15 μmol/L. Vegetarians had a higher serum concentration of MMA but a lower TAS. Vitamin B12 and folate did not differ significantly between vegetarian and omnivorous subjects. Overall, HCY and MMA were significantly correlated. Vitamin B12 correlated negatively with MMA, HCY, and folate, whereas the correlation with TAS was positive. Backward regression analysis revealed an independent influence of MMA on HCY, of HCY and vitamin B12 on MMA, and of vitamin B12 on TAS. The increased MMA concentration suggested a 25% frequency of functional vitamin B12 deficiency in all vegetarians. Serum vitamin B12 was below the lower reference limit in only five subjects. Conclusions: Functional vitamin B12 deficiency in vegetarians may contribute to hyperhomocysteinemia and decreased TAS, which may partly counteract the beneficial lifestyle of vegetarians. However, increased serum HCY is most likely not responsible for the lower TAS values in vegetarians. We recommend assaying of MMA and HCY to investigate functional vitamin B12 status.

scholarly journals Serum folate, vitamin B12 levels and clinicohematological profile in 200 anaemic children aged 1-5 years

2018 ◽  
Vol 5 (6) ◽  
pp. 2167
Author(s):  
Sunita Arora ◽  
Pushpjeet Singh Sheemar ◽  
Mandeep Singh Khurana ◽  
Jaskiran Kaur ◽  
Ashwani Kumar
Keyword(s):  
Vitamin B12 ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Serum Folate ◽  
Age Group ◽  
Folate Supplementation ◽  
Total Prevalence ◽  
B12 Deficiency ◽  
Combined Deficiency

Background: This study was conducted in 200 anaemic children aged 1-5 years to check their serum folate, vitamin B12 levels and their correlation with sociodemographic parameters and clinicohaematological profile.Methods: Present study was a hospital based observational cross-sectional study carried out in paediatric OPD and IPD of tertiary care institute in Amritsar. Study subjects included 200 anaemic children aged 1-5 years attending paediatric OPD or admitted in IPD of paediatrics department of SGRDIMSAR, Amritsar. Serum folate, vitamin B12 levels were measured in 200 enrolled anaemic children and their correlation with sociodemographic parameters and clinicohaematological profile was studied.Results: Isolated vitamin B12 deficiency was present in 22 (11%), folate deficiency in 28 (14%) and combined deficiency was present in 10 (5%) cases. Isolated vitamin B12 deficiency was more prevalent in 1-2-year age group 10 (45.5%) cases, isolated folate deficiency in 2-3 years age group 12 (42.9%) cases whereas combined deficiency was more prevalent in 4-5 years age group 6 cases (60%). Statistically significant correlation was observed between severity of anaemia and poor socio-economic status, nutritional status, rural background. There was statistically significant association between vitamin B12 deficiency and poor socioeconomic status. Folate and combined deficiency had a positive correlation with age group. Combined vitamin B12 and folate deficiency had a statistically significant correlation with severity of anaemia.Conclusions: Apart from iron deficiency anaemia, vitamin B12 and folate deficiency contributes significantly in total prevalence of anaemia. Vitamin B12 and folate supplementation is equally important in prevention as well as treatment of nutritional deficiency anaemias in paediatric population.

Relationships among Urinary Aminoimidazolecarboxamide in Urine and Folate, and Vitamin B12 Concentrations in Serum

1973 ◽  
Vol 19 (9) ◽  
pp. 1049-1052 ◽  
Author(s):  
J W Harrison ◽  
B A Slade ◽  
W Shaw
Keyword(s):  
Vitamin B12 ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Strong Relationship ◽  
Automated System ◽  
Serum Folate ◽  
B12 Deficiency ◽  
The Mean ◽  
Folate And Vitamin B12

Abstract Urinary aminoimidazolecarboxamide (AIC), serum folate, and serum vitamin B12 values were determined in 84 apparently healthy individuals. An automated system for determination of AIC in urine is described. Despite claims to the contrary, we found no evidence of a strong relationship between elevated (e.g., &gt;1.3 µg/mg of creatinine) AIC excretion as reflected in a casual sample of urine and folate or vitamin B12 deficiency. Urinary AIC values ranged from 0.10 to 5.20 µg/mg of creatinine. The mean for the population examined was 1.36 ± 1.02 µg/mg of creatinine.

scholarly journals Cobalamin and folate status in malnourished children

2017 ◽  
Vol 4 (4) ◽  
pp. 1480 ◽  
Author(s):  
Suresh Goyal ◽  
Kavita Tiwari ◽  
Pradeep Meena ◽  
Sunny Malviya ◽  
Mohd. Asif
Keyword(s):  
Vitamin B12 ◽  
Severe Acute Malnutrition ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Acute Malnutrition ◽  
Serum Folate ◽  
Plasma Vitamin ◽  
Folate Status ◽  
Malnourished Children ◽  
B12 Deficiency

Background: Vitamin B12 and folate are essential micronutrients which are critical especially during infancy and early childhood as these are periods of rapid growth, development, and increased demand. Malnutrition further increases the risk of these micronutrient deficiency due to poor socioeconomic status, inadequate intake and poor absorption. Aim of present work was to study the cobalamin and folate status in malnourished children.Methods: A hospital based observational study on 80 children suffering from severe acute malnutrition (SAM) aged 6-60 months. Detailed socio-economic, feeding and development history with complete anthropometric evaluation was done. Blood samples sent for measurement of plasma vitamin B12 and serum folate levels. Statistical analysis was done using SPSS version 20.0.Results: Mean age of SAM children was 17.25±12.60 months. 30 (37.5%) had vitamin B12 deficiency (vitamin B12 levels<100pg/ml) and 9 (11.25%) had borderline vitamin B12 levels (100-200pg/ml). Folate deficiency was found in only 7 (8.75%) children. Mean vitamin B12 and folate levels were found to be 353.65±330.76pg/ml, 11.18±4.17ng/ml respectively. Among vitamin B12 deficient children, majority (26, 86.66%) belong to lower socio-economic status, 17 (56.66%) were still predominantly on breast feeding and 11 (36.66%) had delayed introduction of complementary feeding. Among B12 deficient children 23 (76.66%) had delayed development (DQ <70). 100% of B12 deficient children were anemic with majority (21,70%) having severe anemia. 17 (56.66%) B12 deficient children also had associated thrombocytopenia (PC <1.5 lakh/cumm).Conclusions: There was a high prevalence of vitamin B12 deficiency among malnourished children. Folate deficiency was found only in few. Efforts should be directed to prevent its deficiency in pregnant and breastfeeding women and their infants with special attention on malnourished children.

Serum Folate of Less than 7.0 ng/mL is a Marker of Malnutrition

2020 ◽  
Vol 51 (5) ◽  
pp. 507-511
Author(s):  
Diana Kozman ◽  
Samantha Mattox ◽  
Gurmukh Singh
Keyword(s):  
Vitamin B12 ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Normal Serum ◽  
Serum Folate ◽  
Folate Supplementation ◽  
B12 Deficiency ◽  
The Difference

Abstract Objective To identify clinical/laboratory factors associated with folate deficiency in tertiary care patients. Methods We reviewed the medical records of 1019 patients with serum folate &lt;7.0 ng/mL, 301 patients with serum folate of 15 ng/mL, and 300 patients with serum folate &gt; 23 ng/mL. Results Serum prealbumin levels were subnormal in 54.8% of patients with serum folate &lt;7.0 ng/mL. Vitamin B12, hemoglobin, and serum albumin levels were significantly lower in the &lt;7.0 ng/mL folate group. In 62.4% of patients with serum folate &lt;7.0 ng/mL, 1 or more markers of malnutrition were present. The low-folate group had a significantly higher prevalence of gastrointestinal (GI) disorders, sepsis, and abnormal serum creatinine level. There were no significant differences in the 2 groups regarding diabetes; behavioral/neurological disorders, including drug and alcohol abuse; bariatric surgery; or a diagnosis of malnutrition. The average body mass index (BMI) for the &lt;7.0 ng/mL and 15 ng/mL folate groups was significantly different (28.89 and 28.31, respectively), although the difference does not appear to be clinically meaningful. Conclusions The prevalence of folate deficiency depends on what is considered a normal serum folate level. Approximately 10% of tertiary-care patients have levels &lt;7.0 ng/mL and exhibit other markers of malnutrition. It is recommended that patients with GI disorders, chronic kidney disease, and sepsis be routinely tested for serum folate levels, before administration of vitamin supplements. Patients with serum folate levels &lt;7.0 ng/mL should be evaluated for malnutrition, despite BMI &gt; 25. Folate supplementation should be administered only after excluding coexisting vitamin B12 deficiency.

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