scholarly journals Erythrocyte folate analysis: a cause for concern?

1998 ◽  
Vol 44 (9) ◽  
pp. 1886-1891 ◽  
Author(s):  
Anthony J A Wright ◽  
Paul M Finglas ◽  
Susan Southon
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Quaternary Structure ◽  
Venous Blood ◽  
Red Cell ◽  
Adequate Intake ◽  
Folate Status ◽  
Erythrocyte Folate

Abstract Neural tube defects can be prevented by adequate intake of periconceptional folate, and inverse associations between folate status and cardiovascular disease and various cancers have been noted. Thus, there is renewed interest in the analysis of red cell folate (RCF) as an indicator of folate deficiency risk. Assessment of the assumptions that underpin RCF assays indicates that many are false. Published literature suggests that increased deoxy-hemoglobin (which can bind RCF electrostatically) yields more assayable folate, and increased oxy-hemoglobin (which cannot bind RCF) yields less assayable folate. It is argued that as deoxy-hemoglobin picks up oxygen and switches quaternary structure, any bound folate must, on purely theoretical grounds, become physically “trapped”. Venous blood taken for analysis is 65% to 75% saturated with oxygen, and pro-rata “trapping” will lead to serious underestimation of RCF. Hence, doubt is cast over the validity of all previous RCF values. Some strategies for accurately assessing RCF are suggested.

scholarly journals Inadequate Status and Low Awareness of Folate in Switzerland—A Call to Strengthen Public Health Measures to Ensure Sufficient Intakes

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3729
Author(s):  
Isabelle Herter-Aeberli ◽  
Nina Wehrli ◽  
Kurt Bärlocher ◽  
Maria Andersson ◽  
Janice Sych
Keyword(s):  
Pregnant Women ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Online Survey ◽  
Elevated Risk ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Convenience Sample ◽  
Folate Concentration ◽  
Folate Status

Background: Folate plays an essential role in the prevention of neural tube defects, yet little is known about the folate status of women of reproductive age or to what degree the general population is aware of the importance of folate in early-life development. We aimed to determine folate status in women of reproductive age and pregnant women in Switzerland, and to assess folate awareness in the Swiss population. Methods: In a convenience sample of 171 women of reproductive age and 177 pregnant women throughout Switzerland, we measured red blood cell (RBC) folate concentration. In a second convenience sample (n = 784, men and women) we assessed folate knowledge with an online survey. Results: RBC folate concentration (median interquartile range) was 442 (366, 564) nmol/L in women of reproductive age and 873 (677, 1177) nmol/L in pregnant women. Folate deficiency (RBC folate <340 nmol/L) was found in 19.9% of women of reproductive age and 2.8% of pregnant women, while 91.8% of women of reproductive age and 52.0% of pregnant women showed folate concentrations indicating an elevated risk of neural tube defects (RBC folate <906 nmol/L). The online survey showed that a high proportion (≥88%) of participants were aware of folate’s role in neural tube defect (NTD) prevention and fetal development, yet knowledge about dietary sources and national recommendations of folate supplementation when planning pregnancy were limited. Conclusion: The high prevalence of folate inadequacy in Swiss women suggests an elevated risk of neural tube defects and calls for urgent measures to increase folate intakes.

scholarly journals Measurement of Maternal Folate Status and Risk of Neural Tube Defects

1997 ◽  
Vol 43 (1) ◽  
pp. 185-186 ◽  
Author(s):  
Gregory S Makowski ◽  
Sidney M Hopfer
Keyword(s):  
Neural Tube ◽  
Neural Tube Defects ◽  
Folate Status

scholarly journals Is there more to folates than neural-tube defects?

2003 ◽  
Vol 62 (3) ◽  
pp. 591-598 ◽  
Author(s):  
Paul M. Finglas ◽  
Anthony J. A. Wright ◽  
Caroline A. Wolfe ◽  
David J. Hart ◽  
Dawn M. Wright ◽  
...  
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Gene Polymorphisms ◽  
Common Gene ◽  
Folate Status ◽  
Health And Disease ◽  
Precision And Accuracy ◽  
Folate Bioavailability ◽  
B Vitamin

The purpose of the present paper is to review our current understanding of the chemistry and biochemistry of folic acid and related folates, and to discuss their impact on public health beyond that already established in relation to neural-tube defects. Our understanding of the fascinating world of folates and C1metabolism, and their role in health and disease, has come a long way since the discovery of the B-vitamin folic acid by Wills (1931), and its first isolation by Mitchellet al. (1941). However, there is still much to do in perfecting methods for the measurement of folate bioavailability, and status, with a high extent of precision and accuracy. Currently, examination of the relationships between common gene polymorphisms involved in C1metabolism and folate bioavailability and folate status, morbidity, mortality and longevity is evaluated as a series of individual associations. However, in the future, examination of the concurrent effects of such common gene polymorphisms may be more beneficial.

Maternal folate status and risk of neural tube defects

The Lancet ◽  
1996 ◽  
Vol 348 (9019) ◽  
pp. 67-68 ◽  
Author(s):  
Peadar N Kirke ◽  
Leslie E Daly ◽  
Anne Molloy ◽  
Donald G Weir ◽  
John M Scott
Keyword(s):  
Neural Tube ◽  
Neural Tube Defects ◽  
Folate Status

scholarly journals Effect of once weekly folic acid supplementation on erythrocyte folate concentrations in women to determine potential to prevent neural tube defects: a randomised controlled dose-finding trial in Malaysia

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034598
Author(s):  
Kaitlyn L I Samson ◽  
Su Peng Loh ◽  
Geok Lin Khor ◽  
Zalilah Mohd Shariff ◽  
Lisa N Yelland ◽  
...  
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Controlled Trial ◽  
Folic Acid Supplementation ◽  
Dose Finding ◽  
Baseline Measure ◽  
Intention To Treat ◽  
Erythrocyte Folate ◽  
Randomised Controlled

IntroductionFolic acid (0.4 mg) taken prior to and during early pregnancy reduces the risk of neural tube defects (NTDs). Because these birth defects occur early in pregnancy, before women may know they are pregnant, many countries have mandated the addition of folic acid to food staples. In countries where fortification is not possible, and weekly iron folic acid programmes exist to reduce anaemia, the WHO recommends that 2.8 mg (7×0.4 mg) folic acid be given instead of the current weekly practice of 0.4 mg. Currently, there is a lack of evidence to support if the 2.8 mg folic acid per week dose is sufficient to raise erythrocyte folate concentrations to a level associated with a reduced risk of a NTD-affected pregnancy. We aim to conduct a three-arm randomised controlled trial to determine the effect of weekly folic acid with iron on erythrocyte folate, a biomarker of NTD risk.Methods and analysisWe will recruit non-pregnant women (n=300; 18–45 years) from Selangor, Malaysia. Women will be randomised to receive either 2.8, 0.4 or 0.0 (placebo) mg folic acid with 60 mg iron weekly for 16 weeks, followed by a 4-week washout period. The primary outcome will be erythrocyte folate concentration at 16 weeks and the mean concentration will be compared between randomised treatment groups (intention-to-treat) using a linear regression model adjusting for the baseline measure.Ethics and disseminationEthical approval was obtained from the University of British Columbia (H18-00768) and Universiti Putra Malaysia (JKEUPM-2018-255). The results of this trial will be presented at scientific conferences and published in peer-reviewed journals.Trial registration numbersACTRN12619000818134 and NMRR-19-119-45736.

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