Prevalence and correlates of high red blood cell folate concentrations in the Canadian population using 3 proposed cut-offs

2015 ◽  
Vol 40 (10) ◽  
pp. 1025-1030 ◽  
Author(s):  
Cynthia K. Colapinto ◽  
Deborah L. O’Connor ◽  
Lise Dubois ◽  
Mark S. Tremblay
Keyword(s):  
Folic Acid ◽  
Blood Cell ◽  
Health Outcomes ◽  
Red Blood Cell ◽  
Folic Acid Supplement ◽  
Cross Sectional ◽  
Folate Status ◽  
Supplement Use ◽  
Acid Supplement ◽  
Nationally Representative

A distinct shift towards higher folate concentrations has emerged in Canada. These higher concentrations have known benefits, including prevention of neural tube defects, but concerns have been raised regarding potential associations with adverse health outcomes. The aim of this research was to propose cut-offs for high red blood cell (RBC) folate concentrations and identify their correlates. RBC folate was measured in a nationally representative cross-sectional sample of Canadians (N = 5248) aged 6 to 79 years. RBC folate concentrations were adjusted from the IMMULITE 2000 immunoassay to a microbiologic assay. The population was characterized at 3 RBC folate cut-offs: 1450 nmol/L, 1800 nmol/L, and 2150 nmol/L. We used t tests to examine differences by age, sex, income, and body mass index (BMI) at each cut-off and logistic regression to explore associations with folic acid supplement intake. The prevalence of high RBC folate was 16%, 6%, and 2% at thresholds of 1450 nmol/L, 1800 nmol/L, and 2150 nmol/L, respectively. Females, those aged 60 to 79 years, and overweight or obese participants had the greatest prevalence of having high RBC folate at each cut-off. Folic acid supplement users were more likely than non-users to have high RBC folate concentrations. Older age, higher BMI, and folic acid supplement use were identified as correlates of high folate status. A high RBC folate concentration cut-off will advance the field towards consistent measurement and reporting of high folate status. This may facilitate future investigation of associations between RBC folate concentrations at the upper end of the distribution and health outcomes.

scholarly journals Folic acid supplement use and menstrual cycle characteristics: a cross-sectional study of Danish pregnancy planners

2015 ◽  
Vol 25 (10) ◽  
pp. 723-729.e1 ◽  
Author(s):  
Heidi T. Cueto ◽  
Anders H. Riis ◽  
Elizabeth E. Hatch ◽  
Lauren A. Wise ◽  
Kenneth J. Rothman ◽  
...  
Keyword(s):  
Folic Acid ◽  
Menstrual Cycle ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Folic Acid Supplement ◽  
Cross Sectional ◽  
Supplement Use ◽  
Acid Supplement

scholarly journals Examining the folate status of Canadians: An analysis of the Canadian Health Measures Survey to assess and guide folate policies

2014 ◽  
Vol 39 (3) ◽  
pp. 401-401 ◽  
Author(s):  
Cynthia K. Colapinto
Keyword(s):  
Folic Acid ◽  
Folic Acid Supplement ◽  
Folate Concentration ◽  
Folate Status ◽  
Health Measures ◽  
Acid Supplement ◽  
Canadian Population ◽  
Canadian Health ◽  
Nationally Representative ◽  
Canadian Health Measures Survey

Canada fortifies certain products with folic acid and has periconceptional supplementation guidelines [Formula: see text] policies designed to improve folate status and reduce the incidence of poor birth outcomes. Though optimal folate concentrations have been linked to health benefits, concerns have been raised regarding potential associations with adverse health outcomes. Direct biochemical assessment of the folate status of Canadians based on a nationally representative sample has not been done in more than 40 years. The overall purpose of this research was to investigate the folate status of the Canadian population. All analyses used the nationally representative 2007–2009 Canadian Health Measures Survey (CHMS). Red blood cell (RBC) folate was measured by Immulite 2000 immunoassay. Key findings indicate that folate deficiency (<305 nmol/L) was virtually nonexistent in the Canadian population (6–79 years old). Still, one-fifth of women of childbearing age (WCBA; 15–45 years old) had suboptimal concentrations for the prevention of neural tube defects (<906 nmol/L). Folic acid supplement intake was a primary determinant of WCBA, achieving a RBC folate concentration of ≥906 nmol/L. A distinct shift towards elevated RBC folate concentrations emerged. Three hypothetical cut-offs (1450 nmol/L, 1800 nmol/L and 2150 nmol/L) were examined to create a dialogue since a universal definition of high RBC folate concentration does not exist. Females, participants aged 60–79 years, and those who were overweight or obese had the greatest prevalence of having high RBC folate at each cut-off. We conducted the first national-level comparison of RBC folate concentrations between the United States and Canada. Two different folate assay methods [Formula: see text] microbiologic assay (NHANES) and Immulite 2000 immunoassay (CHMS) [Formula: see text] necessitated the application of a conversion equation. Median Canadian RBC folate concentrations (adjusted to microbiologic assay) were lower than those of Americans but unadjusted Canadian median RBC folate values were higher. Canadian WCBA were less likely than American WCBA to have RBC folate ≥906 nmol/L, though Canadian WCBA with unadjusted RBC folate values were more likely to achieve this cut-off. These results indicate a need for strategies targeting WCBA to improve compliance with folic acid supplement recommendations. The strength and necessity of supplements for the general population should be re-assessed. Further, harmonization of folate measurement procedures in future surveillance efforts would support comparisons and inform policy directions.

scholarly journals Epidemiology and (Patho)Physiology of Folic Acid Supplement Use in Obese Women before and during Pregnancy

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 331
Author(s):  
Melissa van der Windt ◽  
Sam Schoenmakers ◽  
Bas van Rijn ◽  
Sander Galjaard ◽  
Régine Steegers-Theunissen ◽  
...  
Keyword(s):  
Folic Acid ◽  
Scientific Evidence ◽  
Folate Deficiency ◽  
Folate Intake ◽  
Low Grade ◽  
Obese Women ◽  
Folic Acid Supplement ◽  
Physiological Uptake ◽  
Supplement Use ◽  
Acid Supplement

Preconception folic acid supplement use is a well-known method of primary prevention of neural tube defects (NTDs). Obese women are at a higher risk for having a child with a NTD. As different international recommendations on folic acid supplement use for obese women before and during pregnancy exist, this narrative review provides an overview of epidemiology of folate deficiency in obese (pre)pregnant women, elaborates on potential mechanisms underlying folate deficiency, and discusses considerations for the usage of higher doses of folic acid supplements. Women with obesity more often suffer from an absolute folate deficiency, as they are less compliant to periconceptional folic acid supplement use recommendations. In addition, their dietary folate intake is limited due to an unbalanced diet (relative malnutrition). The association of obesity and NTDs also seems to be independent of folate intake, with studies suggesting an increased need of folate (relative deficiency) due to derangements involved in other pathways. The relative folate deficiency, as a result of an increased metabolic need for folate in obese women, can be due to: (1) low-grade chronic inflammation (2) insulin resistance, (3) inositol, and (4) dysbiotic gut microbiome, which plays a role in folate production and uptake. In all these pathways, the folate-dependent one-carbon metabolism is involved. In conclusion, scientific evidence of the involvement of several folate-related pathways implies to increase the recommended folic acid supplementation in obese women. However, the physiological uptake of synthetic folic acid is limited and side-effects of unmetabolized folic acid in mothers and offspring, in particular variations in epigenetic (re)programming with long-term health effects, cannot be excluded. Therefore, we emphasize on the urgent need for further research and preconception personalized counseling on folate status, lifestyle, and medical conditions.

scholarly journals Patterns and predictors of folic acid supplement use among pregnant women: the Norwegian Mother and Child Cohort Study

2006 ◽  
Vol 84 (5) ◽  
pp. 1134-1141 ◽  
Author(s):  
Roy M Nilsen ◽  
Stein E Vollset ◽  
Håkon K Gjessing ◽  
Per Magnus ◽  
Helle M Meltzer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Folic Acid ◽  
Pregnant Women ◽  
Folic Acid Supplement ◽  
Supplement Use ◽  
Acid Supplement ◽  
Mother And Child

scholarly journals Preconceptional folic acid supplement use in Lebanon

2009 ◽  
Vol 12 (5) ◽  
pp. 687-692 ◽  
Author(s):  
H Tamim ◽  
G Harrison ◽  
M Atoui ◽  
G Mumtaz ◽  
F El-Kak ◽  
...  
Keyword(s):  
Folic Acid ◽  
Economic Status ◽  
National Level ◽  
Folic Acid Supplementation ◽  
Folic Acid Supplement ◽  
Awareness Campaigns ◽  
Supplement Use ◽  
Acid Supplement ◽  
Trained Personnel ◽  
History Of

AbstractObjectiveThe objective of the present study was to assess the prevalence and determinants of preconceptional folic acid supplement use among pregnant women in Lebanon.Design/setting/subjectsThe study was a descriptive epidemiological study. Analysis was performed on 5280 deliveries admitted to twelve member hospitals of the National Collaborative Perinatal Neonatal Network during the period September 2003–January 2005. Information on folic acid intake and maternal and neonatal characteristics were obtained from obstetric charts along with direct interviews performed by trained personnel. Logistic regression was performed to determine the predictors of preconceptional folic acid use.ResultsThe overall use of preconceptional folic acid supplementation was 14·0 % (18·6 % in urban hospitals v. 2·7 % in rural hospitals). Higher socio-economic status, lower parity and having a history of previous spontaneous abortions were significantly associated with preconceptional folic acid use.ConclusionOur study shows that Lebanon currently has a low rate of preconceptional folic acid supplement use. Intervention through the means of awareness campaigns needs to be implemented on a national level.

The Administration of a Multivitamin/Mineral Fortified Dairy Product Improves Folate Status and Reduces Plasma Homocysteine Concentration in Women of Reproductive Age

2004 ◽  
Vol 74 (3) ◽  
pp. 234-240 ◽  
Author(s):  
Baró ◽  
Martínez-Férez ◽  
Rodríguez ◽  
Valero ◽  
Fonollá ◽  
...  
Keyword(s):  
Folic Acid ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Dairy Product ◽  
Plasma Homocysteine ◽  
Reproductive Age ◽  
Total Plasma ◽  
Women Of Reproductive Age ◽  
Homocysteine Concentration ◽  
Folate Status

Background and objectives: Folate deficiency during the periconceptional period is related to the occurrence and recurrence of neural tube defects. The aim of the study was to assess whether the administration of folic acid and other vitamins and minerals as a fortified dairy product (400 mug per day of folic acid) improves the folate status in women of reproductive age. Design and methods: Plasma and red blood cell folate, plasma vitamin E, B12, total plasma homocysteine, plasma lipid profile, and serum ferritin and transferrin levels were investigated in 31 healthy nonpregnant women receiving 500 mL/day of the fortified dairy product for eight weeks. Results: The women showed a significant increase in plasma levels of folate and vitamin B12 concentrations after four and eight weeks of supplementation. Moreover, we observed an increase in red blood cell folate concentration during the period of the study. Simultaneously, total plasma homocysteine levels decreased significantly during the intervention period. Conclusions: The regular consumption of a folic acid and other vitamins (mainly vitamins B6 and B12) and minerals in alpha fortified dairy product improves folate status and reduces total plasma homocysteine concentration in healthy women of childbearing age.

scholarly journals Folate status and concentrations of serum folate forms in the US population: National Health and Nutrition Examination Survey 2011–2

2015 ◽  
Vol 113 (12) ◽  
pp. 1965-1977 ◽  
Author(s):  
Christine M. Pfeiffer ◽  
Maya R. Sternberg ◽  
Zia Fazili ◽  
David A. Lacher ◽  
Mindy Zhang ◽  
...  
Keyword(s):  
Folic Acid ◽  
National Health ◽  
Geometric Mean ◽  
Population Data ◽  
Serum Folate ◽  
Nutrition Examination Survey ◽  
Folate Status ◽  
Supplement Use ◽  
Health And Nutrition ◽  
Nationally Representative

Serum and erythrocyte (RBC) total folate are indicators of folate status. No nationally representative population data exist for folate forms. We measured the serum folate forms (5-methyltetrahydrofolate (5-methylTHF), unmetabolised folic acid (UMFA), non-methyl folate (sum of tetrahydrofolate (THF), 5-formyltetrahydrofolate (5-formylTHF), 5,10-methenyltetrahydrofolate (5,10-methenylTHF)) and MeFox (5-methylTHF oxidation product)) by HPLC–MS/MS and RBC total folate by microbiologic assay in US population ≥ 1 year (n approximately 7500) participating in the National Health and Nutrition Examination Survey 2011–2. Data analysis for serum total folate was conducted including and excluding MeFox. Concentrations (geometric mean; detection rate) of 5-methylTHF (37·5 nmol/l; 100 %), UMFA (1·21 nmol/l; 99·9 %), MeFox (1·53 nmol/l; 98·8 %), and THF (1·01 nmol/l; 85·2 %) were mostly detectable. 5-FormylTHF (3·6 %) and 5,10-methenylTHF (4·4 %) were rarely detected. The biggest contributor to serum total folate was 5-methylTHF (86·7 %); UMFA (4·0 %), non-methyl folate (4·7 %) and MeFox (4·5 %) contributed smaller amounts. Age was positively related to MeFox, but showed a U-shaped pattern for other folates. We generally noted sex and race/ethnic biomarker differences and weak (Spearman's r< 0·4) but significant (P< 0·05) correlations with physiological and lifestyle variables. Fasting, kidney function, smoking and alcohol intake showed negative associations. BMI and body surface area showed positive associations with MeFox but negative associations with other folates. All biomarkers showed significantly higher concentrations with recent folic acid-containing dietary supplement use. These first-time population data for serum folate forms generally show similar associations with demographic, physiological and lifestyle variables as serum total folate. Patterns observed for MeFox may suggest altered folate metabolism dependent on biological characteristics.

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