Relationship of several serum folate forms with kidney function and albuminuria: Cross-sectional data from the NHANES 2011-2018

We aim to examine the relation of several folate forms (5-methyltetrahydrofolate [5-mTHF], unmetabolized folic acid [UMFA], and MeFox) with kidney function and albuminuria, which remained uncertain. The cross-sectional study was conducted in 18,757 participants from National Health and Nutrition Examination Survey 2011–2018. The kidney outcomes were reduced estimated glomerular filtration rate (eGFR) (<60 mL/min/1.73 m2), microalbuminuria (albumin-to-creatinine ratio of 30-299 mg/g), and macroalbuminuria (albumin-to-creatinine ratio ≥ 300 mg/g).Overall, there were significant inverse associations between serum 5-mTHF and kidney outcomes with significant lower prevalence of reduced eGFR (OR, 0.71; 95%CI: 0.57-0.87) and macroalbuminuria (OR, 0.65; 95%CI: 0.46-0.91) in participants in quartile 3-4 (vs. quartile 1-2; ≥34.0 vs. <34.0nmol/L; both P for trend across quartiles <0.05). In contrast, there were significant positive relationship between serum UMFA and kidney outcomes with significant higher prevalence of reduced eGFR in participants in quartile 2-4 (vs. quartile 1; ≥0.5 vs. <0.5nmol/L; OR, 2.12; 95%CI: 1.45-3.12; P for trend <0.001) and higher prevalence of macroalbuminuria in participants in quartile 4 (vs. quartile 1-3; ≥ 1.0 vs. <1.0 nmol/L; OR, 1.46; 95%CI: 1.06-2.01; P for trend <0.001). However, there was no significant associations of 5-mTHF and UMFA with microalbuminuria. In addition, there were significant positive relationships of serum MeFox with reduced eGFR, microalbuminuria and macroalbuminuria (all P for trend <0.01). In conclusion, higher 5-mTHF level, along with lower UMFA and MeFox level, were associated with lower prevalence of kidney outcomes, which may help counsel future clinical trials and nutritional guidelines regarding the folate supplement.

Folate supplementation in pregnancy

Objectives: To determine the prevalence of low, normal and high folate levels in Omani population. Folate supplement given routinely during pregnancy. Folate added into multi-vitamins supplement as well as into food products. This leads to decrease the prevalence of low folate or increase prevalence of people with excess folate. Low and high folate level leads to adverse side effects. Methods: 3706 folate samples analyzed in Cobas e 601 chemical analyzer. The results separated into three main groups (low, normal and high). Results: Only 0.3% of the study sample shows low folate level. Five (0.2%) out of 2335 female samples show low folate level. Three (0.2%) out of 1371 male samples shows low folate level. Conclusion: Routine folate intake during pregnancy, supplement to the general population for wellbeing and food fortification might lead to excess folate status. Folate testing before supplementation help in avoiding high folate adverse effects.

Prevalence and factors associated with anemia in pregnancy among women receiving antenatal care at the West Gonja District Hospital of Northern Ghana.

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital (WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.

Prevalence and Factors Associated with Anemia in Pregnancy among Women Receiving Antenatal Care at the West Gonja District Hospital of Northern Ghana

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital(WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.

Problem Nutrients in Adolescent Girls With Anemia Versus Nonanemic Adolescent Girls and the Optimized Food-Based Recommendations to Meet Adequacy of These Nutrients in Adolescent School Girls in East Java, Indonesia

Background: Inadequate intake of micronutrients in adolescence leads to high risk of nutritional anemia contributing to the intergenerational cycle of malnutrition. Objective: To compare problem nutrients in diet of girls with anemia and nonanemic girls and develop food-based recommendation (FBR) to prevent anemia (hemoglobin <12.0 g/dL) and micronutrient deficiencies among adolescent schoolgirls. Methods: Screening for anemia was conducted among 355 adolescent schoolgirls aged 15 to 18 years in East Java, Indonesia. Food consumption patterns were assessed from 69 girls with anemia and 78 nonanemic girls aged 15 to 18 years using two 24-hour dietary recalls and 5-day food records. Weighing is used to obtain food portion sizes. Linear Programming (LP) approach using Optifood was used to identify problem nutrient(s) and formulate FBRs. Results: Iron and calcium were problem nutrients among nonanemic girls, while iron, calcium, folate, and vitamin A were problem nutrients among anemic girls. Milk and liver were potential nutrient-dense foods identified to fill the nutrient gaps. Six FBRs would ensure the dietary adequacy for 9 of 12 nutrients except for iron, folate, and calcium. Conclusions: Anemic girls had more problem nutrients compared to their nonanemic counterparts. The FBRs developed using LP can meet adequacy of most nutrients except iron, folate, and calcium. Nutrient gap identified from LP analysis suggests that it is advisable to add a mixture of weekly iron and folate supplement for adolescent girls in order to meet adequacy of iron and folate to prevent anemia.

Analisis Efektivitas Antenatal Care (ANC) dan Konsumsi Suplemen Fe-Folat Pada Ibu Hamil di Kecamatan Karangjati

Birth, growth, and development of babies depends on how they survive in the mother’s womb. They could survive with sufficient maternal nutrition, such as Fe-Folate. Pregnant women with low food intake or poor quality nutrition intake or both could lead to chronic energy deficiency (CED). Moreover, pregnant women with iron deficiency could cause anemia. Both chronic energy deficiency and anemia could lead to an increase in stunting (low birth weight) rate. WHO recommendation to reduce CED and anemia numbers is by implementing the Antenatal Care (ANC) system and Fe-Folate supplement routine distribution to pregnant women in every healthcare services in the world. The objective of this study is to analyze whether ANC and the distribution of Fe-Folate supplement effectively reduce the CED and anemia numbers in Karangjati sub-district, Ngawi. This study was a qualitative method in which researcher interviewed the parties related to the case (The Head of UPT Karangjati), and given the required data (ANC, CED, Anaemia data in UPT Karangjati). The result shows that Antenatal Care (Patteh Paduka Beristri Program) and Fe-Folate supplement routine distribution by UPT Karangjati to pregnant women had effectively reduced CED and anemia numbers in Karangjati sub-district.

Genome-wide survey reveals dynamic effects of folate supplement on DNA methylation and gene expression during C2C12 differentiation

Folic acid supplements taken during pregnancy can prevent neural tube defects and other developmental abnormalities. Here, we explored the effects of folate supplementation on gene expression and DNA methylation during C2C12 differentiation. Based on the folic acid concentration, this study comprised three groups: low folate (L), normal folate (N), and high-folate supplement (H). Our analyses revealed that differentiation and the mRNA expression of the gene myogenin in C2C12 cell were enhanced by folic acid; however, the overall methylation percentage in myogenin promoter between different treatment groups was not significantly different ( P > 0.05). The results of MeDIP-chip showed that hundreds of differentially methylated regions (DMRs) were identified between every two groups in both promoter and CpG islands, respectively. Genes with DMRs between N and L groups were mainly enriched in the processes of cell differentiation and cell development, whereas those with DMRs between H and N groups were frequently enriched in cellular process/cycle and cell metabolic processes. In addition, correlation analysis between methylation profile and expression profile revealed that some genes were regulated by methylation status directly. Together, these analyses suggest that folate deficiency and supplementation can influence the differentiation, genome-wide DNA methylation level and the expression of myogenesis-related genes including myogenin in the C2C12 cell line.

Compliance with Iron-Folate Supplement and Associated Factors among Antenatal Care Attendant Mothers in Misha District, South Ethiopia: Community Based Cross-Sectional Study

Background.In Ethiopia, higher proportions of pregnant women are anemic. Despite the efforts to reduce iron deficiency anemia during pregnancy, only few women took an iron supplement as recommended. Thus, this study aimed to assess compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha district, South Ethiopia.Method. Community based cross-sectional study supported with in-depth interview was conducted from March 1 to March 30, 2015. The sample size was determined using single population proportion to 303. Simple random sampling technique was used to select the study participants. Bivariate and multivariable logistic regression analyses were employed to identify factors associated with compliance to iron-folate supplement.Results. The compliance rate was found to be 39.2%. Mothers knowledge of anemia (AOR = 4.451, 95% CI = (2.027,9.777)), knowledge of iron-folate supplement (AOR = 3.509, 95% CI = (1.442,8.537)), and counseling on iron-folate supplement (AOR = 4.093, 95% CI = (2.002,8.368)) were significantly associated with compliance to iron-folate supplement.Conclusions.Compliance rate of iron-folate supplementation during pregnancy remains very low. This study showed that providing women with clear instructions about iron-folate tablet intake and educating them on the health benefits of the iron-folate tablets can increase compliance with iron-folate supplementation.