scholarly journals Sources of Folate Intake in Women at Risk for Cervical Cancer (CC) in an Era of Folic Acid Fortification

2009 ◽  
Vol 23 (S1) ◽  
Author(s):  
Suguna Badiga ◽  
Chandrika J Piyathilake
Keyword(s):  
Cervical Cancer ◽  
At Risk ◽  
Folic Acid ◽  
Folate Intake ◽  
Folic Acid Fortification

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.

Effect of folic acid fortification of foods on folate intake in female smokers with cervical dysplasia

Nutrition ◽  
2004 ◽  
Vol 20 (5) ◽  
pp. 409-414 ◽  
Author(s):  
James M Shikany ◽  
Douglas C Heimburger ◽  
Chandrika J Piyathilake ◽  
Renee A Desmond ◽  
Paul G Greene
Keyword(s):  
Folic Acid ◽  
Cervical Dysplasia ◽  
Folate Intake ◽  
Folic Acid Fortification

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 Dietary intake of folate by adolescents and the potential effect of flour fortification with folic acid

2001 ◽  
Vol 86 (4) ◽  
pp. 529-534 ◽  
Author(s):  
P. J. Moynihan ◽  
A. J. Rugg-Gunn ◽  
T. J. Butler ◽  
A. J. Adamson
Keyword(s):  
Folic Acid ◽  
Dietary Intake ◽  
Potential Effect ◽  
Folate Intake ◽  
Folic Acid Intake ◽  
Folic Acid Fortification ◽  
Acid Intake ◽  
Department Of Health ◽  
White Flour ◽  
The Uk

The UK Department of Health recently recommended that flour be fortified with folic acid, at 2400 μg/kg. The objectives of the present paper were: to determine the consequence of this on folic acid intake of adolescents; to determine the level of fortification necessary to achieve an intake of 400 μg/d in adolescent girls (the amount recommended periconceptionally); to estimate the consequence of fortification on folic acid intake of high flour consumers; and to report on folate intake of adolescents. Dietary intake of folate and flour were determined by analysis of an existing database of the diets of 379 English adolescents. The folic acid intake that would result from white flour fortification with folic acid at 2400 μg/kg was determined and the level of folic acid fortification necessary to achieve an intake of 400 μg/d in girls from this source was also calculated. Without flour fortification, 6·9 % of girls failed to reach the UK lower reference nutrient intake for total folate. Fortification of white flour with folic acid at 2400 μg/kg would result in an additional folic acid intake of 191(SEM 6) μg/d in girls. To ensure 97 % of girls received 400 μg/d from white flour, white flour would need to be fortified at a level of 10 430 μg/kg, resulting in intakes of 1260 μg/d from flour in the highest (97·5 centile) female white flour consumers and 1422 μg/d from flour in the highest (97·5 centile) male white flour consumers.

The determinants of maternal homocysteine in pregnancy: findings from the Ottawa and Kingston Birth Cohort

2020 ◽  
Vol 23 (17) ◽  
pp. 3170-3180
Author(s):  
Shazia H Chaudhry ◽  
Monica Taljaard ◽  
Amanda J MacFarlane ◽  
Laura M Gaudet ◽  
Graeme N Smith ◽  
...  
Keyword(s):  
Folic Acid ◽  
Birth Cohort ◽  
Subgroup Analysis ◽  
Folic Acid Supplementation ◽  
Folate Intake ◽  
Chronic Hypertension ◽  
Folic Acid Fortification ◽  
Acid Supplementation ◽  
Homocysteine Concentration ◽  
Randomised Controlled

AbstractObjective:Observational studies have linked elevated homocysteine to vascular conditions. Folate intake has been associated with lower homocysteine concentration, although randomised controlled trials of folic acid supplementation to decrease the incidence of vascular conditions have been inconclusive. We investigated determinants of maternal homocysteine during pregnancy, particularly in a folic acid-fortified population.Design:Data were from the Ottawa and Kingston Birth Cohort of 8085 participants. We used multivariable regression analyses to identify factors associated with maternal homocysteine, adjusted for gestational age at bloodwork. Continuous factors were modelled using restricted cubic splines. A subgroup analysis examined the modifying effect of MTHFR 677C>T genotype on folate, in determining homocysteine concentration.Setting:Participants were recruited in Ottawa and Kingston, Canada, from 2002 to 2009.Participants:Women were recruited when presenting for prenatal care in the early second trimester.Results:In 7587 participants, factors significantly associated with higher homocysteine concentration were nulliparous, smoking and chronic hypertension, while factors significantly associated with lower homocysteine concentration were non-Caucasian race, history of a placenta-mediated complication and folic acid supplementation. Maternal age and BMI demonstrated U-shaped associations. Folic acid supplementation of >1 mg/d during pregnancy did not substantially increase folate concentration. In the subgroup analysis, MTHFR 677C>T modified the effect of folate status on homocysteine concentration.Conclusions:We identified determinants of maternal homocysteine relevant to the lowering of homocysteine in the post-folic acid fortification era, characterised by folate-replete populations. A focus on periconceptional folic acid supplementation and improving health status may form an effective approach to lower homocysteine.

scholarly journals Population-Level Changes in Folate Intake by Age, Gender, and Race/Ethnicity after Folic Acid Fortification

2006 ◽  
Vol 96 (11) ◽  
pp. 2040-2047 ◽  
Author(s):  
Tanya G.K. Bentley ◽  
Walter C. Willett ◽  
Milton C. Weinstein ◽  
Karen M. Kuntz
Keyword(s):  
Folic Acid ◽  
Population Level ◽  
Folate Intake ◽  
Folic Acid Fortification ◽  
Gender And Race ◽  
Race Ethnicity

scholarly journals Tackling serum folate test in European countries within the health technology assessment paradigm: request appropriateness, assays and health outcomes

2017 ◽  
Vol 55 (9) ◽  
Author(s):  
Simona Ferraro ◽  
Andrea Panzeri ◽  
Mauro Panteghini
Keyword(s):  
At Risk ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Serum Levels ◽  
Folate Intake ◽  
Serum Folate ◽  
Clinical Use ◽  
Folic Acid Fortification ◽  
Total Testing Process ◽  
The Individual

AbstractSeveral authors have recently claimed an excess in serum folate test ordering, suggesting phasing out it from clinical use. According to studies performed in countries undergoing folic acid fortification policies, it is indeed no more cost-effective to test folate in the face of deficiency prevalence <1%. In this paper, we sought to evaluate request appropriateness, analytical issues, and cost-effectiveness of serum folate determination for clinical purposes in the European context, considering if evidence retrieved in fortified countries may be generalized. Studies performed in non-fortified countries have generally reported a suboptimal folate intake and suggest a remarkable prevalence of folate deficiency. Our internal data suggest that ~20%–25% of the subjects undergoing serum folate test are at risk for deficiency. However, a reliable evaluation of the risk for deficiency implies the knowledge of all issues related to the total testing process of folate measurement as well as the identification of the appropriate population in which to perform the test. The cost-effectiveness of the test is maximized when the request is oriented to subjects suggestive/at risk for deficiency, becoming low if the test is used as a screening tool or for monitoring of vitamin intake/supplementation. Because the individual folate status has a key role in ensuring normal development, physiologic growth, and maintenance of optimal health, the evaluation of its serum levels has to be retained in the clinical use in non-fortified countries, boosting for more appropriate request, and evidence from countries following fortification policies should be cautionary interpreted.

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 Intake of Older Adults Before and After Fortification of Grain Products

2007 ◽  
Vol 68 (4) ◽  
pp. 218-220 ◽  
Author(s):  
Judy DeWolfe
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Folic Acid ◽  
Folate Intake ◽  
Serum Folate ◽  
Convenience Sample ◽  
Dietary Folate ◽  
Before And After ◽  
Grain Products ◽  
Age Range

Purpose: To determine whether fortification allowed older adults in the Kingston, Frontenac, and Lennox & Addington (KFL&A) Public Health area to obtain adequate amounts of food folate, and the proportion at risk of consuming more than the upper limit (UL) of folic acid (1,000 mcg). Methods: Dietary intake of a convenience sample of 103 healthy, active older adults (age range: 65 to 95 years) was measured using three 24-hour recalls. Dietary folate preand post-fortification was estimated. Results: Mean dietary folate increased from pre- to postfortification, but 43.4% of women and 20% of men still consumed less than the Estimated Average Requirement of 320 mcg dietary folate equivalent. No intakes exceeded the UL. Participants whose diet met grain products and vegetable and fruit recommendations of Canada's Food Guide to Healthy Eating consumed significantly more folate. Conclusions: Despite fortification, some older adults in the KFL&A area may not be obtaining enough folate to meet their nutritional needs, and may be at risk for health problems associated with folate deficiency. However, without concomitant serum folate measurements, the proportion is not known. Dietitians need to continue promoting foods naturally rich in folate, along with folic acid-fortified foods. While none of the older adults consumed more than the UL, some could exceed this amount if folic acid supplements were added to a folic acid-rich diet.

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