Abstract
Background: Daily folic acid (FA) supplementation improves folate status, but little is known about the impact of weekly FA supplementation.Objectives: To compare the efficacy of daily versus weekly FA supplementation.Methods: A randomized, double‐blind trial was conducted in Guatemala. 459 women were randomly assigned to 4 groups to receive weekly (5000 or 2800μg) or daily (400 or 200 μg) FA for 12 weeks. Daily and weekly iron, zinc and vitamin B12 were also provided. Serum and red blood cell (RBC) folate were determined by microbiological assays but the latter was only available at baseline. Serum homocysteine (Hcy) and vitamin B12 were also measured. Generalized linear regression models were used to assess the effects of treatment on biochemical indicators.Results: After intervention, folate metabolic status improved similarly across all 4 groups. Overall, the mean serum folate concentration increased by 15.4 nmol/L (95% CI: 13.8, 16.9), and the geometric mean Hcy concentration decreased by 9.8% (95% CI: −12.3%, −7.1%). Daily supplementation improved serum vitamin B12 levels by 20% (95% CI: 8%, 33.2%) while weekly supplementation had no significant impact.Conclusion: Weekly FA (either high or low dose) may be as efficacious as daily supplementation in improving serum folate and lowering Hcy concentrations in Guatemalan women of reproductive age.
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