Abstract
ScopeWe modeled red blood cell (RBC)‐folate response to supplementation and developed personalized folate supplementation concepts.Methods and resultsThe changes of RBC‐folate were modeled in a time‐ (4 or 8 weeks) and dose‐ (400 or 800 μg d−1 folate) dependent manner. Post‐supplementation RBC‐folate levels were predicted from folate‐loading capacities (= measured RBC‐folate – [baseline RBC‐folate × RBC‐survival]). The prediction equations were validated in 119 participants. The median increase of RBC‐folate was higher in the 800 μg d−1 than in the 400 μg d−1 group (275 vs 169 nmol L−1 after 4 weeks, and 551 vs 346 nmol L−1 after 8 weeks). Medians (interquartile range) of RBC‐folate loading were (4 weeks: 299 (160) vs 409 (237) nmol L−1) and (8 weeks: 630 (134) versus 795 (187) nmol L−1) in the 400 and 800 μg d−1 group, respectively. The individual measured and predicted RBC‐folate values (after 4 weeks/400 μg d−1 = 25 + 1.27 × baseline RBC‐folate) and (after 4 weeks/800 μg d−1 = 65 + 1.41 × baseline RBC‐folate) did not differ significantly. The measured and predicted concentrations showed high agreement in the validation cohort.ConclusionsThe models can guide nutritional recommendations in women when baseline RBC‐folate concentrations are measured and the time to pregnancy between 4 and 8 weeks.
Highlights
Introduction with folic acidSeveral international organizations recommend supplementing 400–800 μg d–1 folic acid for women who are Prevention of folate-responsive neural tube defects (NTDs) de- planning or capable of pregnancy.[3,4] No explicit recommendapends on reaching a relatively high folate status before the tions exist regarding the minimal duration of supplementationAarhus Institute of Advanced Studies University of Aarhus Aarhus C, Denmark C
We found that red blood cell (RBC)-folate concentrations close to the population mean would require 800 μg d–1 folate for 4 weeks or 400 μg d–1 for 8 weeks to reach the 906 nmol L–1 (Supporting Information Table S4)
We quantified the effect of folate dose- and supplementation duration on the changes of RBC-folate in young nonpregnant women
Summary
Several international organizations recommend supplementing 400–800 μg d–1 folic acid for women who are Prevention of folate-responsive neural tube defects (NTDs) de- planning or capable of pregnancy.[3,4] No explicit recommendapends on reaching a relatively high folate status before the tions exist regarding the minimal duration of supplementation. Aarhus Institute of Advanced Studies University of Aarhus Aarhus C, Denmark C. The trial was registered at The German Clinical Trials Register: DRKS-ID: DRKS00009770.
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