Folate Intake Research Articles

100% Orange Juice Consumption is Associated with Socioeconomic Status, Improved Nutrient Adequacy, and Higher Bioactive Compounds Intake: Results from Brazilian National Dietary Survey 2017–2018

Objective The consumption of 100% orange juice (OJ) has been associated with nutrient adequacy and better diet quality. To date, there are few analyses exploring 100% OJ consumption patterns across populations, with no data from Brazil. We aimed to explore the associations between 100% OJ consumption, sociodemographic factors, and nutrient intake in a representative sample of the Brazilian general population aged 10 years or older. Methods Data were obtained from the National Dietary Survey 2017–2018, a cross-sectional study including data on individual food intake of 46,164 subjects aged ≥10 years collected using two 24-h dietary recalls. Results 100% OJ was consumed by 11% of the population, with a mean intake of 43.0 ml/d. Males were more frequent consumers compared to females, and the percentage of consumers increased with education and income. 100% OJ consumption was associated with higher intakes of energy, vitamin C, folate, calcium, magnesium, potassium, polyphenols, and carotenoids. There is no significant difference in fiber intake between consumers and non-consumers. 100% OJ consumers had a higher percentage of the population meeting the Estimated Average Requirement for vitamin A, vitamin C, vitamin D, folate, calcium, and magnesium. Conclusion Our results suggest that 100% OJ could be a component of a healthy diet, helping individuals to achieve nutrient recommendations.

Maternal usage of varying levels of dietary folate affects the postnatal development of cerebellar folia and cortical layer volumes

ABSTRACT Objective The cerebellum has a long, protracted developmental period; therefore, it is more sensitive to intrauterine and postnatal insults like nutritional deficiencies. Folate is an essential nutrient in fetal and postnatal brain development, and its supplementation during pregnancy is widely recommended. This study aimed to describe the effects of maternal folate intake on postnatal cerebellum development. Methods Twelve adult female Rattus norwegicus (6–8 weeks old) rats were randomly assigned to one of four groups and given one of four premixed diets: a standard diet (2 mg/kg), a folate-deficient (folate 0 mg/kg), folate-supplemented (8 mg/kg), or folate supra-supplemented (40 mg/kg). The rats began consuming their specific diets 14 days before mating and were maintained on them throughout pregnancy and lactation. Five pups from each group were sacrificed, and their brains processed for light microscopic examination on postnatal days 1, 7, 21, and 35. The data gathered included the morphology of the cerebellar folia and an estimate of the volume of the cerebellar cortical layer using the Cavalieri method. Results Folia of the folate-supplemented and supra-supplemented groups were thicker and showed extensive branching with sub-lobule formation. The folate-deficient diet group's folia were smaller, had more inter-folial spaces, or fused. When compared to the folate-deficient group, the volumes of the cerebellum and individual cerebellar cortical layers were significantly larger in the folate-supplemented and supra-supplemented groups (p<0.05). Conclusion Folate supplementation during pregnancy and lactation improves the degree and complexity of the cerebellar folia and the volumes of individual cerebellar cortical layers.

Evaluating the potential role of determinants of health on encephalocele patient outcomes - a combined retrospective study and systematic review.

To evaluate the outcomes and demographics of encephalocele patients who were born and received treatment in our neonatal ICU and conduct a PRISMA literature review. An Institutional Review Board (IRB)-approved retrospective cohort study was undertaken to investigate the results of treating encephalocele patients at Jackson Memorial Hospital (JMH) from 1998 to 2022. The study focused on assessing outcomes and the impact of maternal socioeconomic factors, such as religion, age, and education, along with the timing of diagnosis, in connection with a systematic review. A total of 20 encephalocele patients were identified (13 females and 7 males), with 15 having available medical records for review. Most of these cases involved occipital encephaloceles (73.3%). Maternal ages at the time of delivery ranged from 15 to 42years, with a mean age of 27.3years. The average gestational age at birth was 37weeks. Ten cases had a prenatal diagnosis documented, occurring between 12 and 24.5weeks of gestation. Three of the surviving patients had records of prenatal counseling that included discussions about termination. No infections were reported. Among the 15 cases, 11 patients (73.3%) were alive at the last follow-up, with a mean age at follow-up of 4.12years, ranging from 6weeks to 15years post-birth. Hydrocephalus was noted in 26.7%. Only 1 mother had completed high school. Most mothers were either on Medicaid (9 patients) or uninsured (3 patients), with only 3 having commercial insurance. Religious affiliations varied among the mothers, with 14 out of 15 identifying with a particular religion. The systematic review identified 22 articles from various countries, with 11 articles meeting the inclusion criteria for qualitative analysis. These articles revealed potential maternal risk factors for encephaloceles, including low-nutrient diets, inadequate folic acid intake, young maternal age, advanced maternal age, low socioeconomic status, and limited educational attainment. In the twenty-first century, there is a positive trend in the survival rates of children born with encephalocele. However, maternal factors such as low socioeconomic status and limited educational attainment remain prominent, affecting their ability to access timely prenatal care and impacting follow-up medical care for these children.

Women in Canada are consuming above the upper intake level of folic acid but few are meeting dietary choline recommendations in the second trimester of pregnancy: data from the CHILD cohort study.

There is concern that during a low-risk pregnancy, women are consuming more than recommended (400 µg/day) supplemental folic acid and may not meet recommendations for other nutrients. The objective of this study was to determine folic acid supplement use and dietary folate intakes in the second trimester (week 18) of pregnancy in women (n=2996) in the Canadian CHILD cohort study. Vitamin B12 and choline intakes were also assessed because they are metabolically related to folate. The majority of participants (71.6%) were consuming a daily prenatal supplement. Twenty-eight percent of women (n=847) reported consuming a folic acid supplement and of these women, 45.3% had daily supplemental folic acid intakes above the upper intake level (UL; 1000 µg/day). Daily dietary folate intakes were (mean (SD)) 575 (235) DFE µg/day. In contrast, only 24.8% of women met the dietary choline adequate intake (AI) recommendation (AI ≥ 450mg/day) with a mean (SD) intake of 375 (151) mg/day. Further understanding of the impact of supplemental folic acid intake above the UL and low choline intake during pregnancy requires further investigation.

Association of serum folic acid levels in response to fasting blood glucose in early pregnancy with the risk of gestational diabetes mellitus: A retrospective cohort study

ObjectiveWith increasingly prevalent folic acid consumption in early pregnancy, concerns about its potentially negative effect on maternal metabolism have been raised. Recent findings regarding folic acid levels in the first trimester and the risk of gestational diabetes mellitus have been inconclusive. The aim of this study was to investigate the association of folic acid status in early pregnancy with gestational diabetes mellitus as well as examine whether glucose levels can be modulated by folic acid status during the same first trimester. MethodsThis was a retrospective cohort study based on 27 128 Chinese pregnant women who registered during their first prenatal visit from January 2015 to December 2019. Serum folic acid and fasting blood glucose concentrations were measured during the 9th to 13th gestational weeks. Binary logistic regression was applied to estimate the odds ratios of gestational diabetes mellitus by using the serum folic acid levels quartiles with adjustment for major confounders. To investigate the potential effect of modifying key risk factors for gestational diabetes mellitus, we established subgroups, in which analyses were stratified by age (<25, 25–29, 30–34, and ≥35 y), parity (nulliparous and parous), prepregnancy body mass index (< 18.5, 18.5–23.9, and ≥ 24 kg/m2), and family history of diabetes (yes and no). ResultsThe positive association between maternal folate concentrations and fasting blood glucose was observed: the risk for hyperglycemia was higher in those in the middle (Q3) and higher (Q4) quartiles compared with those in Q1 and Q2. A higher risk for gestational diabetes mellitus was found in hyperglycemia of early pregnant women with high folate concentrations (Q3: odds ratio = 5.63; 95% CI, 4.56–6.95, and Q4: odds ratio = 5.57; 95% CI, 4.68–6.64) compared with normal fasting glucose mothers with folate concentrations in Q1 and Q2 after accounting for multiple covariables. Similar patterns were observed for different subgroups. Restricted cubic spline plots had a positive correlation of serum folic acid level with fasting blood glucose concentration as well as risk of gestational diabetes mellitus in a nonlinear pattern, with 32.5 nmol/L as the cutoff point for folic acid level. ConclusionsOur findings underscore the importance of maintaining an appropriate folic acid concentration for preserving a lower risk of gestational diabetes mellitus, especially in women with relatively higher blood glucose in early pregnancy. Additionally, folic acid concentration > 32.5 nmol/L may be considered a risk factor for gestational diabetes mellitus. This research suggested that folic acid levels should be monitored during the first trimester from the first prenatal checkup to prevent adverse effects of excessive folic acid intake.

Maternal MTR gene polymorphisms and their interactions with periconceptional folic acid supplementation in relation to offspring ventricular septal defects

To investigate how maternal MTR gene polymorphisms and their interactions with periconceptional folic acid supplementation are associated with the incidence of ventricular septal defects (VSD) in offspring. A case-control study was conducted, recruiting 426 mothers of infants with VSD under one year old and 740 mothers of age-matched healthy infants. A questionnaire survey collected data on maternal exposures, and blood samples were analyzed for genetic polymorphisms. Multivariable logistic regression analysis and inverse probability of treatment weighting were used to analyze the associations between genetic loci and VSD. Crossover analysis and logistic regression were utilized to examine the additive and multiplicative interactions between the loci and folic acid intake. The CT and TT genotypes of the maternal MTR gene at rs6668344 increased the susceptibility of offspring to VSD (P<0.05). The GC and CC genotypes at rs3768139, AG and GG at rs1050993, AT and TT at rs4659743, GG at rs3768142, and GT and TT at rs3820571 were associated with a decreased risk of VSD (P<0.05). The variations at rs6668344 demonstrated an antagonistic multiplicative interaction with folic acid supplementation in relation to VSD (P<0.05). Maternal MTR gene polymorphisms significantly correlate with the incidence of VSD in offspring. Mothers with variations at rs6668344 can decrease the susceptibility to VSD in their offspring by supplementing with folic acid during the periconceptional period, suggesting the importance of periconceptional folic acid supplementation in genetically at-risk populations to prevent VSD in offspring.

The Relationship between Folic Acid Intake and Depression among College Students

The aim of this study was to investigate the relationship between folic acid intake and the incidence of depression among students of Universitas Muhammadiyah Surakarta, department of Nutrition. This cross-sectional study recruited 40 participants following the inclusion criteria. Sample collection was done by random sampling. Data collection on the adequacy of folic acid intake was carried out using the non-consecutive three days 24 four Food recall. The prevalence of depression was obtained by measuring the level of depression in the last two weeks using the Beck Depression Inventory-II (BDI-II) questionnaire. The results showed that 2.5% of the subjects had sufficient folic acid intake and 97.5% had insufficient folic acid intake with mean 78,5 mcg. About 47.5% of subjects experienced minimal depression, 20% experienced mild depression, 25% experienced moderate depression, and 7.5% experienced major depression with mean score 13.4. Futher analysis, the p-value (p=0.145) indicated that there was no significant relationship between folic acid and depression status. Recommended for using the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) to see acid intake folate and pay attention to other factors that cause depression.

Development of Semiquantitative Food Frequency Questionnaire for Identification of Indigenous Dietary Patterns in Prediabetic Adult Women

Dietary patterns influence the progression of prediabetes, so it is necessary to develop representative instruments for measuring eating habits, primarily indigenous dietary consumption. The research aimed to develop a semiquantitative food frequency questionnaire to identify indigenous dietary patterns in prediabetes sufferers in Gorontalo Regency. The research was a descriptive study that tested the validity and reliability of the food frequency questionnaire semiquantitative (FFQ-SQ). The research was conducted in Limboto Barat Health Center, based on the prevalence of diabetes mellitus. Selection samples using purposive sampling with 30 adult women. The validity test used internal validity Pearson correlation, while the reliability test used internal consistency Cronbach α. Comparison of average FFQ-SQ and recall 2 x 24-hours using Wilcoxon test. The results showed that 12 food groups consisted of 207 food items and indigenous food products with validity tests 123 items valid, 67 items invalid, and 17 items never consumed by the subject study in the previous month; the reliability test showed food group category low 10, moderate 5 and high 3. Comparative analysis of the energy and nutrient intake between FFQ-SQ with recall 2 x 24 hours showed significant differences in intake of carbohydrates, fiber, vitamin E, vitamin B1, folic acid, vitamin C, potassium and zinc (p-value &lt; 0.005), and comparison of energy and nutrient intake between FFQ-SQ1 and FFQ-SQ2 showed no significant difference (p-value&gt; 0.005). The conclusion was FFQ-SQ with 123 items of foods and derived products is valid and reliable for measuring the eating habits of prediabetic adult women.

Periconceptional folic acid intake: a one year survey among mothers of patients with myelomeningocele in a regional neurosurgical centre in Northwestern Nigeria

Background: Management of myelomeningocele, the most common neural tube defect in our environment, is quite challenging, and the outcome is usually less pleasing to parents/caregivers. Periconceptional folic acid ingestion reduces the incidence, especially in developed countries with mandated policies for folic acid fortification of staple foods. Awareness of preventive role of folic acid and periconceptional intake has not been studied in our centre. This study aimed to assess the knowledge of the proper intake of folic acid in preventing Myelomeningocele among mothers of patients with myelomeningocele. Methods: This was a prospective cross-sectional study conducted at Usmanu Danfodiyo university teaching hospital (UDUTH) Sokoto state, Nigeria over 12 months period after obtaining ethical clearance and informed consent. Data of mothers of patients with myelomeningocele who presented to the neurosurgical outpatient clinic of our facility was entered into a well-designed proforma. Data was analyzed using simple descriptive statistics, and results were presented in tables and pie chart. Results: Fifty-four mothers were recruited. The most common age range was 20-35 years (70%), with a mean age of 23.8 years±5.49 SD. Nineteen (35%) out of 54 mothers had heard prior information about folic acid, and only 16 (30%) were aware of its appropriate time of intake in preventing myelomeningocele. None of the mothers ingested folic acid in the periconceptional period. Conclusions: There was poor awareness and knowledge of the appropriate timing of folic acid intake in preventing Myelomeningocele in our centre.

The Associations between Intakes of One-Carbon Metabolism-Related Vitamins and Breast Density among Young Women.

Folate is the primary methyl donor and B vitamins are cofactors for one-carbon metabolism that maintain DNA integrity and epigenetic signatures implicated in carcinogenesis. Breast tissue is particularly susceptible to stimuli in early life. Only limited data are available on associations of one-carbon metabolism-related vitamin intake during youth and young adulthood with breast density, a strong risk factor for breast cancer. Over 18 years in the DISC and DISC06 Follow-up Study, diets of 182 young women were assessed by three 24-hour recalls on five occasions at ages 8 to 18 years and once at 25 to 29 years. Multivariable-adjusted linear mixed-effects regression was used to examine associations of intakes of one-carbon metabolism-related vitamins with MRI-measured percent dense breast volume (%DBV) and absolute dense breast volume (ADBV) at ages 25 to 29 years. Folate intake in youth was inversely associated with %DBV (Ptrend = 0.006) and ADBV (Ptrend = 0.02). These inverse associations were observed with intake during post-, though not premenarche. In contrast, premenarche vitamin B2 intake was positively associated with ADBV (Ptrend < 0.001). Young adult folate and vitamin B6 intakes were inversely associated with %DBV (all Ptrend ≤ 0.04), whereas vitamins B6 and B12 were inversely associated with ADBV (all Ptrend ≤ 0.04). Among these DISC participants intakes of one-carbon metabolism-related vitamins were associated with breast density. Larger prospective studies among diverse populations are needed to replicate these findings. Our results suggest the importance of one-carbon metabolism-related vitamin intakes early in life with development of breast density and thereby potentially breast cancer risk later in life.

Plant Foods Intake and Risk of Premature Aging in Adult Survivors of Childhood Cancer in the St Jude Lifetime Cohort (SJLIFE).

To identify dietary factors that are related to premature aging in adult survivors of childhood cancer, we examined the associations between plant food intakes and age-related deficit accumulation. A total of 3,322 childhood cancer survivors (age 18-65 years, mean = 31, standard deviation = 8.4) in the St Jude Lifetime Cohort had total fruit, total vegetables and subgroups, whole grains, refined grains, nuts/seeds, and nutrients intake assessed using a food frequency questionnaire. Premature aging at baseline was assessed by the deficit accumulation index (DAI) and categorized as low, medium, and high risk. Multinomial logistic regressions (reference: low risk) adjusting for confounders estimated odds ratios (ORs) and 95% CIs. Multivariable linear regression of a continuous intake against a continuous DAI was also performed. Dark green vegetable (ORhigh v low = 0.47 [95% CI, 0.28 to 0.78] per 1/2 cup/1,000 kcal increment) and nuts/seeds intakes (ORhigh v low = 0.71 [95% CI, 0.47 to 1.08] per 1 oz/1,000 kcal increment; coefficientlinear = -0.0115, P = .02) were associated with a lower risk of premature aging. Conversely, refined grain intake was related to an increased risk of premature aging (ORhigh v low = 1.33 [95% CI, 0.99 to 1.78], per 1 oz/1,000 kcal increment; coefficientlinear = 0.0093, P = .005). Fruit and whole grain intakes were not associated with premature aging risk. Among nutrients abundant in plant foods, dietary folate intake was associated with a lower risk of premature aging (ORhigh v low = 0.89 [95% CI, 0.80 to 0.99] per 50 mcg/1,000 kcal increase). Beta-carotene, lutein/zeaxanthin, and vitamin E intakes from foods were also related to a modestly lower, but not statistically significant, risk of premature aging. Specific plant foods are associated with lower risk of premature aging, providing targets for the interventions to promote healthy aging in childhood cancer survivors.

Food sources of fiber and micronutrients of concern among infants and young children in Lebanon: a national cross-sectional study

BackgroundIntakes of fiber, iron, zinc, calcium, vitamin D, vitamin A, and folate were shown to be low in a substantial proportion of infants and children in Lebanon. The study aims to identify the top food sources of fiber, iron, zinc, calcium, vitamin D, vitamin A, and folate amongst infants and young children in Lebanon and to evaluate the evolution of food sources of these nutrients from the beginning of the complementary feeding journey up until the age of 47.9 months.MethodsA national cross-sectional survey was conducted in 2012 as part of the “Early Life Nutrition and Health in Lebanon” project using stratified cluster sampling. Dietary intakes for infants and young children aged 6-47.9 months (n = 763) were assessed using 24- Hour Dietary Recall. Food items were categorized into food groups and the percent contribution of each food group to nutrient intakes was determined to identify the top food sources of fiber and selected micronutrients for three age groups: 6-11.9 m (infants), 12-23.9 m (toddlers), and 24-47.9 m (preschoolers).ResultsThe top food source of fiber was vegetables among children aged 6-47.9 months. Among infants and toddlers, infant/young child formula was the main contributor to iron, zinc, calcium, vitamin D, vitamin A, and folate intakes. Baby cereals also contributed to around 14% of iron intakes among infants. Among preschoolers, meat and fish contributed to 13% of iron intakes and 29% of zinc intakes, while cow’s milk was the major contributor of calcium (41%), vitamin D (81%) and vitamin A (25%) intakes. Sweetened beverages and sweet bakery were also ranked among the major food sources contributing to substantial intakes of key nutrients, including fiber, iron, zinc, calcium, vitamin A, and folate among infants, toddlers, and preschoolers.ConclusionsIn addition to milk sources, vegetables, beans and legumes, breads, meats, and rice and pasta, sweet bakery and sweetened beverages have contributed to intakes of key nutrients from early ages. This calls for implementing initiatives and designing approaches to support nutrition education and improve nutrient intakes in infancy and early childhood.

Mango Consumption Was Associated with Higher Nutrient Intake and Diet Quality in Women of Childbearing Age and Older Adults.

Nutritional equity has been recognized as a priority in nutrition research, as reiterated by the new life-stage approach utilized by the Dietary Guidelines for Americans. Two of the life stages focused on are pregnant and lactating females as well as older adults, due to their unique nutritional needs and unique chronic health conditions. Both groups have low intakes of several nutrients, including those of public health concern, and suboptimal diet quality, underlining the importance to improve their dietary intakes. Incorporating fruit into their diets could help alleviate these gaps. Thus, the objective of the current study is to expand upon our current knowledge of the benefits of fruit within these two subgroups that DGA guidelines focus on and determine nutrient and food group intake as well as diet quality in women of childbearing age (WCA; as a proxy for pregnant and/or lactating females, n = 16,774) and older adult (n = 18,784) mango consumers compared with non-consumers, using NHANES 1988-1994 and 1999-2018. Both WCA and older adult mango consumers had greater than 20% higher intakes of fiber and vitamin C and WCA consumers had upwards of 10% higher folate, magnesium, and potassium intakes compared with non-consumers. Both groups of consumers had lower intake of saturated fat and older adults had lower intakes of protein and vitamin B12. Diet quality was 16 and 13% higher in WCA and older adult consumers compared with non-consumers, respectively. Additionally, mango consumers had lower beef, poultry, fish, and solid fat intakes and WCA consumers had higher whole grain intakes compared with non-consumers. This study suggests incorporating mango into the diet could increase select nutrient intake as well as diet quality in specific life stages of adult Americans.

Main sources and predictive factors of folate intake in female university students

ObjectiveThe study aimed to identify the main folate sources and examine socio-demographic and lifestyle determinants influencing folate intake among 1410 women aged 18 to 39. MethodsData were collected using a self-administered health and lifestyle questionnaire and a 5-d dietary record method. To assess folate intake in relation to the dietary reference intakes, the probability approach was used. Folate intake determinants were identified using multivariate-adjusted logistic regression models; odds ratios (ORs) with 95% confidence intervals (95% CIs). ResultsThe average total folate intake among women was 311 ± 144 µg/day dietary folate equivalents. Vegetables (30.7%) and cereals (22.6%) were the most important folate sources. Foods fortified with folic acid were consumed by 20.6% of women, dietary supplements by 7.2%. More than half of the participants (55%) had a high probability of inadequate folate intake. The predictors of being in the highest tertile of folate intake (>303 versus <225 µg) were: physical activity (high versus low; OR: 2.97, 95% CI: 1.77–4.97), nutritional knowledge (high versus low; OR: 5.32, 95% CI: 2.82–10.1), following a vegetarian diet (yes versus no; OR: 6.13; 95% CI: 2.79–13.5), daily number of meals (≥5 versus ≤3; OR: 4.17, 95% CI: 2.38–7.32), excluding/including some foods (yes versus no; OR: 2.47; 95% CI: 1.41–4.31) and energy intake (3rd versus 1st tertile; OR:17.4, 95% CI: 11.1–27.4). ConclusionIdentifying factors associated with a higher intake of folate may be helpful in shaping public health nutrition policy. It allows the design of effective nutrition education programs to promote increased intake of folate in subgroups at risk of deficiency.

Folic Acid and Diabetic Foot Ulcers.

Diabetic foot ulcers (DFUs) remain a major cause of morbidity. This narrative mini-review aimed to investigate the potential role of folic acid (FA) in DFUs. Individuals with DFUs exhibit lower levels of FA and lower daily intake, compared to those without DFUs. There is preliminary evidence that FA administration may contribute to improved DFUs healing. In this context, regular evaluation of dietary FA intake may prove important towards reduction or even prevention of DFUs. However, data are still limited and further research is required to enable definitive conclusions and any recommendations.

The effectiveness of egg supplementation on nutritional status, physical fitness and cognition of school-aged children (8–12 Years) in Ho Municipality, Ghana

BackgroundEgg is a cheap source of essential micronutrients and high-quality protein, which can contribute to the daily nutritional needs of children, support their growth and brain development. Aim: The study evaluated the effectiveness of egg supplementation on nutritional status, physical fitness, and cognition of school-aged Children (8–12 Years) in Ho Municipality, Ghana. MethodsA school-based, double-blind randomized controlled trial design was adopted. Children aged 8 to 12 years from government-run primary schools were randomly allocated to receive either egg supplementation three times a week for three months or no supplementation at all for three months. Dietary intakes using a repeated 24-h dietary recall, Raven's cognition test, fitness level, BMI-for-age, and serum levels of ferritin, zinc, and albumin were assessed at baseline and after the intervention. ResultsAt pre-intervention, mean intake of several nutrients, including energy, CHO, protein, fat, iron zinc and folate were significantly higher in the intervention group. Post-intervention, these differences significantly increased for protein, fat, and iron, and reduced for energy, carbohydrate, folate, vitamin B6 and 12. Children on egg supplementation had a much higher increase in vitamin A intake (142.0 μg) than the controls (49.8 μg) between pre-and post-intervention. Regarding the physical fitness markers, pre-intervention mean handgrip, forward jump and total fitness scores were all higher in the intervention group and similar for the 50-m run. Post-intervention, the difference was lost while the total fitness score increased rather among controls (p < 0.001). For the biochemical markers, both serum ferritin (mean difference in control = 18.2 μg/L versus intervention= 20.1 μg/L) and zinc (mean difference in control 14.4 μg/L versus intervention 69.4 μg/L) increased more in the intervention than the controls. BMI-for-age z-score did not change between the intervention and control (p = 0.894) post-intervention, while the total cognition score improves slightly more in controls (4.8 points, p < 0.001) than in the intervention group (3.3 points, p < 0.001). ConclusionsThe results indicate that school children who consumed boiled eggs three times per week for three months had a higher mean intake of energy, carbohydrate, protein, iron, zinc, folate, and vitamins A and B6. The mean serum ferritin and albumin levels improved significantly higher in the experimental group. Egg supplementation did not significantly improve physical fitness and cognitive test scores of school-aged children. From this study, egg supplementation may improve some nutrients among school children but effects on congintion and physical fitness may require further study.

The relationship between nutrient intake and executive function in adults with post-traumatic stress disorder

BackgroundExecutive function (EF) deficits are common in adults with post-traumatic stress disorder (PTSD). Macro- and micronutrient intake are potential modifiable factors that may influence EF in PTSD. ObjectivesTo explore the relationship between the daily dietary intake of ω−3 and ω−6 polyunsaturated fatty acids (PUFAs), vitamin C, vitamin E, vitamin D, vitamin B12 and folate, and EF in adults with PTSD. MethodsThis was a cross-sectional observational study of adults with PTSD who completed neurocognitive assessments (n = 201). Digit span backwards, spatial span backwards, Stroop test and the Ruff Figural Fluency Task were used to assess EF. FoodFinder nutrient intake based on 24-h dietary recalls was used to calculate average daily nutrient intake. Multivariable linear regression models were used to regress EF on the nutrient variables. ResultsIntake of vitamin E, ω−3 PUFAs, and ω−6 PUFAs were all positively associated with planning and set-shifting, with vitamin E (adjusted β = 0.20, p = 0.004) and ω−6 (adjusted β = 0.17, p = 0.01) remaining significant after adjustment for age; sex; education and body mass index. Vitamin D intake was negatively associated with interference (adjusted β = −0.21, p = 0.01). Vitamin C, vitamin B12 and folate intake were not associated with EF. Limitations24-h dietary recall data is limited by recall bias. Circulating nutrient levels were not measured. ConclusionsDietary intake of vitamins E, ω−3 and ω−6 may be important modifiable factors affecting EF in adults with PTSD. Randomised controlled trials are needed to investigate whether micro- and macronutrient interventions can improve EF and other outcomes in PTSD.

Folic acid supplements and perinatal mortality in China.

Periconceptional use of multivitamins containing folic acid prevents external major birth defects, especially neural tube defects. We aimed to explore the effects of maternal folic acid supplementation alone on perinatal mortality with or without external major birth defects plus neural tube defects. From the China-US Collaborative Project for Neural Tube Defects Prevention, we identified 222, 303 singleton pregnancies with detailed information on periconceptional folic acid use, defined as folic acid supplementary before the last menstrual date until to the end of the first trimester. Perinatal mortality included stillbirths after 20 weeks' gestation and early neonatal deaths within 7 days of delivery. Among the fetuses or infants of women who did not take folic acid, the rate of perinatal mortality was 2.99% and 1.62% at least 20 weeks' gestation in the northern and southern regions. Among the fetuses or infants of the women with periconceptional use of folic acid, the rates were 1.85% and 1.39% in the northern and southern region. The estimated relative risk for perinatal mortality [adjusted risk ratio (RR), 0.72; 95% confidence interval (CI), 0.61- 0.85], stillbirth (adjusted RR, 0.78; 95% CI, 0.64-0.96), early neonatal mortality (adjusted RR, 0.61; 95% CI, 0.45-0.82), and neonatal death (adjusted RR, 0.64; 95% CI, 0.49-0.83) in northern China was significantly decreased in association with periconceptional folic acid supplementation. Compared with northern, there was a lesser effect in southern China. Periconceptional intake of 400μg folic acid daily reduces the overall risk perinatal mortality, as well as the risk from external major birth defects and neural tube defects, especially in northern China.

Ready-to-eat cereal consumption is associated with improved nutrient intakes and diet quality in Canadian adults and children across income levels.

Results from observational studies suggest ready-to-eat cereal (RTEC) consumption is associated with higher diet quality. In the United States, studies have shown that RTEC is an important contributor to nutrient intakes across income levels. However, it is unknown if this association varies by income level in the Canadian population. Given its affordability, RTEC may represent an important source of nutrients for lower-income individuals. This study evaluated the association of RTEC consumption with nutrient intakes and diet quality across household income levels in Canadian adults and children. Income and dietary data from 24 h dietary recalls were obtained from the 2015 Canadian Community Health Survey (CCHS)-Nutrition in 6,181 children (2-18 years) and 13,908 adults (19+ years). Diet quality was assessed with a modified Nutrient Rich Food Index (NRF) 9.3. Income levels were stratified into low, middle, and high based on family size, and data were analyzed by RTEC consumption and income level using multivariate linear regression adjusted for energy, age, and sex. Diet quality was greater in adult and child RTEC consumers across all household income levels. Children and adults consuming RTEC also had higher nutrient intakes, including shortfall nutrients such as calcium, dietary fiber, iron, magnesium, and vitamin D. RTEC provided <10% of energy intake, <4% of saturated fat intake, and <9% of total sugar intake across all ages and income levels, while also providing one-third of daily iron intake and at least 10% of daily intake of dietary fiber, thiamin, folate, and vitamin B6. RTEC consumption was associated with improved nutrient intakes and diet quality in adults and children across household income levels. Nutrient dense and affordable food choices, such as RTEC, may be a helpful strategy to improve the diet quality of Canadians, particularly those with a lower household income.

Associations of dietary choline and betaine with all-cause mortality: a prospective study in a large Swedish cohort.

Investigate the association between choline and betaine intake and all-cause mortality in a large Swedish cohort. Women (52,246) and men (50,485) attending the Västerbotten Intervention Programme 1990-2016 were included. Cox proportional hazard regression models adjusted for energy intake, age, BMI, smoking, education, and physical activity were used to estimate mortality risk according to betaine, total choline, phosphatidylcholine, glycerophosphocholine, phosphocholine, sphingomyelin, and free choline intakes [continuous (per 50mg increase) and in quintiles]. During a median follow-up of 16years, 3088 and 4214 deaths were registered in women and men, respectively. Total choline intake was not associated with all-cause mortality in women (HR 1.01; 95% CI 0.97, 1.06; P = 0.61) or men (HR 1.01; 95% CI 0.98, 1.04; P = 0.54). Betaine intake was associated with decreased risk of all-cause mortality in women (HR 0.95; 95% CI 0.91, 0.98; P < 0.01) but not in men. Intake of free choline was negatively associated with risk of all-cause mortality in women (HR 0.98; 95% CI 0.96, 1.00; P = 0.01). No other associations were found between intake of the different choline compounds and all-cause mortality. In women aged ≥ 55 years, phosphatidylcholine intake was positively associated with all-cause mortality. In men with higher folate intake, total choline intake was positively associated with all-cause mortality. Overall, our results do not support that intake of total choline is associated with all-cause mortality. However, some associations were modified by age and with higher folate intake dependent on sex. Higher intake of betaine was associated with lower risk of all-cause mortality in women.