Mg Of Folic Acid Research Articles

The Critical Role of Folate in Prenatal Health and a Proposed Shift from Folic Acid to 5-Methyltetrahydrofolate Supplementation

Folate, or vitamin B9, is a water-soluble vitamin essential in periconceptional nutrition. In its active form, tetrahydrofolate, it plays a vital role in DNA methylation and homocysteine breakdown. Maintenance of normal serum folate levels is crucial during pregnancy; deviation from these levels, either in dearth or excess, can lead to various pregnancy and infant complications. This article analyzes existing literature on folate’s absorption pathway in human physiology and reviews the evidence surrounding prenatal supplementation guidelines for folic acid. Prior research supports these guidelines because, in the absence of folate during pregnancy, research has shown an increased incidence of neurodevelopmental defects, food allergies, ophthalmic deficits, and other adverse effects for both mother and child. This significant body of evidence has driven most developed countries to implement folic acid supplementation initiatives, with the World Health Organization recommending a daily 400-µg folic acid supplementation for periconceptional women. As progress continues on a global scale, further efforts should be made to improve folic acid levels in pregnant populations among demographic subgroups. Research supports the use of 5-methyltetrahydrofolate in place of traditional folic acid prenatal supplements based on the increased bioavailability, resistance to genetic polymorphisms, and avoidance of several potential risks associated with folic acid supplements. More research and product development should be done to drive and support this shift in prenatal supplementation trends.

Response of One-Carbon Biomarkers in Maternal and Cord Blood to Folic Acid Dose During Pregnancy.

The folate Recommended Daily Allowance (RDA) for pregnant women is 600 μg/day dietary folate equivalents, which is equivalent to approximately 400 μg folic acid. Many prenatal supplements contain much higher doses of folic acid. The body's ability to reduce synthetic folic acid to the metabolically active form may be exceeded with high levels of supplementation. The objective of this double-blinded randomized controlled intervention trial was to determine changes in unmetabolized folic acid and other biomarkers of folate and one-carbon metabolism in maternal and cord blood in response to a folic acid dose commonly found in prenatal supplements (800 μg/day) compared to the dose equivalent of the RDA (400 μg/day). Healthy pregnant women were randomized and provided supplements from their first prenatal visit (<12 weeks gestation) through delivery. Maternal blood was collected at baseline and delivery. Umbilical cord blood from the mothers was collected at delivery. A repeated measures analysis of variance revealed that there was a significant group supplemental dose effect (p = 0.0225) on serum unmetabolized folic acid concentration in mothers but no difference in cord blood unmetabolized folic acid concentrations between groups. Mixed effects analysis found a significant overall effect of pre-pregnancy BMI (p = 0.0360) and length of previous folic acid supplementation (p = 0.0281) on serum folate concentrations. No treatment effect was seen in RBC folate concentrations. Choline concentrations were higher in cord blood from the 800 μg/day group compared to the 400 μg/day group, but there was no group effect in maternal choline concentrations. The results indicate that folic acid dose during pregnancy affects certain folate and one-carbon biomarkers, and these effects are not consistent between maternal and cord blood. Potential long-term effects of these results on both mothers and offspring are unknown and merit further investigation.

Pil-Pintar Intervention Reduce Anemia among Young Teen Girls: A Pilot Study

Background: Iron deficiency anemia and low adherence to take iron tablets are prevalent issues among teenage school girls in Indonesia. To address this concern and encourage regular iron supplementation, the public health office of Sukoharjo Central Java Indonesia introduced a pil-pintar program, colloquially known as the “smart pill.” Aims: This study aimed to measure the increase in hemoglobin (Hb) levels and its correlation with nutrient intake related to Hb synthesis following the pil-pintar intervention. Methods: A quasi-experimental design with a one-group pre-posttest approach was performed involving 49 school teenage girls aged 12-15 years in a public school in Sukoharjo, Indonesia. Each student was given an iron sugar coat tablet containing 182 mg of ferrous-fumarate (equivalent to 60 mg elemental iron) and 0.400 mg of folic acid per tablet, called pil-pintar, once a week for 12 weeks. Results: A decrease in anemia prevalence by 24.4% and a notable increase in Hb levels by 1.0 mg/dL (p = 0.001) were observed in the 12 weeks of intervention. However, the study found no association between the nutrient intakes related to Hb production and the resulting Hb levels. Conclusion: The pil-pintar program effectively improved the hemoglobin levels of anemic teenage girls in the Sukoharjo district, Indonesia.

Iron supplementation post-blood donation in Vietnam: Impact on hemoglobin, red cell indices, and iron reserves

Background. Regular blood donation plays a pivotal role in mitigating the formation of free radicals by regulating iron accumulation. However, frequent blood donation can lead to chronic iron deficiency. In this study, we aimed to evaluate the effectiveness of daily iron supplementation as an intervention to expedite hemoglobin (Hb) recovery among frequent blood donors at a hospital in Vietnam. Methodology. Conducted longitudinally within the Hematology Department of a Hanoi hospital from February to July 2023, our study involved 104 eligible participants. They received a daily iron supplement comprising 100 mg of elemental iron, 0.75 mg of folic acid, and 5 mg of zinc sulfate for a minimum of 8 weeks. Blood samples were collected at three key time points: before blood donation during recruitment, immediately after donation, and at least 8 weeks post-donation. Results. Our findings revealed moderate, statistically significant positive correlations between elemental iron administration and changes in platelet count (PLT), hematocrit (HCT), and mean corpuscular hemoglobin (MCH) (r = 0.753, p &lt;0.001; r = 0.887, p &lt;0.001; and r = 0.703, p &lt;0.001, respectively). Additionally, weak but significant correlations were observed between elemental iron administration and red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width coefficient of variation (RDWC), and red cell distribution width standard deviation (RDWS) (r = 0.260, p = 0.002; r = 0.302, p = 0.005; r = 0.160, p = 0.010; r = 0.120, p = 0.020; and r = 0.400, p &lt;0.001, respectively). Conclusion. Over an eight-week duration, the regimen of daily iron supplementation yielded significant improvements in both red cell variables, red cell indices, and iron study variables, demonstrating its potential clinical impact.

Effects of a food supplement containing phosphatidylserine on cognitive function in Chinese older adults with mild cognitive impairment: A randomized double-blind, placebo-controlled trial

BackgroundPhosphatidylserine (PS) and α-Linolenic acid (ALA), are positively associated with cognitive function, but their combination effects and possible mechanisms remain unclear. We aimed to explore the effects on cognition and potential mechanism of the supplements. MethodsThis randomized, double-blind, placebo-controlled trial recruited 190 MCI patients in Tianjin, China, and randomly assigned in intervention group and placebo group. Each group consumed two capsules every day for 12 months. Each capsule for intervention group contains 144 mg ALA, 31.5 mg PS and 3.6 mg Ginkgo total flavonoids as main functional components, with 0.48 mg Vitamin B1 (as thiamine hydrochloride), 0.48 mg Vitamin B6 (as pyridoxine hydrochloride) and 90 μg folic acid as supplement. Capsules for placebo group were identical but contain no active ingredients. Cognitive function, serum n-3 polyunsaturated fatty acids (PUFAs) and neurotransmitters were assessed at baseline and 12 months. Linear mixed effects model and causal mediation analysis were conducted to explore the effects and potential mechanism of the intervention. ResultsA total of 190 participants (mean [SD] age, 67.95 [5.62] years; 70 (36.8 %) male and 120 (63.2 %) female) were randomized to the placebo group (n = 95) and intervention group (n = 95). Compared with placebo group, the intervention group had statistically significant improvements in arithmetic testing (β, 0.688; 95 % CI, 0.103–1.274), the similarity test (β, 1.070; 95 % CI, 0.472–1.667) and short-term memory (β, 0.600; 95 % CI, 0.399–0.800). Besides, the intervention group had statistically significant increases in serum ALA (β, 1.620; 95 % CI, 0.967–2.265), DHA (β, 2.797; 95 % CI, 1.075–4.532), EPA (β, 1.472; 95 % CI, 0.296–2.643), acetylcholine (β, 0.441; 95 % CI, 0.415–0.468), GABA (β, 0.009; 95 % CI, 0.001–0.016) and 5-HT (β, 0.160; 95 % CI, 0.081–0.238) compared to the placebo group. And the intervention may improve short-term memory by increasing serum ALA levels (average causal mediation effect = 0.132, 95 % CI, 0.053–0.225) with 19.7 % mediation proportion. ConclusionsThis food supplement containing phosphatidylserine could improve different cognitive functions of MCI patients, especially short-term memory, and increase serum n-3 PUFAs and neurotransmitters levels. Serum ALA level might play a mediation role.

Treatment of anaemia in pregnancy with oral iron, folic acid or iron, folic acid and vitamin B12 supplementation: A hospital-based open randomized study

: National iron plus initiative recommended that anaemic pregnant women should be treated with 200 mg of elemental iron and 1 mg folic acid. An increase in vitamin B12 deficiency has been reported in last two decades. An open randomised study was taken up in urban antenatal clinics to assess the impact of addition of vitamin B12 to the iron and folic acid supplementation.: Anaemic pregnant women willing to participate in the study were randomised into Group 1 (240 iron mg and 5 mg folic acid) or Group 2 (240 mg iron, 1.5 mg of folic acid and 15 µg vitamin B12); the impact of supplementation on Hb, ferritin, folic acid and vitamin B12 was assessed.: In both groups mean Hb improved by 1g/dL at 8 weeks and by 1.5g/dL by 38 weeks of pregnancy; at 38 weeks only 30% were anaemic. Mean ferritin and folic acid levels improved in both groups. There was a fall in the mean vitamin B12 levels in the group which received 5 mg of folic acid.: With assured supply and supportive supervision, the supplementation achieved substantial reduction in anaemia in both groups. Supplementation with folic acid 5 mg should not be done because it causes a fall in vitamin B12 levels. The reason why addition of vitamin B12 to iron folic acid supplementation did not result in improvement in mean Hb, or vitamin B12 levels has to be investigated.

Folic acid supplement prescribing practice during the protective period and its associated factors among health professionals in selected governmental health centers in Addis Ababa, Ethiopia, 2023: A cross-sectional study.

Background: Supplementing folic acid (FA) before and in the first month of conception is an essential preventive factor, especially for neural tube defects (NTDs) and other congenital anomalies. Aim: The research aimed to assess FA supplement prescribing practice during the protective period and its associated factors among health professionals in selected governmental health centers in Addis Ababa, Ethiopia, in 2023. Methods: An institutionalized cross-sectional survey was carried out in Addis Ababa public health centers with a total sample size of 396 in February 2023. Systematic random sampling methods were used, and after each respondent's signed consent, a row of data was gathered using pretested self-administered questionnaires. The data was coded, interred to Epi Data 4.6.0.6 and transferred to Statistical Package for Social Sciences 27 software. Then a binary and multivariable logistic regression analysis method was used to show the associated variables with FA prescribing practice using a confidence interval (CI) of 95% and a significance value < 0.05. Results: The total prevalence of FA prescribing practice during the periconceptional period was 64.4% [95% CI (59.68-69.12)]. But those prescribed during the protective period were 26.7%. Ever since the birth of a neonate with NTDs, not prescribing a dose of 4 mg of FA for women with NTD, the type of women for whom FA was prescribed were associated with FA prescribing practice during the protective period. Conclusion: The healthcare professional's prescribing practice during the protective period was still low and needs more attention to strengthen FA supplements.

Influence of folic acid and vitamin B12 supplementation on arsenic methylation: A double-blinded, placebo-controlled trial in Bangladeshi children

BackgroundInorganic arsenic is metabolized to monomethyl- (MMAs) and dimethyl- (DMAs) species via one-carbon metabolism (OCM); this facilitates urinary arsenic elimination. OCM is influenced by folate and vitamin B12 and previous randomized control trials (RCTs) showed that folic acid (FA) supplementation increases arsenic methylation in adults. This RCT investigated the effects of FA + B12 supplementation on arsenic methylation in children, a key developmental stage where OCM supports growth. MethodsA total of 240 participants (8–11 years, 53 % female) drinking from wells with arsenic concentrations > 50 μg/L, were encouraged to switch to low arsenic wells and were randomized to receive 400 μg FA + 5 μg B12 or placebo daily for 12-weeks. Urine and blood samples were collected at baseline, week 1 (only urine) and week 12. Generalized estimated equation (GEE) models were used to assess treatment effects on arsenic species in blood and urine. ResultsAt baseline, the mean ± SD total blood and urinary arsenic were 5.3 ± 2.9 μg/L and 91.2 ± 89.5 μg/L. Overall, total blood and urine arsenic decreased by 11.7% and 17.6%, respectively, at the end of follow up. Compared to placebo, the supplementation group experienced a significant increase in the concentration of blood DMAs by 14.0% (95% CI 5.0, 25.0) and blood secondary methylation index (DMAs/MMAs) by 0.19 (95% CI: 0.09, 0.35) at 12 weeks. Similarly, there was a 1.62% (95% CI: 0.43, 20.83) significantly higher urinary %DMAs and −1.10% (95% CI: −1.73, −0.48) significantly lower urinary %MMAs in the supplementatio group compared to the placebo group after 1 week. The direction of the changes in the urinary %iAs, %MMAs, and %DMAs at week 12 were consistent with those at week 1, though estimates were not significant. Treatment effects were stronger among participants with higher baseline blood arsenic concentrations. Results were consistent across males and females, and participants with higher and lower folate and B12 status at baseline. ConclusionThis RCT confirms that FA + B12 supplementation increases arsenic methylation in children as reflected by decreased MMAs and increased DMAs in blood and urine. Nutritional interventions may improve arsenic methylation and elimination in children, potentially reducing arsenic toxicity while also improving nutritional status.

Adherence and acceptability of multiple micronutrient supplementation during pregnancy: Study protocol for a cluster-randomized non-inferiority trial in Cambodia

BackgroundIron and folic acid (IFA) supplements are currently provided to Cambodian women during pregnancy. However, recent research has found benefits of a multiple micronutrient supplement (MMS) over just IFA alone on several outcomes of perinatal and infant health. The Ministry of Health in Cambodia has proposed a transition from IFA to MMS but to effectively guide this transition requires implementation research on the acceptability and adherence to MMS (over IFA).MethodsThis non-inferiority trial aims to assess the adherence and acceptability of IFA (60 mg elemental iron and 400 μg folic acid) compared to MMS (standard UNIMMAP formulation including 15 micronutrients) during antenatal care in Cambodia. A prospective cohort of 1545 pregnant women will be assigned to one of three trial arms: (1) IFA for 90 days [IFA-90]; (2) MMS for 180 days with two distributions of 90-count tablet bottles [MMS-90]; or (3) MMS for 180 days with one 180-count tablet bottle [MMS-180]. Each arm will enroll 515 women across 48 health centers (clusters) in Kampong Thom Province in Cambodia. The primary outcome is the non-inferiority of adherence rates of MMS-180 compared to IFA-90, as assessed by tablet counts. Mixed-effects logistic and linear regression models will be used to estimate the difference in the adherence rate between the two groups, with an ‘a priori’ determined non-inferiority margin of 15%. Acceptability of MMS and IFA will be measured using a quantitative survey conducted with enrolled pregnant women at 30-day, 90-day, and 180-day time-points. DiscussionFindings from this study will guide an effective and feasible MMS scale-up strategy for Cambodia. Additionally, the findings will be shared globally with other stakeholders planning to scale up MMS in other countries.Trial registrationNCT05867836 (ClinicalTrials.gov, registered May 18, 2023).

Preconception Micronutrient Supplementation Affects Maternal BMI and Body Composition Postpartum: A Randomized Controlled Trial in Vietnam

BackgroundAlthough there is growing evidence on the role of preconception nutrition for birth outcomes, limited evidence exists for its effects on maternal health. ObjectivesThis study evaluates the impact of preconception micronutrient supplementation on maternal BMI (kg/m2) and body composition at 6 to 7 y postpartum (PP). MethodsWe followed females who participated in a randomized controlled trial of preconception supplementation in Vietnam and delivered live offspring (n = 1599). Females received weekly supplements containing either 2800 μg folic acid (FA) only, 60 mg iron and 2800 μg FA (IFA), or multiple micronutrients (MMs) (15 micronutrients including IFA) from baseline until conception followed by daily prenatal IFA supplements until delivery. Height, weight, mid-upper arm circumference, triceps skinfold, and waist-hip circumference were measured at recruitment and at 1, 2, and 6 to 7 y PP. Body fat was assessed using bioelectric impedance at 6 to 7 y PP (n = 867). Group comparisons were made using analysis of variance or chi-square tests and general linear models for adjusted models. ResultsAt 6 to 7 y PP, we found significant differences (P < 0.05) by treatment group for mean percent fat (MM: 29.2%; IFA: 27.6%; FA: 27.8%), absolute fat mass (MM: 15.1 kg; IFA: 14.0 kg; FA: 14.3 kg), and prevalence of underweight based on BMI < 18.5 (MM: 5.8%; IFA: 10.3%; FA: 14.3%). Mean BMI and triceps skinfold thickness were higher in the MM group, but these differences were not statistically significant; the differences in absolute fat mass were also attenuated after controlling for body weight. No differences were observed for fat-free mass, prevalence of overweight (BMI >23), or other anthropometric measurements. ConclusionsPreconception MM supplementation was associated with lower prevalence of underweight and higher percent fat when compared with IFA and/or FA only. Preconception micronutrient interventions may have long-term effects on maternal health and merit further examination.This trial was registered at clinicaltrials.gov as NCT01665378.

Supplementation with antioxidant micronutrients in pregnant women with obesity: a randomized controlled trial.

Obesity increases maternal morbidity and adversely affects child health. Maternal inflammation may play a role in adverse outcomes. The objective of this study was to determine whether providing a higher dose of antioxidant micronutrients to pregnant women with obesity would raise concentrations of key antioxidant vitamins and impact inflammation and oxidative stress during pregnancy. This was a double-blind, randomized controlled trial. We recruited pregnant women with a body mass index (BMI) ≥ 30 kg/m2 at their initial prenatal visit ( < 13 weeks gestation) and collected blood and urine samples at baseline, 24-28 weeks, and 32-36 weeks to measure micronutrient concentrations (vitamin C, E, B6 and folate), markers of inflammation (C-reactive protein, interleukin-6, 8, and 1β) and oxidative stress (8-epi-PGF2α and malondialdehyde). We collected maternal and infant health data from enrollment to delivery as secondary outcomes. We enrolled 128 participants (64 in each arm), and 98 (49 in each arm) completed follow-up through delivery. Both groups received a standard prenatal vitamin containing the recommended daily allowance of micronutrients in pregnancy. In addition, the intervention group received a supplement with 90 mg vitamin C, 30 αTU vitamin E, 18 mg vitamin B6, and 800 μg folic acid, and the control group received a placebo. The intervention group had higher vit B6 (log transformed (ln), β 24-28 weeks: 0.76 nmol/L (95% CI: 0.40, 1.12); β 32-36 weeks: 0.52 nmol/L (95% CI: 0.17, 0.88)) than the control group. Vitamins C, E, erythrocyte RBC folate concentrations did not differ by randomization group. The intervention did not impact biomarkers of inflammation or oxidative stress. There were no differences in maternal or neonatal clinical outcomes by randomization group. Higher concentrations of antioxidant vitamins during pregnancy increased specific micronutrients and did not impact maternal inflammation and oxidative stress, which may be related to dosing or type of supplementation provided. Clinical Trial Identification Number: NCT02802566; URL of the Registration Site: www. gov .

Amelioration of Cytogenotoxic Damage in Drug Abusers Supplemented with Folic Acid.

Cytogenotoxic damage caused by the consumption of legal and illegal drugs in drug abusers has been demonstrated, primarily due to alterations in their antioxidant capacity, cellular repair mechanisms, and increased production of free radicals. Folic acid shows antioxidant activity by acting as a reducing agent, neutralizing present free radicals, and reducing genomic damage. The intervention involved administering 15 mg of folic acid, divided into three doses per day, to a group of 44 drug abusers. The frequency of nuclear abnormalities (NAs) was determined; micronuclei (MNs), nuclear buds (NBUDs), binucleated cells (BNs), abnormally condensed chromatin (CC), karyorrhexis (KX), pyknotic nuclei (PNs), and karyolysis (KL) were determined at different pre-treatment (baseline) and post-treatment time points at 15 and 30 days. Additionally, a group of 44 healthy individuals was used as the control group. We observed a statistically significant decrease in the frequency of NAs in the drug abuser group (28.45 ± 17.74 before supplementation vs. 11.18 ± 7.42 at 15 days and 9.11 ± 10.9 at 30 days of supplementation). Specifically, it decreased the frequency of NBUDs, BNs, CC, KX, and PNs (p < 0.05). Our study demonstrates a clear improvement in cytogenotoxic damage in drug abusers supplemented with folic acid.

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.

One-carbon metabolite supplementation to nutrient-restricted beef heifers affects placental vascularity during early pregnancy.

We hypothesized that restricted maternal nutrition and supplementation of one-carbon metabolites (OCM; methionine, folate, choline, and vitamin B12) would affect placental vascular development during early pregnancy. A total of 43 cows were bred, and 32 heifers successfully became pregnant with female calves, leading to the formation of four treatment groups: CON-OCM (n = 8), CON + OCM (n = 7), RES-OCM (n = 9), and RES + OCM (n = 8). The experimental design was a 2 × 2 factorial, with main factors of dietary intake affecting average daily gain: control (CON; 0.6kg/d ADG) and restricted (RES; -0.23kg/d ADG); and OCM supplementation (+OCM) in which the heifers were supplemented with rumen-protected methionine (7.4g/d) and choline (44.4g/d) and received weekly injections of 320mg of folate and 20mg of vitamin B12, or received no supplementation (-OCM; corn carrier and saline injections). Heifers were individually fed and randomly assigned to treatment at breeding (day 0). Placentomes were collected on day 63 of gestation (0.225 of gestation). Fluorescent staining with CD31 and CD34 combined with image analysis was used to determine the vascularity of the placenta. Images were analyzed for capillary area density (CAD) and capillary number density (CND). Areas evaluated included fetal placental cotyledon(COT), maternal placental caruncle (CAR), whole placentome (CAR + COT), intercotyledonary fetal membranes (ICOT, or chorioallantois), intercaruncular endometrium (ICAR), and endometrial glands (EG). Data were analyzed with the GLM procedure of SAS, with heifer as the experimental unit and significance at P ≤ 0.05 and a tendency at P > 0.05 and P < 0.10. Though no gain × OCM interactions existed (P ≥ 0.10), OCM supplementation increased (P = 0.01) CAD of EG, whereas nutrient restriction tended (P < 0.10) to increase CAD of ICOT and CND of COT. Additionally, there was a gain × OCM interaction (P < 0.05) for CAD within the placentome and ICAR, such that RES reduced and supplementation of RES with OCM restored CAD. These results indicate that maternal rate of gain and OCM supplementation affected placental vascularization (capillary area and number density), which could affect placental function and thus the efficiency of nutrient transfer to the fetus during early gestation.

Pedoman Pemberian Tablet Tambah Darah (TTD) Bagi Remaja Putri di SMA Negeri 8 Makassar

The provision of blood supplement tablets in adolescent girls currently has an urgency to prevent anemia and increase iron reserves in the body which is a provision in preparing healthy quality and productive adolescent girls. Adolescent girls have a menstrual phase every month, plus their rapid growth, so they need a strong and balanced nutritional intake. One of them is by fulfilling the needs of iron (Fe) in the body. Adolescent girls who experience anemia can reduce intelligence, productivity, and learning achievement. This service aims to provide socialization to students to find out the guidelines for taking blood supplement tablets and provide insight to students about the impact of anemia and its prevention. The method used in this service activity is counseling with lecture methods and active discussion between presenters and participants. Students were briefed to follow the guidelines for giving blood supplement tablets according to the guidelines given by the Ministry of Health, namely 1 tablet every week for 1 year (52 weeks). Blood supplement tablets are nutritional supplements containing 60 mg of elemental iron and 0.25 mg of folic acid (in accordance with WHO recommendations). The conclusion of this service activity is that many students have not consumed blood supplement tablets regularly so that after counseling it is expected that students regularly consume TTD.

Low-dose daily folic acid (400 μg) supplementation does not affect regulation of folate transporters found present throughout the terminal ileum and colon of humans: a randomized clinical trial

BackgroundFolic acid supplementation during the periconceptional period reduces the risk of neural tube defects in infants, but concern over chronic folic acid exposure remains. An improved understanding of folate absorption may clarify potential risks. Folate transporters have been characterized in the small intestine, but less so in the colon of healthy, free-living humans. The impact of folic acid fortification or supplementation on regulation of these transporters along the intestinal tract is unknown. ObjectiveThe objective was to characterize expression of folate transporters/receptor (FT/R) and folate hydrolase, glutamate carboxypeptidase II (GCPII), from the terminal ileum and throughout the colon of adults and assess the impact of supplemental folic acid. MethodsIn this 16-wk open-labeled randomized clinical trial, adults consumed a low folic acid-containing diet, a folate-free multivitamin, and either a 400 μg folic acid supplement or no folic acid supplement. Dietary intakes and blood were assessed at baseline, 8 wk, and 16 wk (time of colonoscopy). Messenger RNA (mRNA) expression and protein expression of FT/R and GCPII were assessed in the terminal ileum, cecum, and ascending and descending colon. ResultsAmong 24 randomly assigned subjects, no differences in dietary folate intake or blood folate were observed at baseline. Mean ± SD red blood cell folate at 16 wk was 1765 ± 426 and 911 ± 242 nmol/L in the 400 and 0 μg folic acid group, respectively (P < 0.0001). Reduced folate carrier, proton-coupled folate transporter, and folate-receptor alpha expression were detected in the terminal ileum and colon, as were efflux transporters of breast cancer resistance protein and multidrug resistance protein-3. Other than a higher mRNA expression of FR-alpha and GCPII in the 400 μg supplement group in the ascending colon, no treatment differences were observed (P < 0.02). ConclusionsFolate transporters are present throughout the terminal ileum and colon; there is little evidence that a low dose of folic acid supplementation affects colonic absorption.This trial was registered at clinicaltrials.gov as NCT03421483.

Impact of folic acid supplementation on the epigenetic profile in healthy unfortified individuals – a randomized intervention trial

ABSTRACT Folate is an essential mediator in one-carbon metabolism, which provides methyl groups for DNA synthesis and methylation. The availability of active methyl groups can be influenced by the uptake of folic acid. We conducted a randomized intervention trial to test the influence of folic acid supplementation on DNA methylation in an unfortified population in Germany. A total of 16 healthy male volunteers (age range 23–61 y) were randomized to receive either 400 μg (n = 9) or 800 μg (n = 7) folic acid supplements daily for 8 weeks. Infinium Human Methylation 450K BeadChip Microarrays were used to assay site-specific DNA methylation across the genome. Microarray analyses were conducted on PBL DNA. We estimated several epigenetic clocks and mean DNA methylation across all autosomal probes on the array. AgeAccel was estimated as the residual variation in each metric. In virtually all participants, both serum and red blood cell (RBC) folate increased successively throughout the trial period. Participants with a larger increase in RBC folate had a larger increase in DNAmAge AgeAccel (Spearman Rho: 0.56, p-value = 0.03). No notable changes in the methylome resulting from the folic acid supplementation emerged. In this population with adequate folate levels derived from diet, an increase in RBC folate had a modest impact on the epigenetic clock predicting chronologic age.

Effect of Basic Amino Acids on Folic Acid Solubility.

To prevent neural tube defects and other cardiovascular diseases in newborns, folic acid (FA) is recommended in pregnant women. A daily dose of 600 µg FA consumption is widely prescribed for women during pregnancy and 400 µg for women with childbearing potential. FA is a class IV compound according to the Biopharmaceutics Classification System (BCS) due to its low permeability (1.7 × 10-6 cm/s) and low solubility (1.6 mg/L); therefore, it must be administered via a formulation that enhances its solubility. Studies reported in the literature have proved that co-amorphization and salt formation of a poorly soluble drug with amino acids (AA) can significantly increase its solubility. Although arginine has been used with FA as a supplement, there is no information on the effect of basic AA (arginine and lysine) on the physical and chemical properties of FA-AA binary formulations. The present study implemented a conductimetric titration methodology to find the effective molar ratio to maximize FA solubility. The results showed that a 1:2.5 FA:AA molar ratio maximized solubility for arginine and lysine. Binary formulations were prepared using different methods, which led to an amorphous system confirmed by the presence of a glass transition, broad FTIR bands, and the absence of an X-ray diffraction pattern. Results of FA:AA (1:2.5) solubility increased in the range of 5500-6000 times compared with pure FA. In addition to solubility enhancement, the binary systems presented morphological properties that depend on the preparation method and whose consideration could be strategic for scaling purposes.

Pengaruh Pemberian Jus Umbi Bit terhadap Kadar Hemoglobin Ibu Hamil Trimester III

WHO data (2020), it estimated that worldwide around 32 million pregnant women have anemia. In Indonesia, the incidence of anemia in pregnant women increased in 2018 by 48.8% when compared to 2013, which was 37.1%. Garut Regency in 2019 the prevalence of pregnant women with anemia was 6669 people. Karangpawitan Health Center in 2021, out of 834 pregnant women, 31.5% experienced anemia in the first trimester and as many as 168 pregnant women in third trimester (20.1%). Non-pharmacologically the treatment and prevention of anemia is by consuming green vegetables, nuts, chicken liver, beet tubers, red guava fruit and others. The content of beet tubers in the list of food ingredients includes 108 mg of folic acid, 27.0 mg of calcium, 43.0 mg of phosphorus, 43 mg of vitamin C, 23 mg of magnesium, 9.6 mg of carbohydrates, 1.0 mg of iron (Ministry of Health RI, 2016). Folic acid is very good to help the formation of the baby's brain and overcome the problem of anemia. The purpose of the study was to determine the effect of beetroot juice on hemoglobin levels of pregnant women in the third trimester at Karangpawitan Public Health Center, Garut Regency. The methodology of this research uses Pre test - Post test with control group design. The population in the study were all pregnant women in the third trimester as many as 129 people The samples in this study were TM III pregnant women who experienced mild anemia using purposive sampling as many as 30 people who were divided into 2 groups, namely 15 people in the experimental group and 15 people in the control group. The instruments used are observation sheets and technical instructions for beetroot juice. Data analysis used Paired T-test and Independent Samples Test. The results of the study the average hemoglobin level in the experimental group before being given beet juice was 9.160 and after beet juice was 10.807, while in the control group before the intervention was 8.933 and after the intervention was 9.813. The bivariate results showed a p-value of 0.000 &lt;0.05. The conclusion is that there is an effect of giving beetroot juice + Fe tablets on hemoglobin levels of pregnant women in the third trimester at Karangpawitan Health Center, Garut Regency In 2023. With this study, consumption of beet root juice can be an alternative in increasing hemoglobin levels in pregnant women.

Micronutrient supplements as antioxidants in improving sperm quality and reducing DNA fragmentation

BackgroundSpermatogenesis and sperm quality may be negatively impacted by an increase in reactive oxygen species. This study investigates the efficacy of combined antioxidant therapy for treating male infertility, as measured by semen analyses and the sperm DNA fragmentation index (DFI). Infertile men with a high sperm DNA fragmentation index were instructed to take two oral micronutrient capsules daily for three months. Each antioxidant formulation contained 60 mg vitamin E, 400 µg folic acid, 30 mg selenium, 125 mg L-arginine, 220 mg L-carnitine, 7.5 mg coenzyme Q10, 40 mg L-glutathione, and 20 mg zinc citrate. At entry and post-treatment, the general characteristics, semen analysis, and sperm chromatin dispersion assays were recorded and compared.ResultsAfter three months of treatment with antioxidant compounds, the quality of spermatozoa improved significantly, as indicated by a decrease in the mean DNA fragmentation index from 45.6 ± 17.2% to 34.8 ± 20.3%; an increase in sperm concentration from 29.7 × 106/mL to 35.7 × 106/mL (p < 0.001), an increase in a total number of spermatozoa from 72.1 × 106 to 95.5 × 106 (p = 0.012), and an increase in the vitality from 75.5 ± 17.1 to 81.1 ± 14.4% viable forms (p < 0.001).ConclusionsMicronutrient supplementation can improve sperm quality and DNA integrity in infertile men. Men with infertility and significant sperm DNA fragmentation who take antioxidants for three months experience a reduction in DNA fragmentation index and an increase in sperm quality as measured by the semen analysis.Trial registrationNCT04509583. Registered 12 August 2020, Hue University of Medicine and Pharmacy Ethics Committee—Retrospectively registered.