Mg Of Folic Acid Research Articles

Folic acid supplementation enhances arsenic methylation: results from a folic acid and creatine supplementation randomized controlled trial in Bangladesh

Arsenic exposure through drinking water persists in many regions. Inorganic As (InAs) is methylated to monomethyl-arsenical species (MMAs) and dimethyl-arsenical species (DMAs), facilitating urinary excretion. Arsenic methylation is dependent on one-carbon metabolism, which is influenced by nutritional factors such as folate and creatine. This study investigated the effects of folic acid (FA) and/or creatine supplementation on the proportion of As metabolites in urine. In a 24-wk randomized, double-blinded, placebo-controlled trial, 622 participants were assigned to receive FA (400 or 800 μg per day), 3 g creatine per day, 400 μg FA+3 g creatine per day, or placebo. The majority of participants were folate sufficient; all received As-removal water filters. From wk 12-24, half of the participants receiving FA received placebo. Among groups receiving FA, the mean decrease in ln(%InAs) and %MMAs and increase in %DMAs exceeded those of the placebo group at wk 6 and 12 (P<0.05). In the creatine group, the mean decrease in %MMAs exceeded that of the placebo group at wk 6 and 12 (P<0.05); creatine supplementation did not affect change in %InAs or %DMAs. The decrease in %MMAs at wk 6 and 12 was larger in the 800 µg FA than in the 400 µg FA group (P=0.034). There were no differences in treatment effects between the 400 µg FA and creatine+FA groups. Data suggest a rebound in As metabolite proportions after FA cessation; at wk 24, log(%InAs) and %DMAs were not significantly different than baseline levels among participants who discontinued FA supplementation. The results of this study confirm that FA supplementation rapidly and significantly increases methylation of InAs to DMAs. Further research is needed to understand the strong cross-sectional associations between urinary creatinine and As methylation in previous studies. This trial was registered at https://clinicaltrials.gov as NCT01050556.

The MTHFR C677T polymorphism influences the efficacy of folic acid supplementation on the nerve conduction studies in patients with diabetic polyneuropathy; A randomized, double blind, placebo-controlled study.

Background:Among patients with diabetic polyneuropathy, the status of folic acid, homocysteine, and nerve conduction studies (NCS) variations has been associated with methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms. The objective of the present study is to assess B9 vitamin supplementation associated with MTHRF C677T polymorphism can be effective on NCS variations in patients.Materials and Methods:This study is a randomized, double-blind, placebo-controlled study. Patients were randomly allocated to either intervention (1 mg of folic acid, n = 40) or placebo (n = 40) groups based on parallel group design. Blood samples were taken to determine the serum levels of folic acid and homocysteine. The NCS data were collected for the assessment of diabetic neuropathy. Genotyping was performed for C677T polymorphism of the MTHFR gene.Results:Four months after intervention, patients significantly observed change of serum folic acid and homocysteine levels based on C677T genotypes in the MTHFR gene. The amplitude of sensory peroneal nerve between intervention and placebo groups with CC genotype was significantly different (2.8 ± 1.6 vs. 1.9 ± 1.1). However, peak latency and amplitude of sensory sural nerve between CC (3.8 ± 1.8 vs. 4.0 ± 1.5 for peak latency and 3.5 ± 1.0 vs. 2.5 ± 1.0 for amplitude; and CT + TT genotypes (3.7 ± 1.7 vs. 3.9 ± 1.3 for peak latency and 3.2 ± 1.0 vs. 2.3 ± 1.1 for amplitude) were significant. Furthermore, significant difference for variables of motor tibial nerve and motor peroneal nerve amplitude was observed in different groups of MTHFR C677T genotypes (5.4 ± 2.9 vs. 4.6 ± 3.2 for onset-latency of tibial nerve between CC genotype; 4.8 ± 2.8 vs. 4.6 ± 3.2 for onset-latency of tibial nerve between CT + TT genotype; 0.6 ± 0.2 vs. 0.3 ± 0.1 for amplitude of tibial nerve between CC genotype; 0.5 ± 0.3 vs. 0.3 ± 0.2 for amplitude of tibial nerve between CT + TT genotype; 26.0 ± 13.3 vs. 23.2 ± 13.4 for velocity of tibial nerve between CC genotype; 26.0 ± 13.7 vs. 23.1 ± 9.6 for velocity of tibial nerve between CT + TT genotype; 1.6 ± 1.0 vs. 0.9 ± 0.7 for amplitude of peroneal nerve between CC genotype; 1.4 ± 0.7 vs. 0.9 ± 0.5 for amplitude of peroneal nerve between CT + TT genotype).Conclusion:The study determined that MTHFR C677T polymorphism effects the efficacy of folic acid supplementation on serum folic acid, homocysteine levels and some NCS parameters in diabetic polyneuropathy patients.

Periconceptional intake of folic acid among low-risk women in Canada: summary of a workshop aiming to align prenatal folic acid supplement composition with current expert guidelines

ABSTRACTThe Government of Canada and the Society of Obstetricians and Gynaecologists of Canada both recommend a daily multivitamin supplement containing 400 µg folic acid (FA) for the primary prevention of neural tube defects among low-risk women from before conception and throughout lactation. Prenatal supplements marketed and prescribed in Canada typically exceed the recommended dose, usually providing ≥1000 µg FA/d. This high daily dose, coupled with staple-food FA fortification, has resulted in the observation of very high blood folate concentrations among reproductive-aged women consuming FA-containing supplements. The long-term consequences of high folate status on fetal development are unknown; however, evidence from animal studies and some human epidemiologic data suggest potential adverse consequences. To address this issue, a workshop was convened with the overall goal to identify challenges and solutions to aligning supplemental FA intakes with current evidence-based recommendations. Thirty-eight stakeholders from academia, industry, government, and health professional groups participated. Group discussions facilitated the identification and prioritization of 5 key challenges for which solutions and implementation strategies were proposed. The 5 themes encompassed clarity and harmonization of evidence-based guidelines, reformulation or relabeling of FA-containing supplements, access to FA for all women, knowledge dissemination strategies and education of the public and health care professionals, and attitude change to overcome the perception of “more is better.” A combination of the proposed implementation strategies involving all key stakeholders and directed to health care professionals and the public may enable a sustainable change to align FA intake during the periconceptional period with evidence-based recommendations.

Daily Maternal Lipid-Based Nutrient Supplementation with 20 mg Iron, Compared with Iron and Folic Acid with 60 mg Iron, Resulted in Lower Iron Status in Late Pregnancy but Not at 6 Months Postpartum in Either the Mothers or Their Infants in Bangladesh

Maternal anemia and iron deficiency are prevalent in low- and middle-income countries. We aimed to determine the effects of lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) on hemoglobin (Hb), anemia, and iron status (nonprimary outcomes) at 36 weeks of gestation (women) and 6 mo postpartum (women and infants). The Rang-Din Nutrition Study, a cluster-randomized effectiveness trial, enrolled 4011 Bangladeshi pregnant women at ≤20 weeks of gestation to receive either daily LNS-PL (20 mg Fe) during pregnancy and the first 6 mo postpartum, or iron and folic acid (IFA, 60 mg Fe+400 µg folic acid) daily during pregnancy and every other day during the first 3 mo postpartum. Biochemical measurements from a subsample of women (n=1128) and their infants (n=1117) included Hb (g/L), serum ferritin (µg/L), and soluble transferrin receptor (sTfR; mg/L). Anemia was defined as maternal Hb <110 g/L at 36 weeks of gestation, <120 g/L at 6 mo postpartum, or infant Hb <105 g/L; iron deficiency (ID) was defined as ferritin <12 µg/L or elevated sTfR (>8.3 mg/L for women and >11 mg/L for infants). Compared with the IFA group, women in the LNS-PL group had lower ferritin (-6.2 µg/L; P<0.001) and higher sTfR concentrations (+0.5 mg/L; P<0.001), and higher risk of ID (OR=1.93; P<0.05) at 36 weeks of gestation but not at 6 mo postpartum, whereas no consistent differences were observed for Hb or anemia. Among infants at 6 mo, there were no group differences except for a lower risk of elevated sTfR (OR=0.61; P<0.05) in the LNS-PL group than in the IFA group. Provision of LNS-PL including a lower dose of iron than what is recommended during pregnancy resulted in differences in maternal iron status in late pregnancy that disappeared by 6 mo postpartum, and caused no undesirable effects regarding anemia or iron status of infants. This trial was registered at clinicaltrials.gov as NCT01715038.

Correlation of Vitamin D3 (Calcitriol) Serum Concentrations with Vitamin B12 and Folic Acid in Women Undergoing in vitro Fertilisation/Intracytoplasmatic Sperm Injection

Background: The important role of vitamin D3 in human health is well recognized. In this study, we measured serum concentrations of vitamin D3, vitamin B12 and B9 (folic acid) in 410 women undergoing in vitro fertilisation (IVF)/intracytoplasmatic sperm injection (ICSI) with dedicated focus on 3-month changes in consideration of patients’ BMI. Methods: Patients were of European origin and did not take any supplementation of D3. In preparing for pregnancy, patients took ≥4 weeks 400 µg folic acid combined with 9 µg vitamin B12 and 150 µg iodide as recommended. Results: We found a significant 3-month quartile change of D3 serum concentrations (p < 0.0001) with maximum levels in autumn and lowest in spring. D3 correlated significantly with B12 (p = 0.035, ρ = 0.102) and folic acid (p < 0.0001, ρ = 0.191). BMIs however showed a negative correlation with B12 (p = 0.031, ρ = –0.105) and folic acid (p = 0.012, ρ = –0.125). Conclusions: Our results suggest a model in which the sun exposure during summer months enables storage of D3 followed by a slow release as a major factor to maintain D3 levels throughout the year. Finally, our data indicate that B12 and folic acid uptake might be influenced by vitamin D receptor and D3, where D3 and the BMI appear to have an indirect relationship – via B12 and folic acid.

A Rare Case of Multicentric Reticulohistiocytosis

Multicentric reticulohistiocytosis (MRH) is a rare, histiocytic disorder that primarily affects the skin and joints. This disease can have systemic involvement of various organ systems and has been associated with underlying malignancy. Middle-aged, Caucasian females are the most commonly affected demographic group in this disease. We present a case of a 56-year-old African American male with debilitating joint pain and a papulonodular rash on his face, chest, arms, and hands. Biopsy of skin lesions confirmed the diagnosis of multicentric reticulohistiocytosis. Histological findings revealed dermal infiltrate composed of glassy histiocytes and giant cells with eosinophilic cytoplasm. The patient was started on 15 mg of methotrexate weekly, 1 mg of folic acid daily, and 60 mg of prednisone daily with mild improvement of skin lesions at one month followup. He expired from other comorbidities before long term treatment could be achieved. The potential for disfiguring skin lesions and debilitating arthropathy emphasizes the importance of early recognition and treatment of MRH. Corticosteroids and methotrexate are recommended for patients with moderate to severe disease and have been shown to be successful in some cases. More studies are needed on patients with MRH to further elucidate the etiology and pathogenesis of this disease.

Efektifitas Pemberian Tablet Fe dan Buah Pisang Ambon Dalam Meningkatkan Kadar Hemoglobin

: An effort to overcome anemia can be done by administering iron tablets containing 30-60 mg of iron and 400 mg of folic acid. Ambon bananas contain iron, vitamin B6, and vitamin C which can provide antioxidant benefits in enhancing the immune system and help maximize iron absorption. This study aims to determine the effectiveness of Fe tablets and ambon bananas with Fe tablets in increasing hemoglobin levels. This type of research is a quasi quasi-pretest-posttest two group design experiment. The number of samples is 30 respondents. The distribution of the sample is 15 respondents given Fe tablets and ambon bananas and 15 respondents only given Fe tablets. The results of this study Paired Sample T-Test, the significance value or p-value of Fe tablets and ambon bananas amounted to 0,000, with an average Hb pre-test 10,540 g / dl and post-test 13,840 g / dl or an increase of 3.3 g / dl and the significance value or p-value of Fe tablets of 0,000, with an average Hb pre-test 11,060 g / dl and post-test 12,267 g / dl or an increase of 1.2 g / dl. The conclusion of this study showed that there was a significant difference in the increase in hemoglobin levels between the Fe tablet and ambon banana groups and the Fe tablet group.

Lactating Canadian Women Consuming 1000 µg Folic Acid Daily Have High Circulating Serum Folic Acid Above a Threshold Concentration of Serum Total Folate

Consumption of high-dose folic acid supplements is common throughout pregnancy and lactation in several countries, including Canada, Brazil, and the United States, and may lead to high levels of circulating unmetabolized folic acid. The objective of the study was to characterize serum and whole-blood folate forms in Canadian lactating women regularly consuming a daily high-dose folic acid supplement. One-hundred and seventeen Canadian lactating women aged between 18 and 42 y, with a geometric mean ± SD prepregnancy body mass index (kg/m2) of 23.1 ± 1.2, were enrolled in a vitamin D supplementation trial between 13 and 22 wk of gestation. As part of the trial, the women received a daily multivitamin containing 1000 µg folic acid throughout pregnancy and lactation until 8 wk postpartum. At 8 wk postpartum, serum folate forms, including folic acid and RBC total folate, were determined from nonfasted blood samples. Differences in median folate vitamer concentrations among quintiles of serum total folate status were assessed by the Wald test and quantile regression methods. A breakpoint in the relation between serum folic acid and serum total folate was modeled with the use of the segmented package in R. Median serum total folate concentration among participants was 79.3 nmol/L (5th-95th percentile 30.7-186 nmol/L) and median RBC folate concentration was 2790nmol/L (5th-95th percentile 1330-4850nmol/L). There was a breakpoint in the relation between serum total folate and serum folic acid at 78.5 nmol/L (95% CI: 67.9, 89.1 nmol/L), below which serum folic acid was not associated with serum total folate, and above which serum folic acid increased 0.78 nmol/L (95% CI: 0.70, 0.86 nmol/L; P<0.001) for each 1 nmol/L increase in serum total folate. These data demonstrate the potential for high serum folic acid concentrations proportional to overall folate concentrations in lactating women with serum total folate >80 nmol/L taking high-dose supplemental folic acid. This study was registered at clinicaltrials.gov as NCT01112891.

Folic Acid Improves Vascular Function, But Not Skin Blood Flow, In Heart Failure Patients

PURPOSE: Heart failure (HF) patients’ are limited in their ability to manage a thermal load during exercise secondary to impaired skin blood flow (SkBF). Folic acid has been shown to improve vascular function and accompanying changes in SkBF in healthy older individuals and in those with metabolic and cardiovascular disease. Therefore, we examined the effect of folic acid on vascular function, and SkBF responses during exercise in 10 HF patients and 10 age-matched healthy controls (CON) similar in body size during exercise at a fixed rate of metabolic heat production (Hprod) in a 30°C environment. METHODS: Rectal temperature (Trec) and cutaneous vascular conductance (CVC) were measured during 60min of cycle ergometry before (pre) and after (post) a 6 week intervention period where participants ingested 5mg of folic acid, once daily. At these time points (pre- and post-folic acid), vascular function was assessed using flow-mediated dilation (FMD). RESULTS: Hprod was maintained at the same level for HF (pre: 332±46; post: 337±51W, p=0.84) and CON (pre: 323±31; post: 317±40W, p=0.72), and no differences were observed between groups in both exercise trials (p>0.05). Trec increased to a similar extent for HF (pre: 0.76±0.22°C; post: 0.70±0.11°C, p=0.63) and CON (pre: 0.55±0.27; post: 0.45±0.25°C, p=0.84); however, the rise in Trec was consistently higher in HF during both exercise trials (p<0.05). Similarly, CVC increased to a similar extent for HF (pre: 0.89±0.43; post: 0.83±0.45au/mmHg, p=0.80) and CON (pre: 2.01±0.79; post: 2.03±0.72au/mmHg, p=0.73), but the rise in CVC was consistently lower in HF during both exercise trials (p<0.05). Furthermore, folic acid improved FMD in HF (pre: 3.72±1.16; post: 5.88±1.29, p<0.01); however, no difference was observed in CON (pre-: 5.47±1.98; post: 6.50±2.49%, p=0.20). CONCLUSIONS: Collectively, these findings demonstrate that folic acid supplementation does not serve to enhance SkBF responses and attenuate the rise in core temperature during exercise at a fixed Hprod in HF patients. However, folic acid improved vascular function to a greater extent in HF than CON.

Folate supplementation in people with sickle cell disease.

Folate supplementation in people with sickle cell disease.

Management of women with PCOS using myo-inositol and folic acid. New clinical data and review of the literature.

Introduction The use of 2 × 2000 mg myo-inositol +2 × 200 μg folic acid per day is a safe and promising tool in the effective improvement of symptoms and infertility for patients with polycystic ovary syndrome (PCOS). In addition, PCOS is one of the pathological factors involved in the failure of in vitro fertilization (IVF). Typically, PCOS patients suffer of poor quality oocytes. Patients and methods In an open, prospective, non-blinded, non-comparative observational study, 3602 infertile women used myo-inositol and folic acid between 2 and 3 months in a dosage of 2 × 2000 mg myo-inositol +2 × 200 μg folic acid per day. In a subgroup of 32 patients, hormonal values for testosterone, free testosterone and progesterone were analyzed before and after 12 weeks of treatment. The mean time of use was 10.2 weeks. In the second part of this trial it was investigated if the combination of myo-inositol + folic acid was able to improve the oocyte quality, the ratio between follicles and retrieved oocytes, the fertilization rate and the embryo quality in PCOS patients undergoing IVF treatments. Twenty-nine patients with PCOS, underwent IVF protocols for infertility treatment and were randomized prospectively into two groups. Group A (placebo) with 15 patients and group B (4000 mg myo-inositol +400 μg folic acid per day) with 14 patients were evaluated. The patients of group B used 2 months' myo-inositol + folic acid before starting the IVF protocol. For statistically analyses Student's t-test was performed. Results Seventy percent of the women had a restored ovulation, and 545 pregnancies were observed. This means a pregnancy rate of 15.1% of all the myo-inositol and folic acid users. In 19 cases a concomitant medication with clomiphene or dexamethasone was used. One twin pregnancy was documented. Testosterone levels changed from 96.6 ng/mL to 43.3 ng/mL and progesterone from 2.1 ng/mL to 12.3 ng/mL in the mean after 12 weeks of treatment (p < 0.05) Student's t-test. No relevant side effects were present among the patients. The women in the IVF treatment the group A showed a higher number of retrieved oocytes than group B. Nevertheless, the ratio follicle/retrieved oocyte was clearly better in the myo-inositol group (= group B). Out of the 233 oocytes collected in the myo-inositol group, 136 where fertilized whereas only 128 out of 300 oocytes were fertilized in the placebo group. With regards to the oocytes quality, better data were obtained in the myo-inositol group. More metaphase II and I oocytes were retrieved in relation to the total number of oocytes, when compared with the placebo group. Also, more embryos of grade I quality were observed in the myo-inositol group than in the placebo group. The duration of stimulation was 9.7 days (±3.3) in the myo-inositol group and 11.2 (±1.8) days in the placebo group and the number of used follicle-stimulating hormone (FSH) units was lower in the myo-inositol group in comparison to the placebo group: 1850 FSH units (mean) versus 1850 units (mean). Discussion Myo-inositol has proven to be a new treatment option for patients with PCOS and infertility. The achieved pregnancy rates are at least in an equivalent or even superior range than those reported using metformin as an insulin sensitizer. No moderate to severe side effects were observed when myo-inositol was used at a dosage of 4000 mg per day. In addition, our evidence suggests that a myo-inositol therapy in women with PCOS results in better fertilization rates and a clear trend to a better embryo quality. As by the same way the number of retrieved oocytes was smaller in the myo-inositol group, the risk of a hyperstimulation syndrome in these patients can be reduced. Therefore, myo-inositol also represents an improvement in IVF protocols for patients with PCOS.

Folate Supplementation in People with Sickle Cell Disease

Folate Supplementation in People with Sickle Cell Disease

Effects of Low-Dose Dairy Protein Plus Micronutrient Supplementation during Resistance Exercise on Muscle Mass and Physical Performance in Older Adults: A Randomized, Controlled Trial.

To investigate whether supplementation with low-dose dairy protein plus micronutrients augments the effects of resistance exercise (RE) on muscle mass and physical performance compared with RE alone among older adults. Randomized controlled trial. Tokyo, Japan. Eighty-two community-dwelling older adults (mean age, 73.5 years) were randomly allocated to an RE plus dairy protein and micronutrient supplementation group or an RE only group (n = 41 each). The RE plus supplementation group participants ingested supplements with dairy protein (10.5 g/day) and micronutrients (8.0 mg zinc, 12 μg vitamin B12, 200 μg folic acid, 200 IU vitamin D, and others/day). Both groups performed the same twice-weekly RE program for 12 weeks. Whole-body, appendicular, and leg lean soft-tissue mass (WBLM, ALM, and LLM, respectively) with dual-energy X-ray absorptiometry, physical performance, biochemical characteristics, nutritional intake, and physical activity were measured before and after the intervention. Data were analyzed by using linear mixed-effects models. The groups exhibited similar significant improvements in maximum gait speed, Timed Up-and-Go, and 5-repetition and 30-s chair stand tests. As compared with RE only, RE plus supplementation significantly increased WBLM (0.63 kg, 95% confidence interval [CI]: 0.31-0.95), ALM (0.37 kg, 95% CI: 0.16-0.58), LLM (0.27 kg, 95% CI: 0.10-0.46), and serum concentrations of 25-hydroxyvitamin D (4.7 ng/mL, 95% CI: 1.6-7.9), vitamin B12 (72.4 pg/mL, 95% CI: 12.9-131.9), and folic acid (12.9 ng/mL, 95% CI: 10.3-15.5) (all P < 0.05 for group-by-time interactions). Changes over time in physical activity and nutritional intake excluding the supplemented nutrients were similar between groups. Low-dose dairy protein plus micronutrient supplementation during RE significantly increased muscle mass in older adults but did not further improve physical performance.

English

Objectives: The objective of our study was to assess the effectiveness offolic acid in optimizing the red blood cells folate levels and to observe the frequency of folateresistance among Pakistani female patients. Setting: Outpatient Department of Obstetrics &amp;Gynaecology, Jinnah Post graduate Medical Centre (JPMC), Karachi. Period: January–July2016. Methodology: Participants fulfilling the inclusion criteria were included after informedconsent. Detail history and physical examination was done in each participant. All studyparticipants received 5mg (400 μg) folic acid as a daily supplement for 24 weeks. Red bloodcell folate concentrations were measured at baseline and after 24 weeks of therapy. Pairedsample t-test was used to find out significant difference between folate levels. Results: A totalof 44 women (23 pregnant while 21 non pregnant) were included in the study. Mean age of theparticipants was 27.6 ± 5.9years and mean BMI was 23.9 ± 4.1kg/m2 respectively. The meanvalues of Red blood cells folate at baseline and at 24 weeks were 623.6 ± 406.6 and 861.9 ±432.4respectively. Paired sample t-test results showed that there was no significant difference.Thirty-two (70.4%) women showed an increase in RBC folate status while 13 (29.6%) womenhad steady or decreased levels of folate after taking folic acid for 24 weekswhich may be dueto RBS enzyme methylenetetrahydrofolate reductase (MTHFR) deficiency. Conclusion: Simplefolic acid supplementation is not very helpful in improving folate status in female Pakistanipatients. Resistant to improvement may be due to MTHFR deficiency in our study subjects.

FOLIC ACID;

Objectives: The objective of our study was to assess the effectiveness offolic acid in optimizing the red blood cells folate levels and to observe the frequency of folateresistance among Pakistani female patients. Setting: Outpatient Department of Obstetrics &amp;Gynaecology, Jinnah Post graduate Medical Centre (JPMC), Karachi. Period: January–July2016. Methodology: Participants fulfilling the inclusion criteria were included after informedconsent. Detail history and physical examination was done in each participant. All studyparticipants received 5mg (400 μg) folic acid as a daily supplement for 24 weeks. Red bloodcell folate concentrations were measured at baseline and after 24 weeks of therapy. Pairedsample t-test was used to find out significant difference between folate levels. Results: A totalof 44 women (23 pregnant while 21 non pregnant) were included in the study. Mean age of theparticipants was 27.6 ± 5.9years and mean BMI was 23.9 ± 4.1kg/m2 respectively. The meanvalues of Red blood cells folate at baseline and at 24 weeks were 623.6 ± 406.6 and 861.9 ±432.4respectively. Paired sample t-test results showed that there was no significant difference.Thirty-two (70.4%) women showed an increase in RBC folate status while 13 (29.6%) womenhad steady or decreased levels of folate after taking folic acid for 24 weekswhich may be dueto RBS enzyme methylenetetrahydrofolate reductase (MTHFR) deficiency. Conclusion: Simplefolic acid supplementation is not very helpful in improving folate status in female Pakistanipatients. Resistant to improvement may be due to MTHFR deficiency in our study subjects.

Pregnancy and polymorphisms in folate-cycle genes: what dose and formulation of folates to choose?

Study objectives: To compare the course of pregnancy and perinatal outcomes of term delivery in women with polymorphisms in the folatecycle genes and a history of miscarriage, depending on what strategy was chosen to correct folate deficiency.Study design: This was a retrospective, comparative study.Materials and methods: We analyzed medical records of 114 patients (Medical Forms No. 025/у, 111/у and 113/у) with polymorphisms in the folate-cycle genes and a history of miscarriage. In Group I, 54 women received conventional treatment with folic acid (5.8 mg/day) before conception and until week 28 of pregnancy as a combination of a single supplement or a vitamin B complex with vitamin-mineral combination supplements. In Group II, 60 patients received a vitamin-mineralcombination supplement, containing 208 mg of metafolin and 200 mg of folic acid, and other B vitamins (В1, В2, В5, В6 and В12) before conception and throughout pregnancy. Also, we compared the levels of homocysteine, blood-coagulation parameters, the course of pregnancy and delivery, and the health state of newborns.Study results: Compared to patients in Group I, patients in Group II had significantly lower levels of homocysteine, fibrinogen and the markers of abnormally increased blood levels of thrombin. In the second group, the rates of some obstetrical and perinatal complications were also lower (1.5–3.9-fold, p &lt; 0.05) than in the first group.Conclusion: In women with polymorphisms in the folate-cycle genes and a history of miscarriage, the use of vitamin-mineral-combination supplements, containing an active form of folates (metafolin), improves the course of pregnancy and perinatal outcomes of term delivery.

Prenatal early food and multiple micronutrient supplementation trial reduced infant mortality in Bangladesh, but did not influence morbidity.

A previous maternal and infant nutrition intervention in rural Matlab, Bangladesh, showed that prenatal nutrient supplements improved child survival, but had no effect on size at birth. This secondary analysis examined whether prenatal multiple micronutrient supplements (MMS), on their own or combined with an early invitation to receive prenatal food supplements, affected child morbidity. This randomised trial enrolled 4436 pregnant women from November 2001 to October 2003 and allocated them to early or standard invitations to food supplements, in the ninth and 20th weeks of pregnancy, respectively, and supplements of either the standard 60 mg iron with 400 μg folic acid, 30 mg iron with 400 μg folic acid or MMS. Quasi-Poisson regression was used to analyse morbidity. There were 3560 single live births and 3516 had morbidity data. The incidence rates of fever, diarrhoea and acute lower respiratory tract infection were 15.3, 3.6 and 2.3 episodes per person-year, respectively. The separate or combined interventions had no effect on morbidity up to 24 months. Early invitations to prenatal food supplements or prenatal MMS had no effect on common infections in rural Bangladesh, suggesting that earlier findings on improved child survival were not mediated by an effect on child morbidity.

Whole-body propionate and glucose metabolism of multiparous dairy cows receiving folic acid and vitamin B12 supplements

This study was undertaken to evaluate the effect of supplementation of folic acid and vitamin B12 on glucose and propionate metabolism. Twenty-four multiparous cows were assigned according to a complete block design in a 2 × 2 factorial arrangement to one of the following treatments: (1) saline 0.9% NaCl, (2) 320 mg of folic acid, (3) 10 mg of vitamin B12, or (4) 320 mg of folic acid and 10 mg of vitamin B12. Intramuscular injections were given weekly from 3 wk before the expected calving date until 9 wk postpartum. At 63 d in milk, d-[6,6-2H2]-glucose (16.5 mmol/h; jugular vein) and [1-13C]-sodium propionate (13.9 mmol/h; ruminal vein) were simultaneously infused for 4 h; blood samples were collected from 2 to 4 h of the infusion period. Liver biopsies were carried out the following day. Supplements of folic acid and vitamin B12 respectively increased folate and vitamin B12 concentrations, both in milk and liver. Although dry matter intake was unaffected by treatments, milk and milk lactose yields tended to be lower by 5.0 and by 0.25 kg/d, respectively, for cows receiving the folic acid supplement. Plasma β-hydroxybutyrate concentration with the folic acid supplement followed the same tendency. Hepatic gene expression of methylmalonyl-CoA mutase and S-adenosylhomocysteine hydrolase was higher for cows receiving the combined folic acid and vitamin B12 supplement compared with cows receiving only the supplement of folic acid, whereas no treatment effect was noted for cows not receiving the folic acid supplement. Whole-body glucose rate of appearance and the proportion of whole-body glucose rate of appearance secreted in milk lactose decreased by 229 g/d and 5%, respectively, for animals receiving the folic acid supplement, concomitant with the lower milk lactose synthesis in these cows, indicating that supplementary folic acid may alter energy partitioning in cows. The absence of treatment effect on plasma concentrations of methylmalonic acid as well as on the proportion of glucose synthesized from propionate, averaging 60%, supports the fact that vitamin B12 supply was sufficient in control cows in the current study. Our results suggest that the folic acid supplement reduced glucose-derived lactose synthesis by redirecting glucose for other metabolic activity in the mammary gland or in other tissues.

Preconception Micronutrient Supplementation with Iron and Folic Acid Compared with Folic Acid Alone Affects Linear Growth and Fine Motor Development at 2 Years of Age: A Randomized Controlled Trial in Vietnam

Background: Maternal health and nutrition play a crucial role in early child growth and development. However, little is known about the benefits of preconception micronutrient interventions beyond the role of folic acid (FA) and neural tube defects.Objective: We evaluated the impact of weekly preconception multiple micronutrient (MM) or iron and folic acid (IFA) supplementation on child growth and development through the age of 2 y compared with FA alone.Methods: We followed 1599 offspring born to women who participated in a randomized controlled trial of preconception supplementation in Vietnam. Women received weekly supplements that contained either 2800 μg FA, 60 mg Fe and 2800 μg FA, or 15 MMs including IFA, from baseline until conception followed by daily prenatal IFA supplements until delivery. Child anthropometry was measured at birth and at 3, 6, 12, 18, and 24 mo. Child development was measured with the use of the Bayley Scales for Infant Development III at 24 mo.Results: The groups were similar for baseline maternal and offspring birth characteristics. At 24 mo of age, the offspring in the IFA group had significantly higher length-for-age z scores (LAZs) (0.14; 95% CI: 0.03, 0.26), reduced risk of being stunted (0.87; 95% CI: 0.76, 0.99), and smaller yearly decline in LAZs (0.10; 95% CI: 0.04, 0.15) than the offspring in the FA group. Similar trends were found for the offspring in the MM group compared with the FA group for LAZs (0.10; 95% CI: -0.02, 0.22) and the risk of being stunted (0.88; 95% CI: 0.77, 1.01). Offspring in the IFA group had improved motor development (P = 0.03), especially fine motor development (0.41; 95% CI: 0.05, 0.77), at the age of 24 mo, but there were no differences for measures of cognition or language.Conclusions: Preconception supplementation with IFA improved linear growth and fine motor development at 2 y of age compared with FA. Future studies should examine whether these effects persist and improve child health and schooling. The trial was registered at clinicaltrials.gov as NCT01665378.

Folate serum levels in Italian women entering an in vitro fertilization program

Italian public health authorities recommend women of childbearing age to assume a daily dose of 0.4 mg of folic acid (FA) from at least one month before conception in order to reduce the risk of having children affected by neural tube defects (NTDs). In this study, folate, homocysteine and vitamin B12 serum levels were determined in 77 women entering an in vitro fertilization program. About 75% of patients had serum folate values compatible with the intake of the recommended dose of FA for at least three months, whereas only the 61% of them reached or exceeded the serum folate concentration regarded as the optimal concentration during the periconceptional period. Mean vitamin B12 serum levels and mean homocysteine plasma levels resulted in normal range in all the women with mean values of 381.2 ± 2.2 pg/ml and 8.48 ± 2.2 μmol/l, respectively. In conclusion, only a portion of women entering an IVF program presents proper folate levels.