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Effect of oral folic acid supplements on zinc, copper, and iron absorption and excretion.

Effects of folic acid supplements on zinc excretion patterns were seen during studies of mild zinc deficiency in men. During these studies eight men were fed diets containing 150 micrograms of folacin (by analysis) per day. Four of the men were supplemented with 400 micrograms of pteroylglutamic acid (folic acid) every other day. All of the men were fed diets containing about 3.5 mg/Zn per day which were supplemented with 4.0 mg/Zn day for 4 wk and unsupplemented for 16 wk, then supplemented with 30.0 mg/Zn day for 4 wk. Their body weights were kept constant by adjustments of energy intakes and expenditures. Duplicate diets, stools, and urines were analyzed for zinc, copper, and iron. Fecal zinc was significantly (p less than 0.001) higher in the group that received folic acid supplements during the initial control and low zinc intake periods. No significant differences were seen during the period of high zinc intake. During all dietary periods urinary zinc excretion was reduced by about 50% by folic acid supplementation. No apparent changes occurred in iron or copper excretion. These data indicate that supplemental folate influences zinc homeostasis, perhaps through formation of an insoluble chelate and impairment of absorption.

Adult↗

Folic acid and colorectal cancer prevention: molecular mechanisms and epidemiological evidence (Review).

Epidemiological studies suggest that a diet rich in fruits and vegetables protects against colorectal cancer. This effect may result from their high levels of folic acid (pteroylglutamic acid). Folic acid holds a key position in DNA synthesis and mitosis as well as DNA methylation and regulation of gene expression. Folic acid deficiency has been associated with site- and gene specific DNA hypo- and hypermethylation. Furthermore thymidylate synthesis is restricted by folic acid deficiency which causes misincorporation of nucleotides and DNA strand breaks. Much epidemiological evidence supports the hypothesis that insufficient folic acid supply favors the development of colorectal tumors, particularly prospective studies have supported this connection. However, the data from case-control studies are less consistent. Functional polymorphisms in folate-metabolizing genes, especially the methylenetetrahydrofolate reductase (MTHFR) are capable of modifying the risk of colorectal cancer. Observational studies show that individuals with the homozygote genotype for the MTHFR (677C-->T) polymorphism are at higher risk when folic acid supply is low. Currently there are only few human intervention trials which show that folic acid can modify and inhibit the development of colorectal tumors. Additional studies are required in order to determine whether folic acid will be a useful agent in colorectal cancer prevention.

Adenoma↗

Pregnancy intendedness and the use of periconceptional folic acid.

OBJECTIVE: Periconceptional use of folic acid can prevent birth defects, including at least 50% of neural tube defects. This study used an ongoing surveillance system to explore the association between pregnancy intendedness and women taking periconceptional folic acid. METHODS: Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) surveys a stratified random sample of women after a live birth. In 1998-1999, 1867 women completed the survey (64.0% response rate); responses were weighted for nonresponse. Women were asked whether they took folic acid most days in the month before becoming pregnant. RESULTS: Overall, 33.2% of women took folic acid most days in the month before becoming pregnant, and 39.9% said that their pregnancy was unintended. Adolescent mothers were less likely to take periconceptional folic acid (9.2%) and more likely to report unintended pregnancy (62.0%) than older women. Overall, women who said that their pregnancy was intended were more likely to report that they had taken periconceptional folic acid (odds ratio: 4.75; 95% confidence interval: 3.16-7.14); after controlling for maternal age and income the odds ratio was 3.70 (95% confidence interval: 2.38-5.56). CONCLUSIONS: Women whose pregnancies were intended were more likely to have been taking periconceptional folic acid than women whose pregnancies were unintended. The importance of fertile women's taking daily multivitamins that contain 400 microg (0.4 mg) of folic acid should be stressed among women who are not contemplating pregnancy, especially adolescents and low-income women.

Age Factors↗

Prevention of folate deficiency by food fortification. III. Effect in pregnant subjects of varying amounts of added folic acid.

Maise meal fortified with folic acid was administered to subjects in late pregnancy in a daily dose of either 500 or 300 mug of folic acid. Changes in hematological and folate nutritonal status were compared to those in subjects receiving 300 mug folic acid/day in tablet form, and also in subjects in a previous study who received unfortified maize meal (control group) or meal containing 1,000 mug folic acid/day. In all groups receiving folic acid, red cell and serum folate levels rose progressively, and the rate of rise increased with increasing doses of folic acid. Maize meal containing a daily dose of 500 mug folic acid produced an effect similar to that of 300 mug daily in tablet form. Maize containing 300 mug added folic acid daily was effective in preventing the progression of folate depletion in late pregnancy.

Dose-Response Relationship, Drug↗

[Evaluation of knowledge, attitudes and practice in healthy women of childbearing age concerning prophylactic folic acid--preliminary report].

Use of folic acid supplements before conception and during the first trimester of pregnancy, is associated with a reduced incidence of neural tube defects. The Ministry of Health guidelines recommend the use of folic acid supplements by all women in childbearing age. The aim of this study was to evaluate knowledge, attitudes and behaviour of women in childbearing age with regard to the effectiveness of folic acid prophylaxis in neural tube foetal defects. The effect of the education al level on knowledge about folic acid supplementation and its implementation was also studied. Data were collected by questionnaires administered by trained staff in July 1999 in 8 Primary Health Centres in Warsaw on a sample of 400 women aged 15-50. Only 52.8% of women reported ever hearing of or reading about folic acid, 15% reported that folic acid helped to reduce the risk for neural tube defects. The most commonly cited sources of information were the woman's general practitioner (43.0%) and magazines (41.7%). Overall, 13% of women reported taking multivitamins containing folic acid on a daily basis. Failure to take supplements was significantly associated with lower education. Educational interventions are required to inform women of the benefit of peri-conceptional folate supplementation and to increase folate intake among them.

Adolescent↗

Folic acid: miscarriages, anomalies, thromboses, cancers.

Folic acid is an essential micronutrient that merits special attention. In spite of plentiful sources in a balanced diet, recent data indicate that folic acid intake of many persons has long been inadequate. To some degree, this is due to destruction of folic acid by storage and processing of foodstuffs and to dietary practices that vary from recommendations. However, the common hereditary thermolabile variant of methylenetetrahydrofolate reductase (MTHFR) imposes an increased folic acid requirement which, if not met, may result in recurrent early pregnancy loss, anomalous progeny, thrombotic disorders, and cancers. There are recent reports that folic acid metabolism is also altered by other hereditary variations of MTHFR and other enzymes involved in folic acid metabolism. Optimal management requires dietary guidance and, for many patients, folate supplements. Caution is required because mandated folate fortification of grain products may produce levels that are inadequate for some patients and excessive for others. Laboratory tests for red cell folate and serum homocysteine are valuable adjuncts.

Adolescent↗

Reduction of incidence of prematurity by folic acid supplementation in pregnancy.

Folic acid administered to pregnant Bantu, whose diet is low in folate, was associated with a significant reduction in the incidence of prematurity. No such effect could be demonstrated in White patients subsisting on an average Western diet. This suggests that folate deficiency may contribute to the "pregnancy wastage" in populations whose dietary folate intake is low, and is a further indication for folic acid supplementation during pregnancy in these groups.

Anemia, Macrocytic↗