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PubMed1993

The dietary requirement of young rainbow trout (Oncorhynchus mykiss) for folic acid.

We sought to determine the dietary folic acid requirement of young rainbow trout using growth indices supported by measurements of tissue folate concentrations. The investigation was conducted with purified diets that had, by assay, basal folic acid levels of 0.08 and 0.16 mg/kg in the first and second, respectively, of two experiments. Each experiment was started with fry (initial mean weight, 1.4 and 2.8 g/fish in Experiments 1 and 2, respectively) and was conducted at a water temperature of 15 degrees C. Experiment 1 lasted 18 wk and Experiment 2 lasted 16 wk. Recovery tests (of 8 wk duration, performed on fish fed the unsupplemented diet) and pair-feeding showed that the unsupplemented diet led to a folate-specific deficiency condition in which the main hematological abnormality was the appearance of misshapen nuclei in a small proportion (2.3%) of erythrocytes. Dietary requirements were shown not to exceed 0.3 and 0.6 mg folic acid/kg (17 and 33 micrograms/MJ digestible energy) for optimizing survival and growth indices, respectively. We conclude that the dietary folate requirement of the trout is comparable to that of other vertebrates for the purpose of achieving maximal weight gain.

Analysis of Variance↗
PubMed2001

Folic acid and preconceptional care.

If all women capable of becoming pregnant consumed 400 µg (0.4 mg) of the B vitamin folic acid daily before conception and during the first trimester, the annual number of neural-tube birth defect (NTD)-affected pregnancies in this country could be reduced by 50% to 70%. Despite this important relationship, most women are not aware that folic acid prevents NTDs, and folic acid supplementation rates remain low. If folic acid consumption is to succeed as a public health intervention on a societal scale, physicians who care for reproductive-age women must become informed about the folic acid-NTD prevention linkage. Next, they must be encouraged to counsel patients about the need to consume sufficient folic acid before conception. Studies reveal that few physicians have adequate knowledge of the appropriate timing and dosage of folic acid supplementation. Studies also show that women are more likely to get important folic acid information not from their physicians but from other sources. This article provides information about ways in which physicians can improve their folic acid knowledge and education practices.

Journal Article↗
PubMed2004

Folic acid supplements to prevent neural tube defects: trends in East of Ireland 1996-2002.

Promotion of folic acid to prevent neural Tube Defects (NTD) has been ongoing for ten years in Ireland, without a concomitant reduction in the total birth prevalence of NTD. The effectiveness of folic acid promotion as the sole means of primary prevention of NTD is therefore questionable. We examined trends in folic acid knowledge and peri-conceptional use from 1996-2002 with the aim of assessing the value of this approach. From 1996-2002, 300 women attending ante-natal clinics in Dublin hospitals annually were surveyed regarding their knowledge and use of folic acid. During the period the proportion who had heard of folic acid rose from 54% to 94% between 1996 and 2002 (c2 test for trend: p<0.001). Knowledge that folic acid can prevent NTD also rose from 21% to 66% (c2 test for trend: p<0.001). Although the proportion who took folic acid during pregnancy increased from 14% to 83% from 1996 to 2002 (c2 test for trend: p<0.001), peri-conceptional intake did not rise above 24% in any year. There is a high awareness of folic acid and its relation to NTD, which is not matched by peri-conceptional uptake. The main barrier to peri-conceptional uptake is the lack of pregnancy planning. To date promotional campaigns appear to have been ineffective in reducing the prevalence of NTD in Ireland. Consequently, fortification of staple foodstuffs is the only practical and reliable means of primary prevention of NTD.

Adult↗
PubMed2002

Assessment of student pharmacists' knowledge concerning folic acid and prevention of birth defects demonstrates a need for further education.

Adequate periconceptional consumption of folic acid can prevent neural tube birth defects, and all women capable of becoming pregnant are recommended to consume 400 microg/d. Most women, however, are unaware of this recommendation and do not consume adequate amounts of folic acid. It is important, therefore, that healthcare professionals, such as pharmacists, be capable of educating women regarding folic acid. The aim of this study was to assess knowledge regarding prevention of birth defects by folic acid among student (future) pharmacists in the final year of a professional degree program. Over a 3-y period (1998-2000), students (n = 98) enrolled in a PharmD program completed a survey consisting of five multiple-choice questions concerning folic acid and birth defects. Almost all students (93.9%) correctly identified folic acid as preventing birth defects. Of these students, many also knew that supplementation should begin before pregnancy (73.9%). Fewer, however, were able to correctly identify either the recommended level of intake (55.4%) or good sources of folic acid (57.6-65.2%). These results show that although student (future) pharmacists are aware of folic acid's ability to prevent birth defects, many lack the specific knowledge needed to effectively counsel women in future clinical practice.

Congenital Abnormalities↗
PubMed2006

Awareness and use of folic acid, and blood folate concentrations among pregnant women in northern China--an area with a high prevalence of neural tube defects.

BACKGROUND: The prevalence of neural tube defects (NTDs) in northern China remains high after 10 years since periconceptional supplementation with folic acid has been known to be effective in reducing the risk of NTDs. OBJECTIVE: The objectives of this study were to characterize folic acid awareness and use and to examine the association between folic acid supplementation with blood folate concentrations among early pregnant women in an area with a high prevalence of NTDs in northern China. SUBJECT AND METHOD: From December 2002 to February 2004, 693 early pregnant women were recruited and interviewed about folic acid awareness, knowledge and use. Four millilitres of venous blood was drawn and blood folate concentrations were measured. RESULTS: About 36% of women reported having ever heard of folic acid. Of these, 82.7% knew that folic acid can prevent NTDs, and 64.5% knew the best time to take it. Overall, 15% of women reported having ever taken folic acid. However, only 34.3% had begun to take it before the last menstrual period. Women with less education (21.1%), farmers (19.6%), rural dwellers (23.5%), and women who had a previous child (23.0%) were less likely to be aware of folic acid, and were less likely to take folic acid. Among women who had ever heard of folic acid, 37.5% took it during current pregnancy, compared with only 2.0% among those who had not. Women who were aware of folic acid were 25 times more likely to take it than women who were not. Overall, 44% of women had plasma folate deficiency, and 35% had red cell folate deficiency. Those who reported having ever taken folic acid had a lower rate of plasma folate deficiency (13.7%), compared with those who reported not taking folic acid (49.4%). The former group's mean plasma concentrations were twice as high as those of the latter group. CONCLUSION: The levels of folic acid awareness, knowledge and use among Chinese women living in a high NTD prevalence area during early pregnancy were very low and folate deficiency was quite prevalent. Campaigns aimed at increasing the awareness, knowledge, and periconceptional use of folic acid should target to less educated, parous women and women living in rural areas.

Adult↗
PubMed1986

Intestinal transport of zinc and folic acid: a mutual inhibitory effect.

Recent observations suggest an inverse relationship between folic acid intake and zinc nutriture and indicate an interaction between folic acid and zinc at the intestinal level. To define that interaction, we designed in vivo and in vitro transport studies in which folic acid transport in the presence of zinc, as well as zinc transport in the presence of folic acid was examined. These studies show that zinc transport is significantly decreased when folate is present in the intestinal lumen. Similarly folic acid transport is significantly decreased with the presence of zinc. To determine whether this intestinal inhibition is secondary to zinc and folate-forming complexes, charcoal-binding studies were performed. These studies indicate that zinc and folate from complexes at pH 2.0, but that at pH 6.0, these complexes dissolve. Therefore, our studies suggest that under normal physiological conditions a mutual inhibition between folate and zinc exists at the site of intestinal transport.

Animals↗
PubMed2002

[Folic acid consumption by pregnant women prior to and during pregnancy.].

OBJECTIVE: To study consumption of folic acid supplements by women before conception and during pregnancy. Concurrently, the incidence of planned pregnancy and the women's knowledge of the preventive value of folic acid was investigated. MATERIAL AND METHODS: A questionnaire was presented to all 128 pregnant women attending a maternal clinic in rural area during one month's period. The aim was to reveal the women's knowledge of folic acid and its use prior to conception and during pregnancy. Demographic information were collected and questions designed to reveal whether the pregnancy was planned or not, was included. The distribution within the sample was calculated. RESULTS: The questionnaire was completed by 113 women (88.3%). Nine per cent had taken folic acid regularly before pregnancy. Women who had taken folic acid on a regular basis during the first 12 weeks of pregnancy were 40.7%. The current pregnancy had been planned in 62.9% cases. None of the women in the youngest age group of 15-19 years had planned their pregnancy. Advice regarding folic acid intake before pregnancy was not given in 68.1% of cases. CONCLUSIONS: Health education regarding the beneficial effect of folic acid must be directed equally towards the providers of health care and the general public. This education must be aimed at all women capable of becoming pregnant, not only at those planning pregnancy. The knowledge of health care providers and the general public about the preventive value of folic acid is important in order to reduce the risk of pregnancies affected by neural tube defects.

English Abstract↗
PubMed2004

A comprehensive evaluation of food fortification with folic acid for the primary prevention of neural tube defects.

BACKGROUND: Periconceptional use of vitamin supplements containing folic acid reduces the risk of a neural tube defect (NTD). In November 1998, food fortification with folic acid was mandated in Canada, as a public health strategy to increase the folic acid intake of all women of childbearing age. We undertook a comprehensive population based study in Newfoundland to assess the benefits and possible adverse effects of this intervention. METHODS: This study was carried out in women aged 19-44 years and in seniors from November 1997 to March 1998, and from November 2000 to March 2001. The evaluation was comprised of four components: I) Determination of rates of NTDs; II) Dietary assessment; III) Blood analysis; IV) Assessment of knowledge and use of folic acid supplements. RESULTS: The annual rates of NTDs in Newfoundland varied greatly between 1976 and 1997, with a mean rate of 3.40 per 1,000 births. There was no significant change in the average rates between 1991-93 and 1994-97 (relative risk [RR] 1.01, 95% confidence interval [CI] 0.76-1.34). The rates of NTDs fell by 78% (95% CI 65%-86%) after the implementation of folic acid fortification, from an average of 4.36 per 1,000 births during 1991-1997 to 0.96 per 1,000 births during 1998-2001 (RR 0.22, 95% CI 0.14-0.35). The average dietary intake of folic acid due to fortification was 70 μg/day in women aged 19-44 years and 74 μg/day in seniors. There were significant increases in serum and RBC folate levels for women and seniors after mandatory fortification. Among seniors, there were no significant changes in indices typical of vitamin B12 deficiencies, and no evidence of improved folate status masking haematological manifestations of vitamin B12 deficiency. The proportion of women aged 19-44 years taking a vitamin supplement containing folic acid increased from 17% to 28%. CONCLUSIONS: Based on these findings, mandatory food fortification in Canada should continue at the current levels. Public education regarding folic acid supplement use by women of childbearing age should also continue.

Journal Article↗
PubMed2002

Hyperhomocysteinemia in rheumatoid arthritis: influence of methotrexate treatment and folic acid supplementation.

OBJECTIVE: To examine the effect of methotrexate (MTX) and folic acid supplementation on the homocysteine level in patients with rheumatoid arthritis (RA). METHODS: A cross sectional study was performed in 81 patients with RA, comprising a standardized clinical interview, an examination, and a blood specimen test. RESULTS: P-homocysteine tended to be lower in 41 patients receiving MTX, compared with 40 patients not receiving MTX. Of the MTX treated patients, 76% received folic acid supplementation. Multivariate analysis revealed a statistically significant association between P-homocysteine and P-creatinine (p < 0.001), and disease activity/progression measured by the Health Assessment Questionnaire score (p < 0.001). There was a tendency to negative association between P-homocys-teine and folic acid supplementation. CONCLUSION: P-homocysteine in patients with RA receiving MTX and folic acid supplementation did not differ significantly from P-homocysteine in RA patients receiving other types of treatment.

Adult↗
PubMed1997

A survey of knowledge and use of folic acid among women of child-bearing age in Dublin.

BACKGROUND: The Medical Research Council vitamin trial highlighted the importance of folic acid in the prevention of neural tube defects. Since 1993, the Irish Department of Health has recommended periconceptional folic acid supplements. The objective of this study was to document the knowledge and behaviour of women in child-bearing years to periconceptional folic acid. METHODS: A cross-sectional community-based survey was conducted in Dublin using an interviewer administered questionnaire. RESULTS: A total of 335 women took part in the study, a response rate of 84 per cent. Approximately two-thirds (213/ 335, 63.6 per cent) had heard of folic acid. Knowledge was significantly associated with higher social class and higher education (p < 0.05). Few (18/335, 5.4 per cent), had been advised to take folic acid before pregnancy. Only 9/335 (2.7 per cent) of the women in the study were currently taking folic acid supplements. Three-quarters (75.9 per cent) of the group would be willing to take periconceptional folic acid supplements if they believed it would reduce the risk of malformations. The majority (77.4 per cent) would prefer to take folic acid in tablet form rather than have it added to food. CONCLUSIONS: This study shows that few women in child-bearing years in Dublin have been advised on folic acid, and very few are taking supplements. However, if advised appropriately the majority would be willing to take periconceptional folic acid in tablet form.

Adolescent↗
PubMed1995

The folic acid requirements of starting broiler chicks fed diets based on practical ingredients. 2. Interrelationships with dietary methionine.

Two experiments were conducted to determine the effects of dietary supplemental folic acid and methionine on the performance of starting broiler chicks for 18 d. Four levels of dietary folic acid (.24, .54, 1.14, and 2.34 mg/kg) and four levels of dietary methionine (.45, .53, .61, and .69%) were fed in a factorial design. There were three replicates of eight chicks each per each treatment. The basal diet was based on corn, isolated soybean protein, meat and bone meal, and fish meal. It contained adequate amounts of all nutrients except methionine and folic acid. Increased growth was observed in chicks fed the basal diet supplemented with either folic acid or methionine. Total dietary folic acid and methionine plus cysteine requirements for maximum growth were estimated to be 1.80 mg/kg and .85% in Experiment 1 and 1.47 mg/kg and .87% in Experiment 2, respectively. There were interactions between dietary folic acid and methionine on weight gain in both experiments. Chicks fed the diet containing 2.34 mg folic acid/kg tended to have depressed growth, as in previous experiments. There was a significant linear feed conversion response to folic acid in Experiment 1 and to methionine in Experiment 2. There were both linear and quadratic liver folic acid responses to dietary folic acid in both experiments. There was no indication that dietary methionine had any effect on liver folic acid content. No differences in bone ash, hemoglobin, hematocrit, or incidence of tibial dyschondroplasia were detected due to methionine or folic acid supplementation.

Animals↗
PubMed1991

[Parenteral iron and folic acid in patients on chronic hemodialysis: requirements, monitoring, and effective use].

Iron and folic acid metabolism were prospectively studied over a 7 year period in 12 patients on chronic hemodialysis. Three protocols of iron and folic acid administration were successively used: in Phase A (mean 35.5 months) iron dextran intravenously was used at high dose (mean 416 mg monthly) with folic acid 1 mg/day; in Phase B (mean 8.1 months) iron and folic acid were not given, and in Phase C low dose iron dextran (mean of 10 mg monthly) and folic acid 3 mg per week were administered. No other medications, except for blood transfusion or Aluminum hydroxide were used throughout. A good correlation was found between serum ferritin levels and bone marrow iron stores. No side effects of iron administration were noted. A significant rise in Hb levels was observed (9.21 g/dl in Phase A to 10.3 g/dl in Phase C). Red cell protoporphyrin levels remained normal. With folic acid supplement of 3 mg per week, serum folate level remained within normal limits.

Adult↗
PubMed2006

Fluorometry of hydrogen peroxide using oxidative decomposition of folic acid.

Hydrogen peroxide (H2O2) is one of the most important reactive oxygen species. In the present study, a fluorometry method for detecting H2O2 utilizing folic acid was evaluated. Folic acid was decomposed by H2O2 in the presence of Cu(II) into pterine-6-carboxylic acid, leading to strong fluorescence enhancement. In the absence of the metal ion, superoxide and H2O2 could not decompose folic acid. Also, H2O2 plus sodium hypochlorite (a source of singlet oxygen) could not induce fluorescence enhancement. These results demonstrate that H2O2 can be selectively detected using folic acid plus Cu(II). The limit of detection (LOD; at S/N=3) for H2O2 is 0.5 microM. This method based on the fluorescence enhancement of folic acid was applied in order to determine small amounts of H2O2 generated through the autooxidation of semicarbazide (generation rate: approximately 0.01 microM min(-1)), a carcinogenic compound.

Carcinogens↗
PubMed2002

Three years after the dutch folic acid campaign: growing socioeconomic differences.

BACKGROUND: We investigated periconceptional awareness and the use of folic acid tablets 3 years after the 1995 campaign in the northern Netherlands. We studied whether the socioeconomic differences we found in 1996 with respect to awareness and use of folic acid remained in 1998. METHODS: The present study took place in 1998. Pregnant women were asked to complete a questionnaire. RESULTS: A total of 452 women completed the questionnaire in 1998. Sixty percent of the women with a lower level of education and 85% of the women with a higher level of education had heard of folic acid before pregnancy. Newspapers and magazines were the most often cited sources of information. Fifty percent of the women with a lower educational level used folic acid, while this figure was 80% for the group with higher education. CONCLUSION: Awareness and use of folic acid increased after the 1995 campaign. However, socioeconomic differences with respect to awareness of folic acid remained and even increased with respect to knowledge of the advised period. Use of folic acid is also associated with level of education more strongly than in 1996. Therefore, fortification of staple foods is an attractive option.

Awareness↗
PubMed2005

Folic acid deficiency increases chromosomal instability, chromosome 21 aneuploidy and sensitivity to radiation-induced micronuclei.

Folic acid deficiency can lead to uracil incorporation into DNA, hypomethylation of DNA, inefficient DNA repair and increase chromosome malsegregation and breakage. Because ionising radiation increases demand for efficient DNA repair and also causes chromosome breaks we hypothesised that folic acid deficiency may increase sensitivity to radiation-induced chromosome breakage. We tested this hypothesis by using the cytokinesis-block micronucleus assay in 10 day WIL2-NS cell cultures at four different folic acid concentrations (0.2, 2, 20, and 200 nM) that span the "normal" physiological range in humans. The study showed a significant dose-dependent increase in frequency of binucleated cells with micronuclei and/or nucleoplasmic bridges with decreasing folic acid concentration (P<0.0001, P=0.028, respectively). These biomarkers of chromosomal instability were also increased in cells irradiated (1.5 Gy gamma-rays) on day 9 relative to un-irradiated controls (P<0.05). Folic acid deficiency and gamma-irradiation were shown to have a significant interactive effect on frequency of cells containing micronuclei (two-way ANOVA, interaction P=0.0039) such that the frequency of radiation-induced micronucleated cells (i.e. after subtracting base-line frequency of un-irradiated controls) increased with decreasing folic acid concentration (P-trend<0.0001). Aneuploidy of chromosome 21, apoptosis and necrosis were increased by folic acid deficiency but not by ionising radiation. The results of this study show that folate status has an important impact on chromosomal stability and is an important modifying factor of cellular sensitivity to radiation-induced genome damage.

Aneuploidy↗
PubMed1988

Folic acid--an innocuous means to reduce plasma homocysteine.

With an improved highly reproducible method, we measured total plasma homocysteine (free plus protein-bound) and related amino acids in the fasting state in healthy subjects, before and after treatment with co-factors for homocysteine metabolism: 1 mg cyanocobalamin (n = 14), 5 mg folic acid (n = 13) or 40 mg pyridoxine hydrochloride (n = 15) daily for 14 days. Cyanocobalamin and pyridoxine hydrochloride had no effects on plasma levels of amino acids, but folic acid had a considerable homocysteine-lowering effect. Total plasma homocysteine was reduced in all but two subjects, from 19.9 +/- 4.4 (mean +/- SEM) to 9.5 +/- 1.0 mumol/l (-52%, p less than 0.01). We propose that folic acid in excess acts by enhancing the remethylation of homocysteine to methionine. The finding confirms a previous report by us. Since homocysteine is considered to be an atherogenic amino acid and recent reports suggest that mild to moderate homocysteinaemia is also associated with premature vascular disease, treatment with folic acid might be of use as prophylaxis.

Adult↗
PubMed1976

Neurochemical and behavioral effects of diet related perinatal folic acid restriction.

Some effects of restricting dietary folic acid during the perinatal period on tissue folate and S-adenosyl-L-methionine (SAM) concentrations and on behavior were examined in 35-day-old DBA/2J mice. In one study dams were started on diets containing no folate (FO), 1.1 mg of folic acid/kg diet (F1.1) or 9.9 mg of folic acid/kg diet (F9.9) on the day of parturition. In a second study some mice were started on the FO or F9.9 diets 6-7 days prior to parturition and some remained on lab chow (LC). The dams and their pups remained on their assigned diets until offspring were killed for biochemical assays. The major findings of the 2 studies are: (1) that eliminating folic acid from diets of dams and developing pups from birth or 1 week prior to birth causes a reduction of folate in brain tissue; (2) that reduction in brain tissue is not as severe as that of liver; (3) that initiating the folate free diet 1 week prior to birth caused reductions in body, liver, and brain weights and in activity levels of surviving offspring; and (4) that offspring of dams started on either the FO or F9.9 diet one week prior to parturition are less viable and have lower levels of SAM in brain tissue than animals reared on the LC diets.

Aging↗