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Nutritional status: blood vitamins A, E, B6, B12, folic acid and carotene. Euronut SENECA investigators.

This chapter describes the vitamin plasma concentration data collection, preliminary analysis and results of the Euronut SENECA study. Blood plasma was collected from approximately 2500 elderly subjects born in 1913-1918 living in 17 small towns in 11 European countries, and the plasma levels of carotene, retinol, alpha-tocopherol, vitamin B12, folic acid and pyridoxal 5'-phosphate were determined. There were very large within- and between-centre differences in vitamin levels with no definite geographical pattern emerging. The vitamin status for retinol and folic acid was adequate in all centres. The prevalence of biochemical vitamin B6 deficiency was widespread and reached over 50% in some centres. Vitamin B12 biochemical deficiency was limited to ten centres and its prevalence was 1.6%-10%. Vitamin E biochemical deficiency was found in seven centres and varied from 0.5% to 25%.

Aged↗

[Therapy with mitomycin C, folic acid and 5-fluorouracil in treatment of metastatic, refractory urinary bladder carcinoma--phase II study].

We performed a phase II trial with second-line chemotherapy in patients with refractory, metastatic cancer of the bladder. Second-line therapy consists of 2.6 cycles of mitomycin-C, 5-fluorouracil and folic acid. Two patients suffered from WHO grade III side effects (nephrotoxicity, leukocytopenia). We did not find any complete or partial remission. Four patients had a stable disease; 3.3 months after therapy, patients developed tumor progression with a median survival of 9 months. Four patients reported an improvement in quality of life. Since all patients received supportive care, improvement in quality of life cannot be related to chemotherapy alone. In conclusion, second-line chemotherapy with mitomycin-C, 5-fluorouracil and folic acid has no effect on refractory, metastatic cancer of the bladder and is no alternative for cisplatin and methotrexate-based chemotherapy.

Aged↗

Increased urinary excretion and prolonged turnover time of folic acid during ethanol ingestion.

The effect of ethanol on the kinetics of folic acid urinary excretion was studied in five chronic alcoholic patients who were maintained in a folate replete state. For 17 days, 95% ethanol was administered orally at 2-h intervals (X9). The folate pool(s) were labeled with the tritium labeled pteroyl glutamic acid at the start of the period of ethanol ingestion and at the start of a control abstinent period. The 24-h urine volume did not change with consumption of ethanol. Total urinary folate excretion was significantly greater by 20 to 40% in four of five patients during the ethanol administration period (p less than 0.05). The fall-off in urinary radioactivity corrected for total folate excretion (dpm/microgram Lactobacillus casei folate) was resolved into a biexponential decay with two distinct slopes. Ethanol caused the slope of the second component to flatten significantly with mean t1/2 of 63.7 days on ethanol versus 9.6 days off (p less than 0.05). These kinetic results are consistent with the known interference by ethanol of folate utilization in a functional tissue pool.

Adult↗

High-performance liquid chromatographic determination of the distribution of naturally occurring folic acid derivatives in rat liver.

Procedures which allow extraction and quantitation of labile, reduced folic acid derivatives in rat liver have been developed. These procedures entail extraction of hepatic folates at 100 degrees C in 2% (w/v) sodium ascorbate, 0.2 M 2-mercaptoethanol, pH 7.85. The extract was treated with conjugase to hydrolyze folate polyglutamates and reverse-phase, ion-pair high-performance liquid chromatography was used to separate the resulting monoglutamates which were measured by microbiological assay using Lactobacillus casei. Experiments with HPLC-purified standard derivatives, so treated, showed excellent stability of tetrahydropteroylglutamic acid (H4PteGlu), 10-formyl-H4PteGlu, 5-formyl-H4PteGlu, 5-methyl-H4PteGlu, and pteroylglutamic acid (PteGlu). Under these conditions, approximately 56% of H2PteGlu was recovered unchanged while about 27% was converted to PteGlu; 5,10-methylene-H4PteGlu was quantitatively recovered as H4PteGlu. These procedures were applied to the task of measuring the distribution of naturally occurring folate cofactors in rat liver. These results indicated that rat liver folates have the following compositions: 5-methyl-H4PteGlu, 37.2%; H4PteGlu, 32.7%; 10-formyl-H4PteGlu, 22.6%; and 5-formyl-H4PteGlu, 7.7%. Experiments with [3H]PteGlu injection showed that all hepatic folates had the same specific radioactivity as determined by radioassay and L. casei assay, indicating that L. casei exhibited the same growth response to all the folates detected in rat liver.

Animals↗

The use of willingness to pay to assess public preferences towards the fortification of foodstuffs with folic acid.

OBJECTIVES: To assess public attitudes towards the fortification of flour with folic acid, and quantify their intensity of preference towards the proposed policy. DESIGN: Structured interviews describing the proposed policy of fortification followed by questions about the respondent's preferences towards fortification. SETTING AND PARTICIPANTS: A United Kingdom community sample of 76 people interviewed at home. MAIN VARIABLES STUDIED: Direction of preference towards fortification, willingness to pay (WTP) for the preferred course of action, and the reasons behind their preferences. RESULTS: Responses showed that 51 (67%) were in favour of fortification, 15 (20%) were opposed, while the remaining 10 (13%) were either indifferent or were unsure. Those in favour of fortification tended to be younger and poorer than those opposed to it. Willingness to pay estimates show that those in favour of food fortification had more intense preferences, with mean and median WTP around twice as great. Reasons for being willing to pay were centred on the health benefits, with particular reference being made to the intervention saving lives and it being preventative. Those opposed tended to believe that there was insufficient evidence. CONCLUSIONS: The combination of a policy vote, WTP and qualitative data, allow us to assess the direction, intensity and motivations behind people's preferences. Further work needs to be undertaken to gather more robust estimates of public preferences for fortification, and to better understand attitudes towards public health interventions more generally.

Adolescent↗

In vitro effects of the teratogen and folic acid antagonist, 9-methyl pteroylglutamic acid, on glycosaminoglycan accumulation in fetal rat limbs.

Fetal rat limbs were obtained from pregnant females on the 14th day of gestation. Forelimbs and hindlimbs were pooled separately and preincubated for 22 hours at 37 degrees C in Eagle's MEM containing the teratogen and folic acid antagonist, 9-methyl pteroylglutamic acid (9-mePGA). Following removal of old medium, fresh medium together with the teratogen were added at the same concentration as before. Tritiated glucosamine (10 micro Ci) was added to each vial and the incubation continued for 4 hours at 37 degrees C. Tissues were homogenized, digested with pronase, and glycosaminoglycans (GAG) selectively precipitated with cetylpyridinium chloride. In vitro exposure of fetal limbs to various doses of 9-mePGA resulted in a significant increase in the accumulation of labeled GAG by fetal forelimbs at the high and intermediate dosage levels. No effect was observed at the lowest dose. Accumulation of labeled GAG by fetal hindlimbs although similar to fetal forelimbs in control incubations, was unaffected by in vitro exposure to 9-mePGA at any of the dosage levels studied.

Animals↗

Folic acid and mental symptoms in children with epilepsy.

312 children resident at a hospital school received a neuropsychiatric examination and information was provided on their IQ status. Children with a fall in their IQ were identified. Serum and red cell folate values were estimated and the relationship between neuropsychiatric disturbances and folate disturbances explored. Patients with a fall in IQ, neurotic disturbance and depression all had significantly lower serum folic acid levels than the rest of the population, and the children with neurotic disturbances and depression had significantly lower red cell folate values. The relationship between folic acid metabolism and the neuropsychiatric disturbances is discussed in the light of these findings.

Child↗

Incorporation of 3H-label from folic acid is tissue-dependent in folate-deficient rats.

To study the tissue-specificity of folate deficiency, male Sprague-Dawley rats were fed folate-replete or folate-deficient diets with and without sulfonamide for 16 wk, and then injected with [3H]folic acid (1.5 nmol/kg). Rats were killed after 24 h, and the blood, urine and various organs were prepared for analysis of endogenous and 3H-labeled folate. Endogenous folate levels decreased due to folate deficiency to the greatest extent in the urine and plasma, followed by liver, kidney and other tissues (spleen, testis, lung and intestine), but no decrease was noted in the brain. Of all tissues of folate-deficient rats, the brain showed the greatest increase in incorporation of 3H-label from folate relative to folate-replete rats, with the largest effect in rats that were most deficient in plasma folate. Incorporation of label was increased due to folate deficiency in a number of tissues, with an inverse correlation with the tissue folate concentration. In contrast, hepatic [3H]folate incorporation was lower in folate-deficient rats than in folate-replete rats, with a direct correlation between endogenous folate concentration and the incorporation of labeled folate. These results show that the brain and other organs adapt to the development of folate deficiency because of greater incorporation of folate from exogenous sources. The lower incorporation by the liver of folate-deficient rats may result from the greater incorporation by other tissues.

Animals↗