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Obeid, R; Schön, C; Wilhelm, M; Pietrzik, K; Pilz, S.
The effectiveness of daily supplementation with 400 or 800 µg/day folate in reaching protective red blood folate concentrations in non-pregnant women: a randomized trial.
Eur J Nutr. 2018; 57(5):1771-1780
Doi: 10.1007/s00394-017-1461-8
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- Co-Autor*innen der Med Uni Graz
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Pilz Stefan
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- Abstract:
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Folate required to achieve desirable red blood cell (RBC) folate concentrations within 4-8 weeks pre-pregnancy is not known. We studied the effect of supplementation with 400 or 800 µg/day folate in achieving RBC-folate ≥906 nmol/L.
Non-pregnant women were randomized to receive multinutrient supplements containing 400 µg/day (n = 100) or 800 µg/day (n = 101) folate [folic acid and (6S)-5-CH3-H4folate-Ca (1:1)]. The changes of folate biomarkers were studied after 4 and 8 weeks in the 198 women who returned at least for visit 2.
At baseline, 12 of the 198 participants (6.1%) had RBC-folate <340 nmol/L, but 88% had levels <906 nmol/L. The RBC-folate concentrations increased significantly in the 800 µg/day (mean ± SD = 652 ± 295 at baseline; 928 ± 330 at 4 weeks; and 1218 ± 435 nmol/L at 8 weeks) compared with the 400 µg/day [632 ± 285 at baseline (p = 0.578); 805 ± 363 at 4 weeks (p < 0.001); 1021 ± 414 nmol/L at 8 weeks (p < 0.001)]. The changes of RBC-folate were greater in the 800 µg/day than in the 400 µg/day at any time (changes after 8 weeks: 566 ± 260 vs. 389 ± 229 nmol/L; p < 0.001). Significantly more women in the 800 µg group achieved desirable RBC-folate concentrations at 4 weeks (45.5 vs. 31.3%; p = 0.041) or 8 weeks (83.8 vs. 54.5%; p < 0.001) compared with the 400 µg group. RBC-folate levels below the population median (590 nmol/L) were associated with a reduced response to supplements.
88% of the women had insufficient RBC-folate to prevent birth defects, while 6.1% had deficiency. Women with low RBC-folate were unlikely to achieve desirable levels within 4-8 weeks, unless they receive 800 µg/day. The current supplementation recommendations are not sufficient in countries not applying fortification.
The trial was registered at The German Clinical Trials Register: DRKS-ID: DRKS00009770.
- Find related publications in this database (using NLM MeSH Indexing)
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Adolescent -
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Adult -
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Dietary Supplements -
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Dose-Response Relationship, Drug -
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Erythrocytes - classification
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Female -
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Folic Acid - administration & dosage
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Folic Acid - blood
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Folic Acid -
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Humans -
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Middle Aged -
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Neural Tube Defects - prevention & control
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Pregnancy -
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Young Adult -
- Find related publications in this database (Keywords)
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(6S)-5-CH3-H4folate-Ca
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Folic acid
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RBC-folate
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Homocysteine
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Preconceptional
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Neural tube defects
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Supplementation