Document Detail

Long-term effect of low-dose folic acid intake: potential effect of mandatory fortification on the prevention of neural tube defects.
MedLine Citation:
PMID:  21593499     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Understanding the full effect of chronic low-dose folic acid is important in interpreting the effect of the mandatory folic acid fortification program in North America.
OBJECTIVE: We aimed to describe the rate of attainment and steady state (plateau) of red blood cell (RBC) folate in response to long-term intake of 140 μg (designed to mimic fortification) and 400 μg (recommended dose for the primary prevention of neural tube defects) folic acid/d in reproductive-aged women living in a country with minimal fortification.
DESIGN: On the basis of pharmacokinetics principles, it was recently proposed that a steady state should be reached after 40 wk. Thus, 144 women aged 18-40 y were randomly assigned to receive a daily folic acid supplement of 140 (n = 49) or 400 (n = 48) μg or placebo (n = 47) for 40 wk. RBC folate was measured at baseline and at 6, 12, 29, and 40 wk.
RESULTS: After 40 wk, RBC folate did not reach a plateau in either treatment group. Kinetic modeling of the data indicated that RBC folate would approximately double from 779 to 1356 nmol/L in response to 140 μg folic acid/d with only ≈50% of model-estimated steady state conditions achieved at 40 wk. An average RBC folate concentration of 1068 nmol/L after 12 wk of supplementation with 400 μg folic acid/d was readily achieved at 36 wk after continuous intake of 140 μg/d.
CONCLUSION: Our model shows the considerable length of time required to attain the full effect of low-dose folic acid, which suggests that 140 μg folic acid/d could be as effective as 400 μg folic acid/d taken during the periconceptional period if given sufficient time. This trial is registered at as ACTRN12609000215224.
Lisa A Houghton; Andrew R Gray; Meredith C Rose; Jody C Miller; Nicola A Hurthouse; Jesse F Gregory
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-05-18
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  94     ISSN:  1938-3207     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-21     Completed Date:  2011-08-24     Revised Date:  2013-08-19    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  136-41     Citation Subset:  AIM; IM    
Departments of Human Nutrition and Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
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MeSH Terms
Double-Blind Method
Erythrocytes / chemistry
Folic Acid / administration & dosage*
Food, Fortified*
Neural Tube Defects / prevention & control*
Young Adult
Grant Support
Reg. No./Substance:
59-30-3/Folic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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