Folate, Vitamin B₁₂ and Homocysteine Status in Women of Childbearing Age: Baseline Data of Folic Acid Wheat Flour Fortification in Iran

Abstract

Background: Folic acid fortification implemented mandatorily in many countries has been associated with significant increase in blood folate concentrations and reduction in the prevalence of neural tube defects. However, there are controversial findings on the probability of vitamin B₁₂ deficiency being masked in the population after folic acid fortification. Baseline data on folate and vitamin B₁₂ status are necessary before mandatory flour fortification is implemented. Objectives: To assess dietary intake of folate and vitamin B₁₂ and to determine blood concentrations of folate, vitamin B₁₂ and homocysteine in women of childbearing age as baseline data regarding folic acid fortification in Iran. Methods: A descriptive cross-sectional survey was performed with 579 healthy women as a representative sample of the Golestan province. Fasting blood samples were taken and dietary (24-hour recall), health and sociodemographic data were collected with an interview. Serum concentrations of folate and vitamin B₁₂ were measured with radioimmunoassay, and plasma homocysteine concentrations were assessed by high-performance liquid chromatography with fluorescence detection. Results: Mean serum concentrations of folate and vitamin B₁₂ were 13.6 nmol/l (95% CI 12.8–14.4) and 194.4 pmol/l (95% CI 183.8–205.0), respectively. Inadequate serum folate levels were present in 14.3% of the women and 22.7% had serum vitamin B₁₂ levels below normal. Mean plasma homocysteine concentration was 12.6 µmol/l (95% CI 12.1–13.2) and hyperhomocysteinemia was observed in 38.3% of the women. Mean daily intake of folate and vitamin B₁₂ was 198.3 µg (95% CI 185.4–211.3) and 2.6 µg (95% CI 1.9–3.2), respectively. Folate intake from food was positively correlated with serum folate concentrations (r = 0.084, p < 0.05) and inversely correlated with plasma homocysteine concentrations (r = –0.115, p < 0.01). Conclusions: An insufficient vitamin B₁₂ as well as folate status is present in Iranian women of childbearing age. The final evaluation will be carried out 18 months after flour fortification and the results will be compared with baseline data obtained from the present study in order to show the efficacy and safety of folic acid fortification in Iran.

Blood folic acid, vitamin B12, and homocysteine levels in pregnant women with fetal growth restriction

“…Methylenetetrahydrofolate reductase, cystathionine condensing enzyme, and methionine synthetase are important metabolic enzymes in methionine metabolism, while FA and Vit B12 are essential prosthetic groups. FA and/or Vit B12 deficiency is associated with hyperhomocysteinemia (Abdollahi et al, 2008). Our study indicated that FA and Vit B12 levels in the maternal blood were negatively correlated with Hcy content, confirming that FA and/or Vit B12 deficiency is associated with hyperhomocysteinemia.…”

“…Insufficient nutrients may lead to FA and Vit B12 deficiencies in the mothers, and thus affect the fetuses as well. In addition, FA and Vit B12 deficiencies can lead to the conversion of homocysteine (Hcy) to methionine, resulting in homocystinemia (Abdollahi et al, 2008). High Hcy content can be damaging to vascular structures and functions, resulting in insufficient blood perfusion to the fetus, and abnormal fetal development.…”

Deficiencies of the Microelements, Folate and Vitamin B12 in Women of the Child Bearing Ages in Gorgan, Northern Iran

“…Our results were comparable with those of Abdolahi et al's study, which reported a folate deficiency in 14.3% of the women of the childbearing ages in Gorgan before a folic acid fortification was implemented [6]. Our study was done six months after a flour fortification with folic acid and iron was given.…”

“…In our study, a vitamin B12 deficiency was detected in 32% of the subjects, which was reported to be 22.7% in the northern Iran before the flour fortification with folic acid implemented [6]. A vitamin B12 deficiency was reported in 39.4% women of the childbearing ages in Lebanon [7], in 21.4% women in Korea [9] and in 13 % women in Bangladesh [8].…”

High Homocysteine Levels are Closely Associated with the Categories of Coronary Artery Diseases as well as Low Status of Folic Acid and Vitamin B12

“…Folic acid and vitamin B 12 as two vital regulators play an important role in regulating the metabolic process of Hcy [27,28]. Folic acid and vitamin B 12 deficiency would result in elevated level of Hcy [29,30].…”