Inadequate Status and Low Awareness of Folate in Switzerland—A Call to Strengthen Public Health Measures to Ensure Sufficient Intakes

Herter-Aeberli, Isabelle; Wehrli, Nina; Bärlocher, Kurt; Andersson, Maria; Sych, Janice Marie

doi:10.3390/nu12123729

Cited by 7 publications

(7 citation statements)

References 22 publications

(32 reference statements)

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“…The prevalence of folate deficiency and insufficiency found in our study population (9.6% and 86.5%, respectively) was much higher than that in neighbouring countries, since available data indicate that they were around 0-5% and 40-50%, respectively (18)(19)(20)(21)(22).…”

Section: Discussioncontrasting

confidence: 63%

“…Despite growing awareness of the need for correct prenatal folate status, the limited data available indicate that folate deficiency and insufficiency are 0-5% (18)(19)(20)(21)(22) and 40-50% (19,22), respectively, in developed countries. As for clinical significance and based on WHO recommendations, folate deficiency refers to depleted folate stores while folate insufficiency indicates a high risk of NTD despite having folate reserves (19,(22)(23)(24). Furthermore, compliance of periconceptional FA supplementation remains low (25,26) while many women start it during the first months of pregnancy, when damage may already have occurred as a result of an inadequate folate level, if any (27).…”

Section: Introductionmentioning

confidence: 99%

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Prenatal folic acid supplementation and folate status in early pregnancy: ECLIPSES study

et al. 2021

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This research evaluates the prevalence of inadequate folate status in early pregnancy, the pattern of prenatal folic acid (FA) supplementation and associated factors in Spanish pregnant women from the ECLIPSES study, which included 791 participants prior gestational week 12. A cross-sectional evaluation of red blood cell (RBC) folate levels was performed at recruitment and used to calculate the prevalence of folate deficiency (RBC folate<340 nmol/L) and insufficiency (RBC folate<906 nmol/L). Sociodemographic and lifestyle data, as well as information on prenatal FA supplementation were recorded. Descriptive and multivariate statistical analyses were performed. The prevalence of folate deficiency and insufficiency were 9.6% and 86.5%, respectively. Most of women used prenatal FA supplements but only 6.3% did so as recommended. Supplementation with FA during the periconceptional period abolished folate deficiency and reduced folate insufficiency. Prenatal folic acid supplementation with ≥1000 µg/d in periconceptional time and pregnancy planning increased RBC folate levels. The main risk factor for folate insufficiency in early pregnancy were getting prenatal FA supplementation out of the periconceptional time (OR 3.32, 95%CI 1.02–15.36), while for folate deficiency they were young age (OR 2.02, 95%CI 1.05–3.99), and smoking (OR 2.39, 95%CI 1.30–4.37). In addition, social and ethnic differences according to folate status were also identified. As conclusion, periconceptional FA use is crucial for achieving optimal folate levels in early pregnancy. Pregnancy planning should focus on young women, smokers, those with low consumption of folate-rich foods, low socioeconomic status or from ethnic minorities.

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Section: Discussioncontrasting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Prenatal folic acid supplementation and folate status in early pregnancy: ECLIPSES study

et al. 2021

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“…This demonstrates that the G-allele is favorable for folate accumulation in sweetcorn. In many populations, dietary folate intake is considerably lower than recommended level [2][3][4][5][6][7][8] . Because high levels of folates were detected in the heterozygous G/A corn, breeders may consider using the G-allele to breed high-folate corn varieties by means of the marker-assisted approach.…”

Section: Discussionmentioning

confidence: 99%

“…The human body cannot synthesize folates de novo and must capture folates from dietary foods 1 . Unfortunately, the dietary intake of folates is inadequate in both developing and developed countries [2][3][4][5][6][7][8] . The worldwide prevalence of neural tube defects, a severe disorder caused by folate deficiency, remains between 0.3 and 124.1 per 10,000 births 9,10 .…”

Section: Introductionmentioning

confidence: 99%

Catalysis of 5-methyltetrahydrofolate to MeFox facilitates folate biofortification in crops

Zhang

Ling

Guo

et al. 2021

Preprint

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Folate deficiency is a global health problem. Biofortification has been considered a cost-effective means to tackle this problem. Here, we describe the genetic cloning and functional identification of a previously uncharacterised plant protein, designated as CTM, which functions as an enzyme in folate metabolism. Plant CTMs are capable of catalysing 5-methyl-tetrahydrofolate to MeFox, a pyrazino-s-triazine derivative of 4α-hydroxy-5-methyl-tetrahydrofolate. The natural asparagine-to-glycine substitution caused by an A-to-G single nucleotide variation in maize CTM enhances its enzymatic activity, as demonstrated by in vitro enzymatic assays and in silico analyses using a maize CTM structure model based on a monomeric sorghum CTM crystal. Loss of the CTM function led to accumulation of 5-methyl-tetrahydrofolate, and overexpression of the maize CTM carrying the G-allele boosted the metabolic flow towards MeFox, and showed no negative impacts on plant growth. Our results suggest that CTM, which has evolved 5-methyl-tetrahydrofolate-to-MeFox converting activity in plants, could be valuable for developing folate-biofortified crops to provide an alternative to the challenge presented by the global folate deficiency.

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“…Other observational studies found no direct association between low folate levels and pregnancy complications (16)(17)(18). To date, the role of folate intake to prevent NTD is veri ed (19,20). Most relevant studies adopted self-statement of multivitamin supplementation, which may be imprecise, so serum folate concentration during pregnancy would be more ideal.…”

Section: Introductionmentioning

confidence: 99%

Folate Deficiency in Early Pregnancy Increases the Risk of Low Birth Weight: Survey of Neonates in Eastern China

Chen

Ying

2021

Preprint

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Objective: Low birth weight (LBW) is a major cause of fetal mortality and morbidity. This study aims to assess the relationship between maternal serum folate levels and LBW in early pregnancy in eastern China. Methods: We conducted a retrospective study including 124 newborns with LBW (born≥1500g to <2500 g) and 393 normal birth weight neonates (NBW). The maternal methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism genotyping was performed by the gene chip hybrid method. The concentrations of serum homocysteine (hcy), folate, vitamin B12 and vitamin D were measured before 18 weeks of pregnancy. Multivariable logistic regression model was used to identify the predictors of LBW. Results: After controlling the covariates, maternal underweight before pregnancy (AOR = 5.15: 95% CI 2.40, 11.05), folate deficiency in early pregnancy (AOR = 2.06: 95% CI 1.03, 4.09), preeclampsia during pregnancy (AOR = 6.02: 95% CI 2.83, 12.81), and premature delivery (AOR =23.81: 95% CI 12.90, 43.95) were risk factors for LBW. However, multipara (AOR = 0.53:95% CI 0.31, 0.91) was a protective factor for LBW. Conclusions: This study revealed different factors associated with LBW in eastern China. Sufficient folate before 18 weeks of pregnancy is a protective factor for LBW. Serum folate > 32.5 nmol/L can reduce the risk of LBW. Therefore, maternal screening of folate statue in the first trimester of pregnancy could be helpful.

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Inadequate Status and Low Awareness of Folate in Switzerland—A Call to Strengthen Public Health Measures to Ensure Sufficient Intakes

Cited by 7 publications

References 22 publications

Prenatal folic acid supplementation and folate status in early pregnancy: ECLIPSES study

Prenatal folic acid supplementation and folate status in early pregnancy: ECLIPSES study

Catalysis of 5-methyltetrahydrofolate to MeFox facilitates folate biofortification in crops

Folate Deficiency in Early Pregnancy Increases the Risk of Low Birth Weight: Survey of Neonates in Eastern China

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