The Folate Status of Reproductive-aged Women in a Randomised Trial of a Folate-fortified Oral Contraceptive: Dietary and Blood Assessments

Overview

Journal Public Health Nutr

Publisher Cambridge University Press

Date 2013 Mar 29

PMID 23534865

Citations 1

Authors

Paula M Castano

Aida Aydemir

Carole Sampson-Landers

Richard Lynen

Affiliations

Soon will be listed here.

Abstract

Objective: To assess the folate status of US women in a study of a folate-fortified oral contraceptive (OC) using the Short Folate Food Frequency Questionnaire and plasma and red blood cell (RBC) folate samples.

Design: Sub-analysis from a multi-centre, randomised, double-blind, controlled contraceptive trial with assessments at baseline and 6 months. We calculated dietary folate equivalents (DFE) consumed and the proportion of participants meeting folate adequacy benchmarks.

Setting: Eight centres in the USA.

Subjects: Healthy women aged 18-40 years requesting contraception with no contraindications for OC use.

Results: Overall, 385 participants were randomised to either a novel folate-fortified OC or a marketed OC. The 262 (68 %) participants compliant with the protocol were included in the analysis set. Baseline daily DFE consumption was 529·8 (sd 342·1) μg and similar in both groups. At follow-up, the fortified OC group had higher intake than the conventional OC group (1225·9 (sd 346·2) μg compared with 500·6 (sd 361·2) μg). Mean plasma folate level increased from 44·5 (sd 17·2) to 55·8 (sd 21·1) nmol/l. Mean RBC folate level increased from 996·7 (sd 369·8) to 1311·9 (sd 436·0) nmol/l. The proportion meeting selected folate adequacy benchmarks increased in the fortified OC group (P < 0·001).

Conclusions: Lack of adequate folate intake in reproductive-aged women from dietary sources or supplements alone suggests the need for novel approaches. Use of folate-fortified OC ensures adequate folate levels and meeting of folate benchmarks.

Citing Articles

Evidence of Drug-Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update.

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References

Yoshino K, Nishide M, Sankai T, Inagawa M, Yokota K, Moriyama Y . Validity of brief food frequency questionnaire for estimation of dietary intakes of folate, vitamins B6 and B12, and their associations with plasma homocysteine concentrations. Int J Food Sci Nutr. 2010; 61(1):61-7. DOI: 10.3109/09637480903286363. View

Mason J . Unraveling the complex relationship between folate and cancer risk. Biofactors. 2011; 37(4):253-60. DOI: 10.1002/biof.174. View

Czeizel A, Dudas I . Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992; 327(26):1832-5. DOI: 10.1056/NEJM199212243272602. View

Durga J, van Boxtel M, Schouten E, Kok F, Jolles J, Katan M . Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet. 2007; 369(9557):208-16. DOI: 10.1016/S0140-6736(07)60109-3. View

Malouf R, Grimley Evans J . Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people. Cochrane Database Syst Rev. 2008; (4):CD004514. DOI: 10.1002/14651858.CD004514.pub2. View

Daly L, Kirke P, Molloy A, Weir D, Scott J . Folate levels and neural tube defects. Implications for prevention. JAMA. 1995; 274(21):1698-702. DOI: 10.1001/jama.1995.03530210052030. View

Shuaibi A, House J, Sevenhuysen G . Folate status of young Canadian women after folic acid fortification of grain products. J Am Diet Assoc. 2008; 108(12):2090-4. DOI: 10.1016/j.jada.2008.09.007. View

Baggott J, Oster R, Tamura T . Meta-analysis of cancer risk in folic acid supplementation trials. Cancer Epidemiol. 2011; 36(1):78-81. DOI: 10.1016/j.canep.2011.05.003. View

Rosenberg M, Waugh M . Oral contraceptive discontinuation: a prospective evaluation of frequency and reasons. Am J Obstet Gynecol. 1998; 179(3 Pt 1):577-82. DOI: 10.1016/s0002-9378(98)70047-x. View

10.

Rofail D, Colligs A, Abetz L, Lindemann M, Maguire L . Factors contributing to the success of folic acid public health campaigns. J Public Health (Oxf). 2011; 34(1):90-9. PMC: 3285116. DOI: 10.1093/pubmed/fdr048. View

11.

Brown J, Jacobs Jr D, Hartman T, Barosso G, Stang J, Gross M . Predictors of red cell folate level in women attempting pregnancy. JAMA. 1997; 277(7):548-52. DOI: 10.1001/jama.1997.03540310046033. View

12.

. Folic acid for the prevention of neural tube defects: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009; 150(9):626-31. DOI: 10.7326/0003-4819-150-9-200905050-00009. View

13.

Wilcox A, Lie R, Solvoll K, Taylor J, McConnaughey D, Abyholm F . Folic acid supplements and risk of facial clefts: national population based case-control study. BMJ. 2007; 334(7591):464. PMC: 1808175. DOI: 10.1136/bmj.39079.618287.0B. View

14.

. Use of supplements containing folic acid among women of childbearing age--United States, 2007. MMWR Morb Mortal Wkly Rep. 2008; 57(1):5-8. View

15.

Ionescu-Ittu R, Marelli A, Mackie A, Pilote L . Prevalence of severe congenital heart disease after folic acid fortification of grain products: time trend analysis in Quebec, Canada. BMJ. 2009; 338:b1673. PMC: 2682153. DOI: 10.1136/bmj.b1673. View

16.

Johansson I, van Guelpen B, Hultdin J, Johansson M, Hallmans G, Stattin P . Validity of food frequency questionnaire estimated intakes of folate and other B vitamins in a region without folic acid fortification. Eur J Clin Nutr. 2010; 64(8):905-13. DOI: 10.1038/ejcn.2010.80. View

17.

Stevens V, McCullough M, Sun J, Jacobs E, Campbell P, Gapstur S . High levels of folate from supplements and fortification are not associated with increased risk of colorectal cancer. Gastroenterology. 2011; 141(1):98-105, 105.e1. DOI: 10.1053/j.gastro.2011.04.004. View

18.

Yen J, Zoumas-Morse C, Pakiz B, Rock C . Folate intake assessment: validation of a new approach. J Am Diet Assoc. 2003; 103(8):991-1000; discussion 1000. DOI: 10.1016/s0002-8223(03)00471-1. View

19.

Bailey R, Dodd K, Gahche J, Dwyer J, McDowell M, Yetley E . Total folate and folic acid intake from foods and dietary supplements in the United States: 2003-2006. Am J Clin Nutr. 2009; 91(1):231-7. PMC: 2793110. DOI: 10.3945/ajcn.2009.28427. View

20.

Venn B, Green T, Moser R, McKenzie J, Skeaff C, Mann J . Increases in blood folate indices are similar in women of childbearing age supplemented with [6S]-5-methyltetrahydrofolate and folic acid. J Nutr. 2002; 132(11):3353-5. DOI: 10.1093/jn/132.11.3353. View