You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT JAMA
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 277 No. 7, February 19, 1997 TABLE OF CONTENTS
  JAMA
  •  Online Features
  Original Contributions
 This Article
 •References
 •Full text PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Contact me when this article is cited
 Related Content
 •Similar articles in JAMA
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati Add to Twitter What's this?

Predictors of Red Cell Folate Level in Women Attempting Pregnancy

Judith E. Brown, PhD; David R. Jacobs, Jr, PhD; Terryl J. Hartman, PhD; Geralyn M. Barosso, MPH; Jamie S. Stang, PhD; Myron D. Gross, PhD; Melanie A. Zeuske, MPH

JAMA. 1997;277(7):548-552.


Abstract

Objective.
—To identify predictors of red cell folate level in women attempting to become pregnant.

Design.
—Cohort study.

Setting.
—A health maintenance organization serving the Minneapolis-St Paul, Minn, area.

Participants.
—A total of 189 healthy, primarily white women aged 22 to 35 years enrolled in the Diana Project, a population-based prospective study of preconceptional and prenatal risks to reproductive outcomes. The sample represents 189 of 219 enrolled women who were sequentially selected from the total Diana Project sample to receive additional laboratory analyses.

Main Outcome Measure.
—Red cell folate level.

Results.
—Folic acid supplements, folic acid intake from fortified cereals, vitamin C supplements, and serum zinc level (inverse) were found to predict red cell folate levels. Previous research has shown that red cell folate levels higher than 906 nmol/L (400 ng/mL) may be optimal for the prevention of folate-responsive neural tube defects. For folic acid supplement users, folate intakes of 450 µg per day and higher corresponded to these protective levels of red cell folate. In nonusers of supplements, intakes of more than 500 µg of folate per day from foods and folic acid-fortified cereals may be needed to attain red cell folate levels higher than 906 nmol/L (400 ng/mL). Red cell folate levels higher than 906 nmol/L (400 ng/mL) were primarily found in women who took folic acid supplements. Only 1 in 4 women had red cell folate levels higher than 906 nmol/L (400 ng/mL), while 1 in 8 had red cell folate levels indicative of a negative folate balance. Addition of a daily, 400-µg folic acid supplement to the usual diet would result in red cell folate levels over 906 nmol/L (400 ng/mL) in a majority of women in this study.

Conclusions.
—Supplementation of diets of women of childbearing potential with 400 µg of folic acid per day would effectively raise red cell folate to levels associated with a low risk of folate-responsive neural tube defects. Protective levels of red cell folate may also be obtained by ample consumption of vegetables, fruits, and folic acid-fortified breakfast cereals. Efforts to increase folic acid supplement use and folate consumption among women of childbearing potential must go beyond fortification of refined cereal and grain products and reach women within all educational and income groups.



Author Affiliations

From Public Health Nutrition, Division of Epidemiology (Drs Brown, Jacobs, Stang, Gross, and Mss Barosso and Zeuske), School of Public Health, University of Minnesota, Minneapolis. Dr Hartman is a Cancer Prevention Fellow, National Cancer Institute, Bethesda, Md.


Footnotes

Reprints: Judith E. Brown, PhD, Public Health Nutrition, Division of Epidemiology, School of Public Health, University of Minnesota, 1300 S Second St, Suite 300, Minneapolis, MN 55454-1015.



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Red blood cell folate concentrations increase more after supplementation with [6S]-5-methyltetrahydrofolate than with folic acid in women of childbearing age
Lamers et al.
Am. J. Clin. Nutr. 2006;84:156-161.
ABSTRACT | FULL TEXT  

The Effect of Folate Fortification of Cereal-Grain Products on Blood Folate Status, Dietary Folate Intake, and Dietary Folate Sources among Adult Non-Supplement Users in the United States
Dietrich et al.
J. Am. Coll. Nutr. 2005;24:266-274.
ABSTRACT | FULL TEXT  

Erythrocyte Folate and Its Response to Folic Acid Supplementation Is Assay Dependent in Women
Clifford et al.
J. Nutr. 2005;135:137-143.
ABSTRACT | FULL TEXT  

Describing a Folic Acid Intervention for Health Care Providers: Implications for Professional Practice and Continuing Education
Helinski et al.
Health Promot Pract 2004;5:326-333.
ABSTRACT  

Influence of reporting error on the relation between blood folate concentrations and reported folic acid-containing dietary supplement use among reproductive-aged women in the United States
Yang and Erickson
Am. J. Clin. Nutr. 2003;77:196-203.
ABSTRACT | FULL TEXT  

Folate Status during Pregnancy in Women Is Improved by Long-term High Vegetable Intake Compared with the Average Western Diet
Koebnick et al.
J. Nutr. 2001;131:733-739.
ABSTRACT | FULL TEXT  

Folic acid: influence on the outcome of pregnancy
Scholl and Johnson
Am. J. Clin. Nutr. 2000;71:1295S-1303.
ABSTRACT | FULL TEXT  

Understanding the intention to permanently follow a high folate diet among a sample of low-income pregnant women according to the Health Belief Model
Kloeblen and Batish
Health Educ Res 1999;14:327-338.
ABSTRACT | FULL TEXT  

Absorption of Dietary and Supplemental Folate in Women with Prior Pregnancies with Neural Tube Defects and Controls
Neuhouser et al.
J. Am. Coll. Nutr. 1998;17:625-630.
ABSTRACT | FULL TEXT  

A Three-Day Weighed Food Record and a Semiquantitative Food-Frequency Questionnaire Are Valid Measures for Assessing the Folate and Vitamin B-12 Intakes of Women Aged 16 to 19 Years
Green et al.
J. Nutr. 1998;128:1665-1671.
ABSTRACT | FULL TEXT  

Folate Status Response to Controlled Folate Intake in Pregnant Women
Caudill et al.
J. Nutr. 1997;127:2363-2370.
ABSTRACT | FULL TEXT  

DIETARY FOLATE ALONE MAY NOT PROTECT AGAINST NEURAL TUBE DEFECTS
JWatch General 1997;1997:2-2.
FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1997 American Medical Association. All Rights Reserved.