Reduced plasma homocysteine levels in elderly Australians following mandatory folic acid fortification – A comparison of two cross-sectional cohorts

Beckett, Emma L.; Martin, Charlotte; Boyd, Lyndell; Porter, T.; King, Katrina; Niblett, Suzanne; Yates, Zoë; Veysey, Martin; Lucock, Mark

doi:10.1016/j.jnim.2017.04.001

Cited by 18 publications

(25 citation statements)

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“…Dietary intake of subjects was estimated using a validated self-administered food frequency questionnaire (FFQ) covering 225 food items and all food groups [38]. Subjects indicated if they obtained additional intake of nutrients via supplement use, and this was converted to total dietary equivalents where appropriate.…”

Section: Questionnaires and Clinical Datamentioning

confidence: 99%

Environmental UVR Levels and Skin Pigmentation Gene Variants Associated with Folate and Homocysteine Levels in an Elderly Cohort

Jones

Lucock

Scarlett

et al. 2020

IJERPH

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Ultraviolet radiation (UVR) is a ubiquitous exposure which may contribute to decreased folate levels. Skin pigmentation mediates the biological effect of UVR exposure, but its relationship to folate levels is unexamined. Interactions may exist between UVR and pigmentation genes in determining folate status, which may, in turn, impact homocysteine levels, a potential risk factor for multiple chronic diseases. Therefore, independent and interactive influences of environmental UVR and genetic variants related to skin pigmentation (MC1R-rs1805007, IRF4-rs12203592 and HERC2-rs12913832) on folate (red blood cell (RBC) and serum) and homocysteine levels were examined in an elderly Australian cohort (n = 599). Genotypes were assessed by RT/RFLP-PCR, and UVR exposures were assessed as the accumulated erythemal dose rate accumulated over 4 months (4M-EDR). Multivariate analysis found significant negative associations between 4M-EDR and RBC folate (p < 0.001, β = −0.19), serum folate (p = 0.045, β = −0.08) and homocysteine levels (p < 0.001, β = −0.28). Significant associations between MC1R-rs1805007 and serum folate levels (p = 0.020), and IRF4-rs12203592 and homocysteine levels (p = 0.026) occurred but did not remain significant following corrections with confounders. No interactions between 4M-EDR and pigmentation variants in predicting folate/homocysteine levels were found. UVR levels and skin pigmentation-related variants are potential determinants of folate and homocysteine status, although, associations are mixed and complex, with further studies warranted.

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Section: Questionnaires and Clinical Datamentioning

confidence: 99%

Environmental UVR Levels and Skin Pigmentation Gene Variants Associated with Folate and Homocysteine Levels in an Elderly Cohort

Jones

Lucock

Scarlett

et al. 2020

IJERPH

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“…Mandatory folic acid fortification has been shown to be safe, cost saving, and highly effective at preventing spina bifida, anencephaly, folate deficiency and related anemia, and hyperhomocysteinaemia (Beckett et al, ; Oakley, ; Odewole et al, ; Williams et al, ). Spina bifida and anencephaly are two major birth defects that occur by 28 days after conception, a period most women are unaware of their pregnancies (Botto, Moore, Khoury, & Erickson, ).…”

Section: Introductionmentioning

confidence: 99%

A 2017 global update on folic acid‐preventable spina bifida and anencephaly

Kancherla

Wagh

Johnson

et al. 2018

Birth Defects Research

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“…10 Fortification levels vary worldwide, with a FA level of 140 µg/100 g implemented in the United States in 1998 5 and 200-300 µg/100 g in Australia as of 2009. 11 Although increased folate reduces plasma homocysteine (Hcy), 6 excessive FA consumption from fortified foods may impair intracellular folate metabolism and play a role in epigenetic changes linked to increased inflammation and non-communicable diseases including depression. 12-16…”

Section: Barnett H Et Al: Folate Supplementation and Depressionmentioning

confidence: 99%

“…In a similarly large trial (n = 4331), Okereke et al 72 studied the effect of supplementing 2.5 mg FA, 50 mg vitamin B 6 71 depression was a secondary outcome (CVD was the primary outcome), and it was determined using the Mental Health Inventory. Despite a reduction in Hcy levels in the supplementation group, there was no significant effect on depressive symptoms in comparison to placebo (relative risk: 1.02; 95% CI: 0.86-1.21; p = 0.81).…”

Section: Fa Supplementation As Standalone Therapy In Prevention Of Dementioning

confidence: 99%

“…[3][4][5] Mandatory fortification exposes the whole population to a synthetic form of folate, rather than just the target population, while consumption of foods containing natural forms of folate is decreasing. [6][7][8] Over 80 countries have implemented a mandatory FA fortification policy. The intake of folate in countries with mandatory fortification is often higher than the recommended ranges, calling into question whether mandatory fortification is warranted in other countries.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Folate Supplementation on Inflammatory Markers in Individuals Susceptible to Depression: A Systematic Review

Barnett¹,

D’Cunha

Georgousopoulou

et al. 2017

Exploratory Research and Hypothesis in Medicine

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Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of neural tube defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p > 0.05). The single L-MTHF trial that explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton depression rating scale from adjunctive treatment with 15 mg/day of L-MTHF compared with placebo (−6.8 ± 7.2 vs. −3.7 ± 6.5; p = 0.017) and improvement with L-MTHF for most genetic markers. Currently, there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.

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Reduced plasma homocysteine levels in elderly Australians following mandatory folic acid fortification – A comparison of two cross-sectional cohorts

Cited by 18 publications

References 50 publications

Environmental UVR Levels and Skin Pigmentation Gene Variants Associated with Folate and Homocysteine Levels in an Elderly Cohort

Environmental UVR Levels and Skin Pigmentation Gene Variants Associated with Folate and Homocysteine Levels in an Elderly Cohort

A 2017 global update on folic acid‐preventable spina bifida and anencephaly

Effect of Folate Supplementation on Inflammatory Markers in Individuals Susceptible to Depression: A Systematic Review

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