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Intake and status of folate and related B-vitamins: considerations and challenges in achieving optimal status

  • Helene McNulty (a1) and John M. Scott (a2)
  • DOI:
  • Published online: 01 June 2008

Folate and the metabolically related B-vitamins, vitamin B12 and riboflavin, have attracted much scientific and public health interest in recent years. Apart from a well established role in preventing neural tube defects (NTDs), evidence is emerging to support other potential roles for folate and/or related B-vitamins in protecting against cardiovascular disease (especially stroke), certain cancers, cognitive impairment and osteoporosis. However, typical folate intakes are sub-optimal, in that although adequate in preventing clinical folate deficiency (i.e. megaloblastic anaemia) in most people, they are generally insufficient to achieve a folate status associated with the lowest risk of NTDs. Natural food folates have a limited ability to enhance folate status as a result of their poor stability under typical cooking conditions and incomplete bioavailability when compared with the synthetic vitamin, folic acid (as found in supplements and fortified foods). Current folate recommendations to prevent NTDs (based primarily on folic acid supplementation) have been found to be ineffective in several European countries. In contrast, in North America and Chile, the policy of mandatory folic acid-fortification has proven itself in terms of lowering the prevalence of NTD, but remains controversial because of concerns regarding potential risks of chronic exposure to high-dose folic acid. In the case of vitamin B12, the achievement of an optimal status is particularly difficult for many older people because of the common problem of food-bound B12 malabsorption. Finally, there is evidence that riboflavin status is generally low in the UK population, and particularly so in younger women; this warrants further investigation.

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*Corresponding author: Professor Helene McNulty, fax +44 028 70323023, email
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7JW Miller , MG Garrod , AL Rockwood , MM Kushnir , LH Allen , MN Haan & R Green (2006) Measurement of total vitamin B12 and holotranscobalamin, singly and in combination, in screening for metabolic vitamin B12 deficiency. Clin Chem 52, 278285.

9AL Morkbak , RM Heimdal , K Emmens , A Molloy , AM Hvas , J Schneede , R Clarke , JM Scott , PM Ueland & E Nexo (2005) Evaluation of the technical performance of novel holotranscobalamin (holoTC) assays in a multicenter European demonstration project. Clin Chem Lab Med 43, 10581064.

10AM Hvas & E Nexo (2005) Holotranscobalamin – a first choice assay for diagnosing early vitamin B deficiency? J Intern Med 257, 289298.

12M Wolters , A Strohle & A Hahn (2004) Cobalamin: a critical vitamin in the elderly. Prev Med 39, 12561266.

17S Liu , R West , E Randell , (2004) A comprehensive evaluation of food fortification with folic acid for the primary prevention of neural tube defects. BMC Pregnancy Childbirth 4, 2029.

25M Eichholzer , O Tonz & R Zimmermann (2006) Folic acid: a public-health challenge. Lancet 367, 13521361.

26LD Botto , A Lisi , E Robert-Gnansia , (2005) International retrospective cohort study of neural tube defects in relation to folic acid recommendations: are the recommendations working? BMJ 330, 571576.

28MA Honein , LJ Paulozzi , TJ Mathews , JD Erickson & L-YC Wong (2001) Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA 285, 29812986.

29P De Wals , F Tairou , MI Van Allen , (2007) Reduction in neural-tube defects after folic acid fortification in Canada. N Engl J Med 357, 135142.

30Homocysteine Studies Collaboration (2002) Homocysteine and risk of ischemic heart disease and stroke. JAMA 288, 20152022.

31DS Wald , M Law & JK Morris (2002) Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. BMJ 325, 12021208.

32P Frosst , HJ Blom , R Milos , (1995) A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet 10, 111113.

33B Wilcken , F Bamforth , Z Li , (2003) Geographical and ethnic variation of the 677C>T allele of 5,10 methylenetetrahydrofolate reductase (MTHFR): findings from over 7000 newborns from 16 areas world wide. J Med Genet 40, 619625.

34M Klerk , P Verhoef , R Clarke , HJ Blom , FJ Kok & EG Schouten (2003) MTHFR 677C>T polymorphism and risk of coronary heart disease: a meta-analysis. JAMA 288, 20232031.

35SJ Lewis , S Ebrahim & G Davey Smith (2005) Meta-analysis of MTHFR 677C → T polymorphism and coronary heart disease: does totality of evidence support causal role for homocysteine and preventive potential of folate. BMJ 331, 10531056.

36Q Yang , LD Botto , JD Erickson , RJ Berry , C Sambell , H Johansen & JM Friedman (2006) Improvement in stroke mortality in Canada and the United States, 1990 to 2002. Circulation 113, 13351343.

37X Wang , X Qin , H Demirtas , J Li , G Mao , Y Huo , N Sun , L Liu & X Xu (2007) Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. Lancet 369, 18761882.

40BF Cole , JA Baron , RS Sandler , (2007) Folic acid for the prevention of colorectal adenomas: a randomized clinical trial. JAMA 297, 23512359.

41JA McMahon , TJ Green , CM Skeaff , RG Knight , JI Mann & SM Williams (2006) A controlled trial of homocysteine lowering and cognitive performance. N Engl J Med 354, 27642772.

42J Durga , MP van Boxtel , EG Schouten , FJ Kok , J Jolles , MB Katan & P Verhoef (2007) Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet 369, 208216.

43Y Sato , Y Honda , J Iwamoto , T Kanoko & K Satoh (2005) Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA 293, 10821088.

44Homocysteine Lowering Trialists' Collaboration (1998) Lowering blood homocysteine with folic acid based supplements: meta-analysis of randomized trials. BMJ 316, 894898.

45SJPM Eussen , LCPGM de Groot , R Clarke , (2005) Oral cyanocobalamin supplementation in older people with vitamin B12 deficiency. A dose finding trial. Arch Intern Med 165, 11671172.

47H McNulty , LC Dowey , JJ Strain , A Dunne , M Ward , AM Molloy , LB McAnena , JP Hughes , M Hannon-Fletcher & JM Scott (2006) Riboflavin lowers homocysteine in individuals homozygous for the MTHFR 677C → T polymorphism. Circulation 113, 7480.

49EP Quinlivan , J McPartlin , H McNulty , M Ward , JJ Strain , DG Weir & JM Scott (2002) Importance of both folic acid and vitamin B-12 in reduction of risk of vascular disease. Lancet 359, 227228.

50G Liaugaudas , PF Jacques , J Selhub , IH Rosenberg & AG Boston (2001) Renal insufficiency, vitamin B-12 status, and population attributable risk for mild hyperhomocysteinemia among coronary artery disease patients in the era of folic acid-fortified cereal grain flour. Arterioscler Thromb Vasc Biol 21, 849851.

51AM Molloy , S Daly , JL Mills , PN Kirke , AS Whitehead , D Ramsbottom , MR Conley , DG Weir & JM Scott (1997) Thermolabile variant of 5,10-methylenetetrahydrofolate reductase associated with low red-cell folates: implications for folate intake recommendations. Lancet 349, 15911593.

52PF Jacques , AG Bostom , RR Williams , RC Ellison , JH Eckfeldt , IH Rosenberg , J Selhub & R Rozen (1996) Relation between folate status, a common mutation in methylenetetrahydrofolate reductase, and plasma homocysteine concentrations. Circulation 93, 79.

53K Yamada , Z Chen , R Rozen & RG Matthews (2001) Effects of common polymorphisms on the properties of recombinant human methylenetetrahydrofolate reductase. Proc Natl Acad Sci U S A 98, 1485314858.

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