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Nutrients 2015, 7(4), 2663-2686; doi:10.3390/nu7042663

Assessing the Association between Natural Food Folate Intake and Blood Folate Concentrations: A Systematic Review and Bayesian Meta-Analysis of Trials and Observational Studies

1
Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN 37831, USA
2
Carter Consulting, Inc., Atlanta, GA 30345, USA
3
Division of Birth Defects and Developmental Disabilities (DBDDD), National Center on Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
4
Acentia, Falls Church, VA 22042, USA
5
SciMetrika, LLC, Atlanta, GA 30329, USA
6
Division of Nutrition, Physical Activity, and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
*
Author to whom correspondence should be addressed.
Received: 5 February 2015 / Revised: 6 March 2015 / Accepted: 9 March 2015 / Published: 10 April 2015
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Abstract

Folate is found naturally in foods or as synthetic folic acid in dietary supplements and fortified foods. Adequate periconceptional folic acid intake can prevent neural tube defects. Folate intake impacts blood folate concentration; however, the dose-response between natural food folate and blood folate concentrations has not been well described. We estimated this association among healthy females. A systematic literature review identified studies (1 1992–3 2014) with both natural food folate intake alone and blood folate concentration among females aged 12–49 years. Bayesian methods were used to estimate regression model parameters describing the association between natural food folate intake and subsequent blood folate concentration. Seven controlled trials and 29 observational studies met the inclusion criteria. For the six studies using microbiologic assay (MA) included in the meta-analysis, we estimate that a 6% (95% Credible Interval (CrI): 4%, 9%) increase in red blood cell (RBC) folate concentration and a 7% (95% CrI: 1%, 12%) increase in serum/plasma folate concentration can occur for every 10% increase in natural food folate intake. Using modeled results, we estimate that a natural food folate intake of ≥450 μg dietary folate equivalents (DFE)/day could achieve the lower bound of an RBC folate concentration (~1050 nmol/L) associated with the lowest risk of a neural tube defect. Natural food folate intake affects blood folate concentration and adequate intakes could help women achieve a RBC folate concentration associated with a risk of 6 neural tube defects/10,000 live births. View Full-Text
Keywords: food folate; serum/plasma folate; RBC folate food folate; serum/plasma folate; RBC folate
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Marchetta, C.M.; Devine, O.J.; Crider, K.S.; Tsang, B.L.; Cordero, A.M.; Qi, Y.P.; Guo, J.; Berry, R.J.; Rosenthal, J.; Mulinare, J.; Mersereau, P.; Hamner, H.C. Assessing the Association between Natural Food Folate Intake and Blood Folate Concentrations: A Systematic Review and Bayesian Meta-Analysis of Trials and Observational Studies. Nutrients 2015, 7, 2663-2686.

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