Systematic Review and Bayesian Meta-analysis of the Dose-response Relationship between Folic Acid Intake and Changes in Blood Folate Concentrations

The threshold for population-level optimal red blood cell (RBC) folate concentration among women of reproductive age for the prevention of neural tube defects has been estimated at 906 nmol/L; however, the dose-response relationship between folic acid intake and blood folate concentrations is unchar...

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Main Authors: Krista S. Crider, Owen Devine, Yan Ping Qi, Lorraine F. Yeung, Ahlia Sekkarie, Ibrahim Zaganjor, Eugene Wong, Charles E. Rose, Robert J. Berry
Format: Article
Language:English
Published: MDPI AG 2019-01-01
Series:Nutrients
Subjects:
Online Access:http://www.mdpi.com/2072-6643/11/1/71
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spelling doaj-dc2ae9278e02419cacaf756ee9d202432020-11-24T21:52:40ZengMDPI AGNutrients2072-66432019-01-011117110.3390/nu11010071nu11010071Systematic Review and Bayesian Meta-analysis of the Dose-response Relationship between Folic Acid Intake and Changes in Blood Folate ConcentrationsKrista S. Crider0Owen Devine1Yan Ping Qi2Lorraine F. Yeung3Ahlia Sekkarie4Ibrahim Zaganjor5Eugene Wong6Charles E. Rose7Robert J. Berry8Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Congenital and Developmental Disorders, Atlanta, GA 30341, USACenters for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Congenital and Developmental Disorders, Atlanta, GA 30341, USACenters for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Congenital and Developmental Disorders, Atlanta, GA 30341, USACenters for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Congenital and Developmental Disorders, Atlanta, GA 30341, USAOak Ridge Institute for Science and Education, Oak Ridge, TN 37831, USAOak Ridge Institute for Science and Education, Oak Ridge, TN 37831, USAOak Ridge Institute for Science and Education, Oak Ridge, TN 37831, USACenters for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Congenital and Developmental Disorders, Atlanta, GA 30341, USACenters for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Congenital and Developmental Disorders, Atlanta, GA 30341, USAThe threshold for population-level optimal red blood cell (RBC) folate concentration among women of reproductive age for the prevention of neural tube defects has been estimated at 906 nmol/L; however, the dose-response relationship between folic acid intake and blood folate concentrations is uncharacterized. To estimate the magnitude of blood folate concentration increase in response to specific dosages of folic acid under steady-state conditions (as could be achieved with food fortification), a systematic review of the literature and meta-analysis was conducted. Of the 14,002 records we identified, 533 were selected for full-text review, and data were extracted from 108 articles. The steady-state concentrations (homeostasis) of both serum/plasma and RBC folate concentrations were estimated using a Bayesian meta-analytic approach and one-compartment physiologically-based pharmacokinetic models. RBC folate concentrations increased 1.78 fold (95% credible interval (CI): 1.66, 1.93) from baseline to steady-state at 375–570 µg folic acid/day, and it took a median of 36 weeks of folic acid intake (95% CI: 27, 52) to achieve steady-state RBC folate concentrations. Based on regression analysis, we estimate that serum/plasma folate concentrations increased 11.6% (95% CI: 8.4, 14.9) for every 100 µg/day folic acid intake. These results will help programs plan and monitor folic acid fortification programs.http://www.mdpi.com/2072-6643/11/1/71folic acidred blood cell folateserum folateplasma folatefortificationsupplementationpublic health
collection DOAJ
language English
format Article
sources DOAJ
author Krista S. Crider
Owen Devine
Yan Ping Qi
Lorraine F. Yeung
Ahlia Sekkarie
Ibrahim Zaganjor
Eugene Wong
Charles E. Rose
Robert J. Berry
spellingShingle Krista S. Crider
Owen Devine
Yan Ping Qi
Lorraine F. Yeung
Ahlia Sekkarie
Ibrahim Zaganjor
Eugene Wong
Charles E. Rose
Robert J. Berry
Systematic Review and Bayesian Meta-analysis of the Dose-response Relationship between Folic Acid Intake and Changes in Blood Folate Concentrations
Nutrients
folic acid
red blood cell folate
serum folate
plasma folate
fortification
supplementation
public health
author_facet Krista S. Crider
Owen Devine
Yan Ping Qi
Lorraine F. Yeung
Ahlia Sekkarie
Ibrahim Zaganjor
Eugene Wong
Charles E. Rose
Robert J. Berry
author_sort Krista S. Crider
title Systematic Review and Bayesian Meta-analysis of the Dose-response Relationship between Folic Acid Intake and Changes in Blood Folate Concentrations
title_short Systematic Review and Bayesian Meta-analysis of the Dose-response Relationship between Folic Acid Intake and Changes in Blood Folate Concentrations
title_full Systematic Review and Bayesian Meta-analysis of the Dose-response Relationship between Folic Acid Intake and Changes in Blood Folate Concentrations
title_fullStr Systematic Review and Bayesian Meta-analysis of the Dose-response Relationship between Folic Acid Intake and Changes in Blood Folate Concentrations
title_full_unstemmed Systematic Review and Bayesian Meta-analysis of the Dose-response Relationship between Folic Acid Intake and Changes in Blood Folate Concentrations
title_sort systematic review and bayesian meta-analysis of the dose-response relationship between folic acid intake and changes in blood folate concentrations
publisher MDPI AG
series Nutrients
issn 2072-6643
publishDate 2019-01-01
description The threshold for population-level optimal red blood cell (RBC) folate concentration among women of reproductive age for the prevention of neural tube defects has been estimated at 906 nmol/L; however, the dose-response relationship between folic acid intake and blood folate concentrations is uncharacterized. To estimate the magnitude of blood folate concentration increase in response to specific dosages of folic acid under steady-state conditions (as could be achieved with food fortification), a systematic review of the literature and meta-analysis was conducted. Of the 14,002 records we identified, 533 were selected for full-text review, and data were extracted from 108 articles. The steady-state concentrations (homeostasis) of both serum/plasma and RBC folate concentrations were estimated using a Bayesian meta-analytic approach and one-compartment physiologically-based pharmacokinetic models. RBC folate concentrations increased 1.78 fold (95% credible interval (CI): 1.66, 1.93) from baseline to steady-state at 375–570 µg folic acid/day, and it took a median of 36 weeks of folic acid intake (95% CI: 27, 52) to achieve steady-state RBC folate concentrations. Based on regression analysis, we estimate that serum/plasma folate concentrations increased 11.6% (95% CI: 8.4, 14.9) for every 100 µg/day folic acid intake. These results will help programs plan and monitor folic acid fortification programs.
topic folic acid
red blood cell folate
serum folate
plasma folate
fortification
supplementation
public health
url http://www.mdpi.com/2072-6643/11/1/71
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