Normal folate
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Understanding Normal Folate Levels and Their Implications
Importance of Folate in Human Health
Folate, a water-soluble B vitamin, plays a crucial role in various metabolic processes, including DNA synthesis, repair, and methylation, as well as amino acid metabolism2 9. Adequate folate intake is essential for maintaining normal plasma and erythrocyte folate concentrations, which are indicators of sufficient folate status in the body2.
Recommended Dietary Allowances (RDA) for Folate
The Recommended Dietary Allowance (RDA) for folate varies by age, sex, and physiological status. For adults aged 19 years and older, the RDA is 400 micrograms per day of dietary folate equivalents (DFE)2. Pregnant and lactating women require higher intakes, with RDAs set at 600 micrograms and 500 micrograms of DFE per day, respectively, to support fetal development and milk production5.
Folate Deficiency and Its Consequences
Folate deficiency can lead to several health issues, including elevated homocysteine levels, which are associated with an increased risk of cardiovascular diseases and chromosome damage in lymphocytes1. In older adults, low folate levels have been linked to anemia, macrocytosis, and cognitive impairment, particularly when accompanied by vitamin B12 deficiency8. Additionally, low serum folate levels have been associated with poorer clinical response in patients with major depressive disorder resistant to fluoxetine treatment6.
Folate and DNA Methylation
Folate is a key source of one-carbon units used in DNA methylation, an epigenetic modification critical for normal genome regulation and development9. Maternal folate levels during pregnancy have been shown to impact DNA methylation patterns in newborns, potentially influencing long-term health outcomes7. This underscores the importance of adequate folate intake during pregnancy to support fetal development and prevent neural tube defects7.
Measurement of Folate Levels
Serum folate levels can be measured using radioassays, which help distinguish between normal, indeterminate, and deficient folate statuses3. Normal serum folate levels are typically greater than 6 ng/mL, while levels below this threshold indicate deficiency3. Monitoring folate levels is crucial for diagnosing and managing folate deficiency, especially in populations at risk, such as older adults and pregnant women3 4.
Folate Supplementation and Fortification
Folate supplementation and food fortification are effective strategies to prevent folate deficiency. Studies have shown that daily supplementation with folic acid can significantly increase plasma and red blood cell folate levels, although it may not always reduce associated risks such as chromosome damage1. Fortification of food with folic acid has been widely implemented to ensure adequate folate intake across populations, particularly in regions with high prevalence of folate deficiency4.
Conclusion
Maintaining normal folate levels is essential for various physiological functions, including DNA synthesis, repair, and methylation. Adequate folate intake, through diet or supplementation, is crucial for preventing deficiency-related health issues such as elevated homocysteine levels, anemia, and cognitive impairment. Regular monitoring and appropriate dietary recommendations can help ensure sufficient folate status, supporting overall health and well-being.
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Most relevant research papers on this topic
Folate, vitamin B12, homocysteine status and chromosome damage rate in lymphocytes of older men.
Daily folic acid supplementation can significantly improve folate, vitamin B12, and homocysteine levels, potentially reducing chromosome damage in older men.
RCT
Highly CitedFolate metabolism and requirements.
The Recommended Dietary Allowance for folate is 400 microg/d for adults over 19 years, with additional requirements for lactating and pregnant women.
Highly CitedMeasurement of serum folate levels and serum folic acid-binding protein by 3H-PGA radioassay.
This radioassay and measuring serum folic acid-binding protein (FABP) simplify the diagnosis of folate deficiency.
In Vitro StudyHighly CitedRecommended dietary intakes (RDI) of folate in humans.
3 micrograms folate/kg (6.8 nmol/kg) daily is sufficient for maintaining adequate folate nutriture and a substantial reserve body pool in normal individuals.
Highly CitedNew standard for dietary folate intake in pregnant women.
The recommended dietary allowance for folate intake in pregnant women is 1362 nmol (600 microg) DFE/d, which is sufficient to maintain normal folate status and prevent deficiency in 97-98% of women.
Highly CitedSerum folate, vitamin B12, and homocysteine in major depressive disorder, Part 1: predictors of clinical response in fluoxetine-resistant depression.
Low serum folate levels are associated with poorer treatment response in patients with fluoxetine-resistant major depressive disorder.
RCTHighly CitedMaternal plasma folate impacts differential DNA methylation in an epigenome-wide meta-analysis of newborns
Maternal plasma folate levels during pregnancy are associated with differential DNA methylation in 320 genes, potentially impacting offspring's developing epigenome and health outcomes.
Meta-AnalysisHighly CitedFolate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification.
High serum folate is associated with anemia and cognitive impairment in seniors with low vitamin B-12 status, but protects against cognitive impairment when vitamin B-12 is normal.
Observational Study
Very Rigorous JournalHighly CitedFolate and DNA methylation: a review of molecular mechanisms and the evidence for folate's role.
Folate plays a crucial role in normal DNA methylation, which is crucial for genome regulation and development, and may link to developmental disorders and chronic diseases like cancer.
Highly CitedChanges of Serum Homocysteine and Vitamin B12, but Not Folate Are Correlated With Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis of Case-Control Studies
Serum high levels of homocysteine and low levels of vitamin B12 are closely correlated with OCD, while normal folate levels show no significant correlation.
Meta-Analysis