Flashcards in Folate and neural tube defects: The role of supplements and food fortification Deck (16):
What does folate do?
1. DNA synthesis and repair
2. Cell growth and division
3. DNA methylation (important for epigenomic regulation)
4. Neural tube defects
What foods are folate found in?
1. Leafy vegetables
3. Red meat
4. Offal i.e. liver
What percentage of folate is lost during cooking?
What is the etiology of NTD?
2. chromosomal abnormalities
3. Environmental factors esp. folate
What foods are fortified with folic acid?
All flour and grain products incld. ready-to-eat cereals and pastas with 150ug folic acid/100g
What was the reduction of NTD post folic acid fortification of foods?
Decrease of spina bifida by 50%
All other NTDs by 2/3
What are the recommendations regarding oral folic acid supplements?
Folic acid 0.4mg PO daily 2-3m pre-conceptation until 4-6w post partum
Which women are considered high risk?
1. Birth of previous child with NTD
2. Family history of NTD
3. Maternal obesity
4. Maternal Hispanic origin
5. Use of some anticonvulsants
6. GDM (low risk)
What are the recommendations regarding oral folic acid supplementation in women with a family history of NTD or other health complications?
Folic acid 5mg PO daily for 3m prior to conception and for 10-12 weeks post conception
What are some challenges regarding food fortification?
There has been a significant decrease in intake of flour
SOGC recommends folic acid fortification of flour increased to 300ug/100g flour
What percentage of N. American women of child-bearing age have suboptimal folic acid levels?
What is the connection between folate supplementation and vitamin B12 deficiency and pernicious anemia?
No threat of masking vitamin B12 deficiency
What is the association between high folate and cancer?
1. No association with breast cancer
2. Unable to r/o some association with increase prostate cancer risk
3. Protective against pancreatic cancer in women, no effect on men
4. Reduction in risk of lung cancer
5. Reduction in risk of colorectal cancer
What are the CPS recommendations re: folate and natural diet?
Eat folate-rich foods such as leafy green vegetables
What are the CPS recommendations re: food fortification with folate?
Increase the level of folic acid food fortification