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The effect of folic acid fortification on plasma folate and total homocysteine concentrations.
N Engl J Med 1999; 340(19):1449-54NEJM

Abstract

BACKGROUND

In 1996, the Food and Drug Administration issued a regulation requiring all enriched grain products to be fortified with folic acid to reduce the risk of neural-tube defects in newborns. Fortification (140 microg per 100 g) began in 1996, and the process was essentially complete by mid-1997.

METHODS

To assess the effect of folic acid fortification on folate status, we measured plasma folate and total homocysteine concentrations (a sensitive marker of folate status) using blood samples from the fifth examination (January 1991 to December 1994) of the Framingham Offspring Study cohort for baseline values and the sixth examination (January 1995 to August 1998) for follow-up values. We divided the cohort into two groups on the basis of the date of their follow-up examination: the study group consisted of 350 subjects who were seen after fortification (September 1997 to March 1998), and the control group consisted of 756 subjects who were seen before fortification (January 1995 to September 1996).

RESULTS

Among the subjects in the study group who did not use vitamin supplements, the mean folate concentrations increased from 4.6 to 10.0 ng per milliliter (11 to 23 nmol per liter) (P<0.001) from the baseline visit to the follow-up visit, and the prevalence of low folate concentrations (<3 ng per milliliter [7 nmol per liter]) decreased from 22.0 to 1.7 percent (P< 0.001). The mean total homocysteine concentration decreased from 10.1 to 9.4 micromol per liter during this period (P<0.001), and the prevalence of high homocysteine concentrations (>13 micromol per liter) decreased from 18.7 to 9.8 percent (P<0.001). In the control group, there were no statistically significant changes in concentrations of folate or homocysteine.

CONCLUSIONS

The fortification of enriched grain products with folic acid was associated with a substantial improvement in folate status in a population of middle-aged and older adults.

Authors+Show Affiliations

Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10320382

Citation

Jacques, P F., et al. "The Effect of Folic Acid Fortification On Plasma Folate and Total Homocysteine Concentrations." The New England Journal of Medicine, vol. 340, no. 19, 1999, pp. 1449-54.
Jacques PF, Selhub J, Bostom AG, et al. The effect of folic acid fortification on plasma folate and total homocysteine concentrations. N Engl J Med. 1999;340(19):1449-54.
Jacques, P. F., Selhub, J., Bostom, A. G., Wilson, P. W., & Rosenberg, I. H. (1999). The effect of folic acid fortification on plasma folate and total homocysteine concentrations. The New England Journal of Medicine, 340(19), pp. 1449-54.
Jacques PF, et al. The Effect of Folic Acid Fortification On Plasma Folate and Total Homocysteine Concentrations. N Engl J Med. 1999 May 13;340(19):1449-54. PubMed PMID: 10320382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of folic acid fortification on plasma folate and total homocysteine concentrations. AU - Jacques,P F, AU - Selhub,J, AU - Bostom,A G, AU - Wilson,P W, AU - Rosenberg,I H, PY - 1999/5/13/pubmed PY - 1999/5/13/medline PY - 1999/5/13/entrez SP - 1449 EP - 54 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 340 IS - 19 N2 - BACKGROUND: In 1996, the Food and Drug Administration issued a regulation requiring all enriched grain products to be fortified with folic acid to reduce the risk of neural-tube defects in newborns. Fortification (140 microg per 100 g) began in 1996, and the process was essentially complete by mid-1997. METHODS: To assess the effect of folic acid fortification on folate status, we measured plasma folate and total homocysteine concentrations (a sensitive marker of folate status) using blood samples from the fifth examination (January 1991 to December 1994) of the Framingham Offspring Study cohort for baseline values and the sixth examination (January 1995 to August 1998) for follow-up values. We divided the cohort into two groups on the basis of the date of their follow-up examination: the study group consisted of 350 subjects who were seen after fortification (September 1997 to March 1998), and the control group consisted of 756 subjects who were seen before fortification (January 1995 to September 1996). RESULTS: Among the subjects in the study group who did not use vitamin supplements, the mean folate concentrations increased from 4.6 to 10.0 ng per milliliter (11 to 23 nmol per liter) (P<0.001) from the baseline visit to the follow-up visit, and the prevalence of low folate concentrations (<3 ng per milliliter [7 nmol per liter]) decreased from 22.0 to 1.7 percent (P< 0.001). The mean total homocysteine concentration decreased from 10.1 to 9.4 micromol per liter during this period (P<0.001), and the prevalence of high homocysteine concentrations (>13 micromol per liter) decreased from 18.7 to 9.8 percent (P<0.001). In the control group, there were no statistically significant changes in concentrations of folate or homocysteine. CONCLUSIONS: The fortification of enriched grain products with folic acid was associated with a substantial improvement in folate status in a population of middle-aged and older adults. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/10320382/The_effect_of_folic_acid_fortification_on_plasma_folate_and_total_homocysteine_concentrations_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM199905133401901?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -