American Journal of Clinical Nutrition, Vol 24, 1337-1345, Copyright © 1971 by The American Society for Clinical Nutrition, Inc.

Experience with an appetizing, high protein, low folate diet in man

¹ Senior Fellow, Division of Hematology, University of Washington School of Medicine; current position: Chief of Hematology, and Assistant Professor of Medicine, Louisiana State University School of Medicine, Shreveport, Louisiana
² Therapeutic Dietitian, Harborview Hospital, Seattle
³ Chief of Hematology, Associate Professor of Medicine, University of Washington School of Medicine, Seattle

By means of Herbert's thrice-boiling method, a palatable, high protein, low folate diet has been devised. This diet contains less than 5 µg folate/day by L. casei assay, but provides a daily intake of 2,000 to 2,400 kcal and 80 to 100 g protein. When supplemented with multivitamins and potassium, this diet allows induction of folate deficiency without the appearance of other vitamin or electrolyte deficiencies. The protein content of the diet is sufficient to maintain normal serum albumin concentration in the face of heavy protein loss via daily phlebotomy. The folate content is so low that no rise in serum folate or hematologic response occurs in the presence of severe folate-deficient megaloblastic anemia. Moreover, alcoholic subjects with subnormal initial folate stores developed megaloblastic hemopoiesis in as few as 5 to 10 weeks on the diet. The ability to maintain subjects on the diet for long periods facilitates clinical investigation of folate deficiency in man. Details of this diet are provided so that it may be used by other investigators.