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ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Nutrition and Food Sciences, Pathophysiology of Nutrition, University of Bonn, Bonn, Germany
Background: For the primary prevention of neural tube defects (NTDs), public health authorities recommend women of childbearing age to take 400 µg folic acid/d 4 wk before conception and during the first trimester. The biologically active derivate [6S]-5-methyltetrahydrofolate ([6S]-5-MTHF) could be an alternative to folic acid.
Objective: We investigated the effect of supplementation with [6S]-5-MTHF compared with that of folic acid on red blood cell folate concentration, an indicator of folate status.
Design: The study was designed as a double-blind, randomized, placebo-controlled intervention trial. Healthy women (n = 144) aged 19–33 y received 400 µg folic acid, the equimolar amount of [6S]-5-MTHF (416 µg), 208 µg [6S]-5-MTHF, or placebo as a daily supplement for 24 wk. Red blood cell and plasma folate concentrations were measured at baseline and at 4-wk intervals.
Results: The increase in red blood cell folate over time was significantly higher in the group receiving 416 µg [6S]-5-MTHF/d than in the groups receiving 400 µg folic acid/d or 208 µg [6S]-5-MTHF/d (P < 0.001). No plateau was reached in red blood cell folate concentration in the 3 treatment groups during 24 wk of intervention; however, plasma folate plateaued after 12 wk.
Conclusions: We showed that administration of [6S]-5-MTHF is more effective than is folic acid supplementation at improving folate status. In addition, the study indicates that the recommended period for preconceptional folic acid supplementation should be extended to >4 wk for maximal prevention of NTDs based on folate concentrations. [6S]-5-MTHF might be an efficient and safe alternative to folic acid.
Key Words: Red blood cell folate • 5-methyltetrahydrofolate • folic acid • preconception supplementation • neural tube defect
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