Journal of the Korean Society of Food Science and Nutrition
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v.26
no.5
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pp.983-992
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1997
During pregnancy and lactation, folate status is important because folate requirements increase during the periods as well as maternal folate status influences on pregnancy outcome and human milk folate; especially folate deficiency around periconceptional period may induce neural tube defects(NTDs) of fetus. There have been a plenty of evidences that maternal folate status deteriorates during pregnancy of fetus. There have been a plenty of evidences that maternal folate status deteriorates during pregnancy and lactation if folate needed is not sufficiently provided. The Public health Service of the United States recommends all child-bearing is not sufficiently provided. The Public Health Service of the United States recommends all child-bearing women to intake 0.4mg of folate daily, and the Food and Drug Administration the folate status of child-bearing women and to reduce the rate of occurrence of NTDs. Many authors have insisted that the current recommended dietary allowances of folate for Americans are too low to maintain good folate status. There are little data about Korean folate status including pregant and lactating women. A couple of reports indicated that the folate intakes of Korean pregant and lactating women are below the Korean RDAs of folate and serum folate levels of them are subnormal. The authors pregnant and lactating women. Therefore, it is worth to review the assessment methods of folate status of pregnant and lactating women, folate RDAs for them, the relationships between maternal folate status and pregnancy outcome as well as human milk folate, the methods to increase folate intake, and the problems of large dose of folic acid supplementatiion.
Lactating women have an increased need of folate in the breastfeeding period and, as a consequence, may be in risk of folate deficiency. Folate content of breast milk, furthermore, is important for infants to support exponential growth. However, little is known about the folate content of breast milk from Korean lactating women and their folate nutritional status. In this study, therefore, we investigated the folate status of Korean lactating women and the folate content of their breast milk during extended lactation. A total of 10 subjects who delivered full-term infants participated this study voluntarily. Dietary folate intakes were measured and blood and breast milk were collected at 1, 2, 3, and 6 months postpartum. The women who did not take folic acid supplements failed to meet the recommended intake(RI) of folate for lactating women during all the study periods but those who did met the RI. The unsupplemented women showed lower plasma folate concentrations compared to the supplemented women and all the women were in suboptimal folate status determined by plasma folate concentration throughout the study periods. But the supplemented women showed lower prevalence of suboptimal folate status only at 3 or 6 months postpartum. Plasma folate concentrations of both groups decreased with the progression of lactation. Erythrocyte folate concentrations were not different between the two groups, however, that of the unsupplemented reduced further as time progressed. Plasma homocysteine levels were not different between the two groups. Concentrations of erythrocyte folate and plasma homocysteine were not changed throughout the study periods. Folate contents of their breast milk through the study periods were not different between the two groups and it decreased as lactation progressed in both groups. The results of this study suggest that the folate nutritional status of Korean lactating women might be deteriorated with the progression of lactation without folic acid supplements.
We examined the relationship between plasma folate and total homocysteine(Hcy) levels and the distribution of plasma folate and Hcy levels from 204 Korean adults(113 men and 91 women aged between 20yr and 69yr). Plasma folate levels were significantly lower in men(12.2nmol/L) than in women(14.6nmol/L) after controlling for smoking and drinking(p<0.05). Plasma Hcy levels were significantly higher in men(13.9$\mu$mol/L) than in women(11.8$\mu$mol/L) after controlling and drinking. Plasma Hcy levels were more more strongly correlated with plasma folate in women(${\gamma}$=-0.321, p<0.05) than in men(${\gamma}$=-0.202, p<0.05), but the difference between men and women was no longer statistically significant controlling for plasma folate concentration. Prevalence of mild homocysteinemia(plama Hcy>15$\mu$mol/L) was greatest among subjects with lowest folate status. These results indicate a strong association between plasma Hcy concentration and folate status and the poor folate status is the strong causative factor of mild homocysteinemia. (Korean J Nutrition 34(4) : 393~400, 2001)
The purpose of this study were to determine the folate status of pregnant women living in kwangju, Korea and to assess the relationships between folate status and pregnancy outcome. Eighty-one women took part in the study: 26 in their first trimester of pregnancy, 23 in the second, and 32 in the final trimester. The folate intake data both from their diets and supplementasage was obtained using a 24-hour recall method and by measuring the use of supplements. Folate levels of serum and erythrocytes were determined by a microbiological assay using Lactovacillus casei(ATTC 7469) as the test organism. A series of determinations for pregnancy outcome was conducted, including birth weight, length, Apgar score at 5 min after birth, and gestational period. The dietary folate intake in each trimester was 118$\pm$85, 148$\pm$117, and 137$\pm$69ug/d, respectively. All levels were far below the Korean recommended diet allowances(RDA)for folate. Eighty-four percent of the subjects consumed supplemental folate after the 20th week of pregnancy until delivery. the supplemental folate intakes in the second and third trimester were 651$\pm$142 and 688$\pm$150ug/d, respectively. Therefore, the women who took folate supplements consumed more folate than the RDA. Serum folate levels for each trimester were 9.0$\pm$3.8, 11.4$\pm$6.0, and 16.3$\pm$11.0ng/ml respectively, greadually increasing as the pregnancy progressed; the serum folate level in the third trimester was significantly higher(p<0.05) than that in first trimester. The erythrocyte folate concentrations in each trimester were recorded as 369.8$\pm$108.8, 396.2$\pm$107.5, and 420$\pm$7 162.6ng/ml respectively. There was no significant differences among the erythrocyte folate concentrations unlike the serum folate levels. There was no significant difference among the erythrocyte folate concentrations unlike the serum folate levels. There was no signifcant correlation between trimester to be important in maintaining adequate folate status, however these results imply that the serum and erythrocyte folate levels were adequate to support the growth of the fetus.
Anemia in women during pregnancy and after delivery has been known to affect the mother, the fetus, and the infant's growth and health status. Studies examining, changes in iron and folate status associated with anemia during pregnancy and during pregnancy, and those supplements are stopped after postpartum. However, the effects of those have not been clearly determined in pregnant and lactating Korea women. Therefore, this study was performed to determine the changes in maternal iron and folate status during pregnancy and six months after delivery longitudinally in six pregnant women who consumed supplements from 20 wk to delivery. We concluded that the iron status deteriorated during pregnancy and especially was weak in the third trimester, but had a tendency to recovery after delivery. On the other hand, the folate status deteriorated in the first and second trimester and was good in the third trimester, but had a tendency to decrease after delivery. These results suggested that the iron status was not improved despite consuming total iron supplements of 50 mg/day through diets and supplements during the second half of the pregnancy. On the other hand, the folate status improved at the end of pregnancy by consuming folate supplements of a total of 800 mg/day through diets and supplements. However, folate status was poor in the first half of the pregnancy, and the tendency of folate status to decrease during postpartum was advanced. At the point in which iron and therefore supplementation is essential. However, the effects of supplement intake time and intake dosage need to be verified and the nutritional status changes of postpartum women should be carefully monitored.
Kim, Hye-Won;Choi, Yun-Jung;Kim, Ki-Nam;Tamura, Tsunenobu;Chang, Nam-Soo
Nutrition Research and Practice
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v.5
no.2
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pp.112-116
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2011
We investigated the effect of paternal folate status on folate content and expression of the folate transporter folate receptor ${\alpha}$ ($FR{\alpha}$) in rat placental tissues. Rats were mated after males were fed a diet containing 0 mg of folic acid/kg of diet (paternal folate-deficient, PD) or 8 mg folic acid/kg of diet (paternal folate-supplemented, PS) for 4 weeks. At 20 days of gestation, the litter size, placental weight, and fetal weight were measured, and placental folate content (n=8/group) and expression of $FR{\alpha}$ (n=10/group) were analyzed by microbiological assay and Western blot analysis, respectively. Although there was no difference observed in litter size or fetal weight, but significant reduction (10%) in the weight of the placenta was observed in the PD group compared to that in the PS group. In the PD group, placental folate content was significantly lower (by 35%), whereas $FR{\alpha}$ expression was higher (by 130%) compared to the PS group. Our results suggest that paternal folate status plays a critical role in regulating placental folate metabolism and transport.
We examined the folate intakes and assessed folate nutritional status of Korean women with childbearing potential. A total of 91 healthy women aged between 15 and 49 participated. They were divided into three groups by their age : A(15-24 yrs), B(25-34 yrs) and C(35-49 yrs). Folate intakes were determined by direct analysis. The foods consumed for 24 hours were collected proportionally and assessed folate. Their blood drawn in fasting state were analyzed folate levels. Folate contents of food homogenate, plasma and erythrocyte were determined a microbiological method using Lactobacillus. casei (ATCC 7469). Prior to the micro-assay, the food homogenate were treated with alpha-amylase, protease and folate conjugase. Mean daily folate intake of the total subjects was 145.8$\mu\textrm{g}$/d and in each group of A, B, and C was 114.0$\mu\textrm{g}$/d, 141.6$\mu\textrm{g}$/d, and 164.6$\mu\textrm{g}$/d, respectively. That of group C was significantly higher than that of group A(p<0.05). However, those of all the groups were lower than compared to the Korean Recommened Dietary Allowances(RDA) for folate. Especially the subjects in the group A consumed folate least that was below the half of the Korean RDA. The mean energy intake of all subjects was 1638㎉/d and those in each group of A, B, and C did not meet the Korean RDA for energy. The energy intake were significantly correlated with folate intakes(r=0.5050, p<0.001). Mean plasma and erythrocyte folate concentrations of total subjects were 6.9ng/mL and 266.3ng/mL, respectively. None were found to be deficient both in plasma(<3ng/mL)and erythrocyte (<140ng/mL) folate levels. There was only one subject who had red blood cell folate level below 157ng/mL concentration. These results show that folate status of the Korean women of reproductive age is not much bad. But it should be better that letting them improve their folate status by increasing energy intake, choosing high folate foods.
It should be concerned to the women with mutated genotype of methylenetetrahydrofolate reductase (MTHFR), C677T or A1298C, since they need more folate than those with wild genotypes. In this study, we evaluated the folate status of Korean women of childbearing age according to their MTHFR polymorpiysm. Dietary folate intakes, plasma and erythrocyte folate concentrations, plasma homocysteine concentrations, and urinary excretions of para-aminobenzoylglutamate (pABG) and para-acetoamidobenzoylglutamate (ApABG) of twenty-five subjects aged between 19 and 35 years old were determined Folate intakes seemed to be inadequate, being only three-quarters of the Korean RDA of folate. More than one-quarter of the subjects was exposed to folate deficiency risk as determined by erythrocyte folate concentration and almost one-quarter of the subjects showed hyperhomocysteinemia, although they had normal plasma folate concentrations. Urinary excretions of pABG and ApABG seemed to be low and ApABG constituted more than $85\%$ of total folate catabolites. There were no significant differences in dietary folate intakes, plasma concentrations of folate and homocysteine, and urinary excretions of pABG and ApABG among the geneotypes of both C677T and A1298C. However, the subjects with 1298AC genotype had significantly lower erythrocyte folate concentration than those with 1298AA. Erythrocyte folate concentration showed an inverse relationship with plasma homocysteine concentration and positive relationships with urinary excretions of pABG and ApABG. The results of this study imply that mutations of 677C$\rightarrow$T and 1298A$\rightarrow$C in the study were not associated with decreased plasma folate and raised plasma homocysteine concentrations. A1298C polymorphism night be, however, more influential on erythrocyte folate concentration than C677T polymorphism, and urinary excretions of folate catabolites, pABG and ApABG, might be reliable indexes of folate nutritional status like plasma homocysteine concentrations.
BACKGROUND/OBJECTTIVES: The purposes of the study were to investigate folate intakes and plasma folate concentrations as well as estimate folate status in Korean healthy adults. SUBJECTS/METHODS: A total of 254 healthy 19- to 64-year-old adults (68 men and 186 women) living in Seoul metropolitan area, Gumi, and Kwangju, Korea participated. Three consecutive 24-hour dietary recalls, information on folate supplementation, and fasting blood samples were collected from the subjects. RESULTS: The mean dietary folate intakes were 587.4 and $499.2{\mu}g$ dietary folate equivalent (DFE)/day for men and women, respectively. The median dietary intakes of men and women were 566.6 and $474.6{\mu}g\;DFE/day$, respectively. Forty subjects (16.7% of total) less total folate than the estimated average requirement (EAR). Folate intakes of 23.3% of men and 34.8% of women aged 19-29 years did not meet the EAR for folate. Major food sources consumed for dietary folate were baechukimchi (Chinese cabbage kimchi), rice, spinach, eggs, and laver, which provided 44% of dietary folate intake for the subjects. Plasma folate concentrations were 23.4 nmol/L for men and 28.3 nmol/L for women, and this level was significantly lower in men than in women. Approximately 13% of men and 3% of women were folate-deficient, and the percentages of subjects showing folate concentrations lower than 10 nmol/L were 27.9% of men and 6.4% of women. CONCLUSIONS: Folate intakes of Korean adults in this study were generally adequate. However, one-third of young adults had inadequate folate intakes.
Chronic abuse of alcohol can lead to the development of folate deficiency due to inadequate folate intaike, excessive urinary excretion and from effects of ethanol on folate absorption and metabolism . To investigate the effects of alcohol and folate intake on folate metabolism, the rates were raised for 4 and 10 weeks on experimental diets containing 0, 2 8mg folate/kg diet, and were administered 50% ethanol(1.8$m\ell$/kg body weight) three times a week intragastrically. Plasma and tissue folate concentrations were found to be significantly influenced by dietary folate level. In animals fed on folate-deficient diet, concentrations of folate in the plasma, liver and kidney were decreased by 60-89% compared to those on folate-adequate diet, and ther values were further decreased with experimental period. Folate supplementation increased plasma and tissue folate levels significantly by 16-78% compared to those on folate-adequate diet, and the folate levels in the plasma and liver were affected most by the supplementation. Alcohol administration did not seem to influence folate status in the body significantly when animals were raised on folate-deficient diet. However, when rats were fed folate-adequate or folate-supplemented diet, alcohol was shown to decrease plasma and tissue folate concentrations. Among the animals receiving alcohol, folate concentrations in the plasma and tissues were significantly higher when animals fed folate-supplemented diet compared to folate adequate diet. Alcohol seems to exert differential effects on urinary foalte excretion by experimental period it increased urinary folate in the 4-week period, but lowered foalte excretion in the urine when the experimental period was extended to 10 weeks. Alcohol did not seem to influence folate excretion in the feces. These results indicate that folate supplementation might be beneficial in ameliorating the inadequate folate status that might occur with chronic alcoholism.
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