Bioavailability of heptaglutamyl relative to monoglutamyl folic acid in healthy adults

Assessing a Fermented Whey Beverage Biofortified with Folate as a Potential Folate Source for Humans

Folate, a vital water-soluble vitamin (B9), requires specific attention as its recommended daily intake frequently is not reached in countries without mandatory fortification. In this regard, biofortification with microorganisms like Bifidobacterium and Streptococcus offers a compelling approach for enhancing food with natural folates. A randomized, nonblinded, and monocentric human pilot study is conducted to assess the bioavailability of a folate-biofortified fermented whey beverage, comprising 3 intervention days and a controlled replenishment phase before and during the assay. Folate plasma concentration (5-CH3-H4folate) is determined using a stable isotope dilution assay and LC-MS/MS detection. Biokinetic parameters (cmax and tmax) are determined, and areas under the curve (AUC) normalized to the basal folate plasma concentration are calculated. An average bioavailability of 17.1% in relation to the 5-CH3-H4folate supplement, ranging from 0% to 39.8%, is obtained. These results reiterate the significance of additional research into folate bioavailability in general and dairy products. Further investigations are warranted into folate-binding proteins (FBP) and other potential limiting factors within the food and individual factors. In summary, biofortification via fermentation emerges as a promising avenue for enhancing the natural folate content in dairy and other food products.

How food matrices modulate folate bioaccessibility: A comprehensive overview of recent advances and challenges

The incomplete absorption of dietary folate makes it crucial to understand how food matrices affect folate bioaccessibility. Bioavailability encompasses bioaccessibility, which depicts the proportion that is liberated from the food matrix during digestion and becomes available for absorption. Bioavailability studies are expensive and difficult to control, whereas bioaccessibility studies utilize in vitro digestion models to parameterize the complex digestion, allowing the evaluation of the effect of food matrices on bioaccessibility. This review covers the folate contents in various food matrices, the methods used to determine and the factors affecting folate bioaccessibility, and the advances and challenges in understanding how food matrices affect folate bioaccessibility. The methods for determining bioaccessibility have been improved in the last decade. Current research shows that food matrices modulate folate bioaccessibility by affecting the liberation and stability of folate during digestion but do not provide enough information about folate and food component interactions at the molecular level. In addition, information on folate interconversion and degradation during digestion is scant, hindering our understanding of the impact of food matrices on folate stability. Moreover, the role of conjugase inhibitors should not be neglected when evaluating the nutritional value of food folates. Due to the complexity of food digestion, holistic methods should be applied to investigate bioaccessibility. By synthesizing the current state of knowledge on this topic, this review highlights the lack of in-depth understanding of the mechanisms of how food matrices modulate folate bioaccessibility and provides insights into potential strategies for accurate evaluation of the nutritional value of dietary folate.

Association Between Dietary Intakes and Plaque Vulnerability Measured by Optical Coherence Tomography in Patients With Coronary Heart Disease: A Mediation Analysis of Inflammatory Factors

Although studies have proven that diet has a critical role in preventing or delaying atherosclerosis and is far simpler to adjust and adhere to than other risk factors, the underlying mechanisms behind this effect remain not well comprehended. The purpose of this investigation was to determine the impact of inflammatory factors on the connection between dietary ingestion and coronary plaque fragility as measured via optical coherence tomography (OCT) in patients with coronary heart disease (CHD). This research eventually comprised 194 participants with CHD who met the inclusion and exclusion criteria. Semi-quantitative food frequency questionnaire (SQFFQ) was utilized to investigate dietary consumption status, serum levels of inflammatory biomarkers were analyzed using enzyme-linked immunosorbent assay, and OCT was employed to identify the plaque susceptibility of causative lesions in the body. Following correction for statistically meaningful possible confounders in univariate analysis, quartiles of soy and nuts, fruits and vitamin C were negatively associated with coronary plaque vulnerability. Conversely, the upper quartile group of sodium intake had 2.98 times the risk of developing vulnerable plaques compared with the most minimal quartile group. Meanwhile, we observed an inverse dose–response connection between vitamin C consumption and inflammatory biomarkers as well as plaque vulnerability. More importantly, tumor necrosis factor- α (TNF-α) and interleukin-6 (IL-6) were significant mediators of the connection between vitamin C and plaque vulnerability, suggesting that vitamin C may inhibit the atherosclerotic inflammatory process by decreasing the expression of IL-6 and TNF-α, thereby reducing the risk of vulnerable plaques. These new findings provide crucial clues to identify anti-inflammatory dietary components as effective therapeutic approaches in the management of CHD, while also providing some insights into their mechanisms of action.

Bioavailability of Micronutrients From Nutrient-Dense Whole Foods: Zooming in on Dairy, Vegetables, and Fruits

In order to fully exploit the nutrient density concept, thorough understanding of the biological activity of single nutrients in their interaction with other nutrients and food components from whole foods is important. This review provides a narrative overview of recent insights into nutrient bioavailability from complex foods in humans, highlighting synergistic and antagonistic processes among food components for two different food groups, i.e., dairy, and vegetables and fruits. For dairy, bioavailability of vitamins A, B2, B12 and K, calcium, phosphorous, magnesium, zinc and iodine are discussed, whereas bioavailability of pro-vitamin A, folate, vitamin C and K, potassium, calcium, magnesium and iron are discussed for vegetables and fruits. Although the bioavailability of some nutrients is fairly well-understood, for other nutrients the scientific understanding of uptake, absorption, and bioavailability in humans is still at a nascent stage. Understanding the absorption and bioavailability of nutrients from whole foods in interaction with food components that influence these processes will help to come to individual diet scores that better reflect absorbable nutrient intake in epidemiologic studies that relate dietary intake to health outcomes. Moreover, such knowledge may help in the design of foods, meals, and diets that aid in the supply of bioavailable nutrients to specific target groups.

Dietary fruits and vegetables and cardiovascular diseases risk

Diet is likely to be an important determinant of cardiovascular disease (CVD) risk. In this article, we will review the evidence linking the consumption of fruit and vegetables and CVD risk. The initial evidence that fruit and vegetable consumption has a protective effect against CVD came from observational studies. However, uncertainty remains about the magnitude of the benefit of fruit and vegetable intake on the occurrence of CVD and whether the optimal intake is five portions or greater. Results from randomized controlled trials do not show conclusively that fruit and vegetable intake protects against CVD, in part because the dietary interventions have been of limited intensity to enable optimal analysis of their putative effects. The protective mechanisms of fruit and vegetables may not only include some of the known bioactive nutrient effects dependent on their antioxidant, anti-inflammatory, and electrolyte properties, but also include their functional properties, such as low glycemic load and energy density. Taken together, the totality of the evidence accumulated so far does appear to support the notion that increased intake of fruits and vegetables may reduce cardiovascular risk. It is clear that fruit and vegetables should be eaten as part of a balanced diet, as a source of vitamins, fiber, minerals, and phytochemicals. The evidence now suggests that a complicated set of several nutrients may interact with genetic factors to influence CVD risk. Therefore, it may be more important to focus on whole foods and dietary patterns rather than individual nutrients to successfully impact on CVD risk reduction. A clearer understanding of the relationship between fruit and vegetable intake and cardiovascular risk would provide health professionals with significant information in terms of public health and clinical practice.

A human microRNA precursor binding to folic acid discovered by small RNA transcriptomic SELEX

RNA aptamers are structured motifs that bind to specific molecules. A growing number of RNAs bearing aptamer elements, whose functions are modulated by direct binding of metabolites, have been found in living cells. Recent studies have suggested that more small RNAs binding to metabolites likely exist and may be involved in diverse cellular processes. However, conventional methods are not necessarily suitable for the discovery of such RNA aptamer elements in small RNAs with lengths ranging from 50 to 200 nucleotides, due to the far more abundant tRNAs in this size range. Here, we describe a new in vitro selection method to uncover naturally occurring small RNAs capable of binding to a ligand of interest, referred to as small RNA transcriptomic SELEX (smaRt-SELEX). By means of this method, we identified a motif in human precursor microRNA 125a (hsa-pre-miR-125a) that interacts with folic acid. Mutation studies revealed that the terminal loop region of hsa-pre-miR-125a is important for this binding interaction. This method has potential for the discovery of new RNA aptamer elements or catalytic motifs in biological small RNA fractions.

Folates in Fruits and Vegetables: Contents, Processing, and Stability

Folates play a key role in human one-carbon metabolism and are provided by food. It is well established that folates are beneficial in the prevention of neural tube defects and cardiovascular and neurodegenerative diseases. Fruits and vegetables, and especially green vegetables, are the main sources of folates. In parallel, fruits and vegetables, with high contents of folates, are mostly consumed after processing, such as, canning, freezing, or home-cooking, which involve folate losses during their preparation. Hence, it is important to know the percentage of folate losses during processing and, moreover, the mechanisms underlying those losses. The current knowledge on folate losses from fruit and vegetables are presented in this review. They depend on the nature of the respective fruit or vegetable and the respective treatment. For example, steaming involves almost no folate losses in contrast to boiling. Two main mechanisms are involved in folate losses: (i) leaching into the surrounding liquid and (ii) oxidation during heat treatment, the latter of which depending on the nature of the vitamer considered. In this respect, a vitamer stability decreases in the order starting from folic acid followed by 5-HCO-H₄ folate, 5-CH₃ -H₄ folate, and, finally, H₄ folate. Further studies are required, especially on the diffusion of the vitamers in real foods and on the determination of folate degradation products.

Biomarker responses to folic acid intervention in healthy adults: a meta-analysis of randomized controlled trials

BACKGROUND

The task of revising dietary folate recommendations for optimal health is complicated by a lack of data quantifying the biomarker response that reliably reflects a given folate intake.

OBJECTIVE

We conducted a dose-response meta-analysis in healthy adults to quantify the typical response of recognized folate biomarkers to a change in folic acid intake.

DESIGN

Electronic and bibliographic searches identified 19 randomized controlled trials that supplemented with folic acid and measured folate biomarkers before and after the intervention in apparently healthy adults aged ≥18 y. For each biomarker response, the regression coefficient (β) for individual studies and the overall pooled β were calculated by using random-effects meta-analysis.

RESULTS

Folate biomarkers (serum/plasma and red blood cell folate) increased in response to folic acid in a dose-response manner only up to an intake of 400 μg/d. Calculation of the overall pooled β for studies in the range of 50 to 400 μg/d indicated that a doubling of folic acid intake resulted in an increase in serum/plasma folate by 63% (71% for microbiological assay; 61% for nonmicrobiological assay) and red blood cell folate by 31% (irrespective of whether microbiological or other assay was used). Studies that used the microbiological assay indicated lower heterogeneity compared with studies using nonmicrobiological assays for determining serum/plasma (I(2) = 13.5% compared with I(2) = 77.2%) and red blood cell (I(2) = 45.9% compared with I(2) = 70.2%) folate.

CONCLUSIONS

Studies administering >400 μg folic acid/d show no dose-response relation and thus will not yield meaningful results for consideration when generating dietary folate recommendations. The calculated folate biomarker response to a given folic acid intake may be more robust with the use of a microbiological assay rather than alternative methods for blood folate measurement.

Folate levels and polyglutamylation profiles of papaya (Carica papaya cv. Maradol) during fruit development and ripening

Folates are essential micronutrients for humans, and their deficiency causes several detrimental effects on human health. Papaya fruit is an important natural source of some micronutrients. This paper presents a first complete characterization of folate derivatives accumulated in cv. Maradol papaya during fruit development and ripening processes. During postharvest ripening, the fruit accumulated up to 24.5% of the daily folate recommended dietary allowance (RDA) for an adult in a 1 cup (145 g) portion. Tetrahydrofolate (THF) and 5-methyl-THF were the predominant folate classes observed. Surprisingly, an unusually long polyglutamylation profile of tentatively up to 17 glutamates linked to 5-methyl-THF was detected; to the authors' knowledge, this very long polyglutamyl tail has not been reported for any organism, and it is probably characteristic of this plant species. This polyglutamylation degree changed throughout fruit development and ripening, showing the largest differences at the onset of ripening. This work raises questions about the functional role of folate derivatives in fruit development.

Absorption of folic acid from a softgel capsule compared to a standard tablet

Consumption of 400 μg folic acid per day from fortified foods and/or supplements, plus food folate from a varied diet is recommended for women of childbearing potential to reduce the risk for neural tube defects during fetal development. This randomized crossover study was designed to evaluate the bioavailability of folic acid from a multivitamin softgel capsule vs a folic acid tablet in 16 premenopausal women (18 to 45 years of age). Participants were randomly assigned to receive a single dose of ∼1,000 μg folic acid in two tablets or ∼1,000 μg folic acid in a multivitamin softgel capsule, and then crossed over to receive the other study product ∼1 week later. Products were administered with a low-folate breakfast. Blood samples were collected predose (0 hour) and 1, 2, 3, 4, 6, and 8 hours post-dose for serum folate analysis. Repeated measures analysis of variance was used to compare responses between treatments. Data from the two sequence groups (n=8 per sequence) were pooled. Mean serum folate total and net incremental areas under the curve (AUC(0-8 hours)) were not significantly different between tablets and softgel capsule (AUC(0-8 hours) 214.9±11.2 hours×ng/mL [487±25.4 hours×nmol/L] and 191.6±13.3 hours×ng/mL [434.2±30.1 hours×nmol/L]; net incremental AUC(0-8 hours) 117.3±8.5 hours×ng/mL [265.8±19.3 hours×nmol/L] and 105.8±12.5 hours×ng/mL [239.7±28.3 hours×nmol/L], respectively), nor was maximum folate concentration (45.1±2.5 ng/mL [102.2±5.7 nmol/L] and 42.5±3.8 ng/mL [96.3±8.6 nmol/L], respectively). Time to peak folate concentration was significantly (P<0.001) delayed for the softgel capsule vs tablet (3.9±0.3 vs 1.7±0.2 hours, respectively). In conclusion, apparent bioavailability of folic acid was similar for the folic acid tablets and a multivitamin softgel capsule.

Supplementation with engineered Lactococcus lactis improves the folate status in deficient rats

OBJECTIVE

The aim of this study was to establish the bioavailability of different folates produced by engineered Lactococcus lactis strains using a rodent depletion-repletion bioassay.

METHODS

Rats were fed a folate-deficient diet, which produces a reversible subclinical folate deficiency, supplemented with different L. lactis cultures that were added as the only source of folate. Three bacterial strains that overexpressed the folC, folKE, or folC +KE genes were used. These strains produce folates with different poly glutamyl tail lengths. The growth response of the rats and the concentration of folates in different organs and blood samples were monitored.

RESULTS

The folate produced by the engineered strains was able to compensate the folate depletion in the diet and showed similar bioavailability compared with commercial folic acid that is normally used for food fortification. Folate concentrations in organ and blood samples increased significantly in animals that received the folate-producing strains compared with those that did not receive bacterial supplementation. Hematologic studies also showed that administration of the L. lactis strains was able to revert a partial megaloblastic anemia caused by folate deficiency. No significant differences were observed in the bioavailability of folates containing different glutamyl tail lengths.

CONCLUSION

To our knowledge, this is the first study that demonstrated that folates produced by engineered lactic acid bacteria represent a bioavailable source of this essential vitamin.

Raw and processed fruit and vegetable consumption and 10-year coronary heart disease incidence in a population-based cohort study in the Netherlands

Background

Prospective cohort studies have shown that high fruit and vegetable consumption is inversely associated with coronary heart disease (CHD). Whether food processing affects this association is unknown. Therefore, we quantified the association of fruit and vegetable consumption with 10-year CHD incidence in a population-based study in the Netherlands and the effect of processing on these associations.

Methods

Prospective population-based cohort study, including 20,069 men and women aged 20 to 65 years, enrolled between 1993 and 1997 and free of cardiovascular disease at baseline. Diet was assessed using a validated 178-item food frequency questionnaire. Hazard ratios (HR) were calculated for CHD incidence using multivariable Cox proportional hazards models.

Results

During a mean follow-up time of 10.5y, 245 incident cases of CHD were documented, which comprised 211 non-fatal acute myocardial infarctions and 34 fatal CHD events. The risk of CHD incidence was 34% lower for participants with a high intake of total fruit and vegetables (>475 g/d; HR: 0.66; 95% CI: 0.45–0.99) compared to participants with a low total fruit and vegetable consumption (≤241 g/d). Intake of raw fruit and vegetables (>262 g/d vs ≤92 g/d; HR: 0.70; 95% CI: 0.47–1.04) as well as processed fruit and vegetables (>234 g/d vs ≤113 g/d; HR: 0.79; 95% CI: 0.54–1.16) were inversely related with CHD incidence.

Conclusion

Higher consumption of fruit and vegetables, whether consumed raw or processed, may protect against CHD incidence.

Causes of Vitamin B12 and Folate Deficiency

This review describes current knowledge of the main causes of vitamin B12 and folate deficiency. The most common explanations for poor vitamin B12 status are a low dietary intake of the vitamin (i.e., a low intake of animal-source foods) and malabsorption. Although it has long been known that strict vegetarians (vegans) are at risk for vitamin B12 deficiency, evidence now indicates that low intakes of animal-source foods, such as occur in some lacto-ovo vegetarians and many less-industrialized countries, cause vitamin B12 depletion. Malabsorption of the vitamin is most commonly observed as food-bound cobalamin malabsorption due to gastric atrophy in the elderly, and probably as a result of Helicobacter pylori infection. There is growing evidence that gene polymorphisms in transcobalamins affect plasma vitamin B12 concentrations. The primary cause of folate deficiency is low intake of sources rich in the vitamin, such as legumes and green leafy vegetables, and the consumption of these foods may explain why folate status can be adequate in relatively poor populations. Other situations in which the risk of folate deficiency increases include lactation and alcoholism.

Folate biofortification in food plants

Folate deficiency is a global health problem affecting many people in the developing and developed world. Current interventions (industrial food fortification and supplementation by folic acid pills) are effective if they can be used but might not be possible in less developed countries. Recent advances demonstrate that folate biofortification of food crops is now a feasible complementary strategy to fight folate deficiency worldwide. The genes and enzymes of folate synthesis are sufficiently understood to enable metabolic engineering of the pathway, and results from pilot engineering studies in plants (and bacteria) are encouraging. Here, we review the current status of investigations in the field of folate enhancement on the eve of a new era in food fortification.

Validation of a food frequency questionnaire to assess folate intake of Dutch elderly people

Folate is required for 1-carbon metabolism and deficiency in folate leads to megaloblastic anemia. Low levels of folate have been associated with increased risk of vascular disease. To investigate whether RDA of folate are met, habitual folate intake needs to be assessed reliably. We developed a FFQ to specifically measure folate intake over the previous 3 months in elderly people in the Netherlands. Major sources of folate intake, i.e. foods contributing to at least 80 % of the average folate intake, were identified through an analysis of the second Dutch Food Consumption Survey for the sub-population of men and women aged 50–70. In 2000 and 2001, folate intake was estimated with this questionnaire in 1286 individuals aged 50–75 years. Concentrations of serum and erythrocyte folate served as biomarkers with which relative validity of the questionnaire was assessed. The same FFQ was repeated after 3 years in 803 subjects in order to assess long-term reproducibility. Mean folate intake was estimated to be 196 (sd 69) μg/d. Spearman correlation coefficients between folate intake and serum and erythrocyte concentrations were 0·14 (P < 0·01) and 0·05 (P = 0·06) respectively. Spearman correlations between folate intakes measured at baseline and after 3 years were 0·58 (P < 0·01). 47 % of the participants were classified in the same quartiles on the two occasions. Our FFQ showed a weak correlation between folate intake and blood folate concentrations and reproducibility was acceptable. This FFQ is able to rank subjects according to their folate intake.

Folate fortification of rice by metabolic engineering

Rice, the world's major staple crop, is a poor source of essential micronutrients, including folates (vitamin B9). We report folate biofortification of rice seeds achieved by overexpressing two Arabidopsis thaliana genes of the pterin and para-aminobenzoate branches of the folate biosynthetic pathway from a single locus. We obtained a maximal enhancement as high as 100 times above wild type, with 100 g of polished raw grains containing up to four times the adult daily folate requirement.

Aleurone flour increases red-cell folate and lowers plasma homocyst(e)ine substantially in man

Aleurone flour (ALF) is a rich source of natural folate (>500 μg/100 g wet weight). Our objective was to establish whether intake of ALF in man can significantly improve folate status and reduce plasma homocyst(e)ine. We performed a randomised, controlled intervention, of 16 weeks duration, in free-living healthy individuals (mean age 46–52 years). Participants were assigned to one of three groups: ALF, 175 g bread made with ALF and placebo tablet each day; PCS, 175 g bread made with pericarp seed coat (PCS) flour and placebo tablet each day (low-folate control); or FA, 175 g bread made with PCS flour and tablet containing 640 μg folic acid each day (high-folate control). The daily folate intake contributed by the bread and tablet was 233 μg in the PCS group, 615 μg in the ALF group and 819 μg in the FA group. The number of participants completing all phases of the PCS, ALF and FA interventions was twenty-five, twenty-five and eighteen, respectively. Plasma and red-cell folate increased significantly (P<0·0001) and plasma homocyst(e)ine decreased significantly (P<0·0001) in the ALF and FA groups only. Plasma folate and red-cell folate in the ALF group (mean, 95 % CI) increased from baseline values of 12·9 (9·9, 15·7) nmol/l and 509 (434, 584) nmol/l to 27·1 (22·5, 31·7) nmol/l and 768 (676, 860) nmol/l, respectively. Plasma homocyst(e)ine in the ALF group decreased from 9·1 (8·2, 10·0) μmol/l at baseline to 6·8 (6·2, 7·5) μmol/l after 16 weeks. In conclusion, moderate dietary intake of ALF can increase red-cell folate and decrease plasma homocyst(e)ine substantially.

Predicted serum folate concentrations based on in vitro studies and kinetic modeling are consistent with measured folate concentrations in humans

The nutritional quality of new functional or fortified food products depends on the bioavailability of the nutrient(s) in the human body. Bioavailability is often determined in human intervention studies by measurements of plasma or serum profiles over a certain time period. These studies are time and cost consuming and often appear to lack an optimal study design, leading to follow-up intervention trials. Therefore, an alternative approach is needed that will optimize the development of new products. This study describes an approach to predict human serum concentrations after the consumption of (fortified) food products. The concept is based on the integration of in vitro results with kinetic modeling. As a case study, human serum folate concentrations were predicted after the consumption of folate-fortified milk products for 4 wk. Oral bioavailability was investigated using a step-wise approach in which luminal bioaccessibility and intestinal absorption were independently evaluated. Subsequently, these in vitro data were integrated in a kinetic mathematical (in silico) model to predict serum folate concentrations after the intake of a single dose and during long-term consumption. This approach was evaluated in comparison to a human intervention study in which folic acid-fortified milk products were tested for their effect on serum folate concentrations. A high predictive quality of this alternative in vitro/in silico approach was demonstrated. Finally, this methodology was applied to predict serum folate concentrations after intake of different fortified milk products for 4 wk, showing its benefits for the development of new nutritional products.

A dual-isotope-labeling method of studying the bioavailability of hexaglutamyl folic acid relative to that of monoglutamyl folic acid in humans by using multiple orally administered low doses

BACKGROUND

The bioavailability of dietary folate may be hampered by the need of the glutamate moieties to be deconjugated before absorption. Previous studies comparing the bioavailabilities of polyglutamyl and monoglutamyl folic acid had inconsistent results.

OBJECTIVE

The objective was to estimate the bioavailability of polyglutamyl relative to that of monoglutamyl folic acid by using a sensitive stable-isotope approach that allowed for the administration of multiple low doses in humans.

DESIGN

Twenty subjects aged 20-50 y ingested 2 capsules daily for 28 d; each capsule contained approximately 50 nmol [(13)C(6)]hexaglutamyl and approximately 50 nmol [(13)C(11)]monoglutamyl folic acid. Amounts of the isotopically labeled compounds in the capsules were verified by various methods. The degrees of isotopic enrichment of plasma 5-methyltetrahydrofolate with (13)C(6) and (13)C(11) were measured by using liquid chromatography tandem mass spectrometry, and the ratio of (13)C(6) to (13)C(11) ((13)C(6):(13)C(11)) in plasma on day 28 was used as a measure of their relative bioavailability.

RESULTS

The (13)C(11):(13)C(6) in plasma 5-methyltetrahydrofolate reached equilibrium on day 4 and was 0.66 (95% CI: 0.58, 0.74) on day 28. The (13)C(11):(13)C(6) content in the capsules varied between 1.18 and 1.96. After correction for this ratio, the estimated bioavailability of hexaglutamyl relative to that of monoglutamyl folic acid was >/=78%.

CONCLUSION

Multiple dosing of low amounts of labeled folic acid is a sensitive, accurate, and efficient method of measuring the relative bioavailability of folic acid compounds, provided that the administered doses can be reliably assessed.

The rate of intestinal absorption of natural food folates is not related to the extent of folate conjugation

BACKGROUND

Evidence is conflicting as to whether the bioavailability of food folates is influenced by the extent of their conjugation.

OBJECTIVE

The objective was to compare the bioavailability of 3 representative food folate sources with various degrees of glutamylation-ie, egg yolk, spinach, and yeast, whose polyglutamyl folate content measured 0%, 50%, and 100%, respectively.

DESIGN

In a randomized crossover trial, 13 male subjects, after a prestudy folate saturation procedure, received in random order either placebo or 500 mug total folate, which was provided as concentrated freeze-dried extract removed from the normal food matrix of egg yolk, spinach, or yeast. Blood samples (n = 10) were collected before and up to 10 h after treatments, which were administered at weekly intervals.

RESULTS

A significant increase from baseline plasma folate concentrations was observed by 0.5 h after treatment with egg yolk folate or spinach folate and by 1 h after treatment with yeast folate, and the concentrations remained significantly elevated for 3-5 h; no plasma folate response was observed after placebo treatment. The overall responses, calculated as plasma folate area under the curve (AUC) for egg yolk, spinach, and yeast folate, were 122.6 +/- 23.6, 136.2 +/- 21.4, and 102.5 +/- 21.1 nmol . h/L, respectively. No significant differences in AUC were seen between monoglutamyl (egg yolk) folate and either of the polyglutamate-containing folates examined.

CONCLUSION

These results suggest that the ratio of monoglutamate to polyglutamate in natural folates is not a factor that limits the extent of intestinal absorption of food folate.

Nutridynamics--studying the dynamics of food components in products and in the consumer

The concentrations and biological effects of nutrients, antinutrients and bioactive compounds, including microbes and their constituents, are affected by production and processing steps, the food matrix in which they reside, the way they are digested and metabolized in the human body, and whether or not and in what form they subsequently reach their target site. A new scientific concept, denoted here as 'nutridynamics', aims to unravel the dynamics of these processes by using a systematic approach to study how a food component is affected by the food matrix itself and what it does in the body. This holistic concept has potential synergy with the areas of food technology and nutrigenomics, and provides a link between food production and the mechanistic effects of bioactive ingredients.

Folate bioavailability

The achievement of optimal folate status to prevent neural-tube defects, and possibly other diseases, is hindered by the well-recognised incomplete bioavailability of the natural folates found in foods compared with the synthetic vitamin, folic acid. Folate bioavailability from different foods is considered to be dependent on a number of factors, including the food matrix, the intestinal deconjugation of polyglutamyl folates, the instability of certain labile folates during digestion and the presence of certain dietary constituents that may enhance folate stability during digestion. There is conflicting evidence as to whether the extent of conjugation of polyglutamyl folate (in the absence of specific inhibitors of deconjugation in certain foods) is a limiting factor in folate bioavailability. Estimates of the extent of lower bioavailability of food folates compared with folic acid (relative bioavailability) show great variation, ranging anywhere between 10 and 98%, depending on the methodological approach used. The lack of accurate data on folate bioavailability from natural food sources is of particular concern in those countries in which there is no mandatory folic acid fortification, and therefore a greater reliance on natural food folates as a means to optimise status. Apart from the incomplete bioavailability of food folates, the poor stability of folates in foods (particularly green vegetables) under typical conditions of cooking can substantially reduce the amount of vitamin ingested and thereby be an additional factor limiting the ability of food folates to enhance folate status. A recent workshop convened by the Food Standards Agency concluded that gaining a better understanding of folate bioavailability in representative human diets is a high priority for future research.

A long-term controlled folate feeding study in young women supports the validity of the 1.7 multiplier in the dietary folate equivalency equation

The presence of folic acid in enriched cereal grain products and the higher bioavailability of folic acid than food folate led to the expression of the 1998 folate RDA, 400 microg/d, as dietary folate equivalents (DFE). DFE are defined as: mug natural food folate + 1.7 x microg synthetic folic acid. The 1.7 multiplier was based on assumptions that added folic acid was 85% available and food folate was 50% available. The 85/50 ratio also inferred that the bioavailability of food folate was approximately 60% relative to added folic acid. The objective of this long-term controlled feeding study was to assess the dietary folate equivalency of folic acid. After a 2-wk period of folate restriction, women (n = 42, 18-45 y old) consumed either 400 or 800 microg DFE/d derived from various combinations of food folate and folic acid for 12 wk. Folic acid was converted to DFE using the 1.7 multiplier from the DFE calculation and was consumed with a meal throughout the treatment period. Folate status response to the various treatments was assessed during wk 12-14. Serum folate, RBC folate, and plasma total homocysteine did not differ among the 400 microg DFE/d groups or among the 800 microg DFE/d groups. In contrast, consumption of 800 microg DFE/d led to higher (P </= 0.05) serum and RBC folate than consumption of 400 microg DFE/d. These data support the validity of the 1.7 multiplier in the DFE equation and suggest that food folate bioavailability is approximately 60% that of added folic acid when consumed as part of a mixed diet.

Plasma concentration of folate as a biomarker for the intake of fruit and vegetables: the Hordaland Homocysteine Study

BACKGROUND

Nutritional biomarkers may be used to assess dietary exposure without the errors commonly associated with self-reported dietary data.

OBJECTIVE

The objective was to examine the association between plasma folate and intake of folate, fruit, and vegetables in a large cohort of healthy adults consuming foods that had not been fortified with folic acid.

DESIGN

The present study population included 5533 middle-aged (47-49 y) and old (71-74 y) subjects from the Hordaland Homocysteine Study. The participants completed a food-frequency questionnaire and provided blood samples for chemical analyses.

RESULTS

We observed a significant difference in plasma concentrations of folate across increasing quartiles of fruit, vegetable, and orange juice consumption. The difference in plasma folate between the highest and lowest quartiles was 1.97 (95% CI: 1.86, 2.07) nmol/L for fruit intake, 1.79 (95% CI: 1.69, 1.89) nmol/L for vegetable intake, and 2.69 (95% CI: 2.51, 2.87) nmol/L for orange juice intake. A significant inverse relation was observed across increasing quartiles of milk and bread intakes. The difference between the highest and lowest quartiles was -1.03 (95% CI: -1.13, -0.92) nmol/L for milk and -1.60 (95% CI: -1.69, -1.50) nmol/L for bread.

CONCLUSION

Plasma folate concentration may be a useful biomarker for the intake of fruit and vegetables in populations consuming unfortified food products. The association can be attenuated by and should be corrected for individual intake of folic acid supplements.

Quantifying folate bioavailability: a critical appraisal of methods

PURPOSE OF REVIEW

Dietary reference intakes for folate rely on a good estimate of folate bioavailability from the general diet. In this review, current methods for quantifying the bioavailability of dietary folate and specific folate vitamers in humans are reviewed. Emphasis is on isotopic labeling techniques that have been developed during the past 15 years.

RECENT FINDINGS

Most reported studies applied single-dose designs, in which blood or urine concentrations of folate are measured for several hours after oral folate administration. To obtain a measurable biochemical response, however, relatively high doses of folic acid are administered and individuals are often saturated with large doses of folic acid prior to study. The effect of this on folate absorption and metabolism is poorly understood. Therefore, study designs in which multiple oral doses are administered are preferred. Several such studies, both with unlabeled and isotopically labeled folic acid, are discussed. Although many studies have been performed on the bioavailability of specific folate compounds and of folate from single foods, reliable data in which the bioavailability of folate from total diets have been measured are currently lacking.

SUMMARY

A multiple oral dose design is the best approach for measuring folate bioavailability because there are several serious drawbacks to designs based on the use of a single oral dose. Studies on folate bioavailability from total diets are urgently required in order to evaluate current recommendations for folate intake.

Bioavailability of polyglutamyl folic acid relative to that of monoglutamyl folic acid in subjects with different genotypes of the glutamate carboxypeptidase II gene

BACKGROUND

Before dietary folate is absorbed, polyglutamate folates are deconjugated to monoglutamates by folylpoly-gamma-glutamyl carboxypeptidase in the small intestine. The 1561T allele of the glutamate carboxypeptidase II gene (GCPII), which codes for folylpoly-gamma-glutamyl carboxypeptidase, may impair intestinal absorption of dietary folates.

OBJECTIVE

Our aim was to study the bioavailability of polyglutamyl folic acid relative to that of monoglutamyl folic acid across GCPII 1561 genotypes.

DESIGN

In a randomized study, 180 healthy adults aged 50-75 y received 323 nmol monoglutamyl folic acid/d (n = 59), 262 nmol heptaglutamyl folic acid/d (n = 61), or placebo (n = 60) for 12 wk. Genotypes were assessed after the intervention. The bioavailability of heptaglutamyl folic acid relative to that of monoglutamyl folic acid was calculated by using the changes in serum folate concentration in the treatment groups, after correction for changes in the placebo group and for the administered dose.

RESULTS

No subjects with the TT genotype were encountered. At baseline, serum and erythrocyte folate concentrations were higher (P < 0.05) in subjects with the CT genotype [16.3 nmol/L (geometric x; 95% CI: 13.7, 19.3 nmol/L) and 863 nmol/L (735, 1012 nmol/L), respectively; n = 19] than in subjects with the CC genotype [13.7 (13.1, 14.3) and 685 (652, 721) nmol/L, respectively; n = 161]. Baseline homocysteine concentrations were not significantly different between genotypes. The bioavailability of heptaglutamyl folic acid relative to that of monoglutamyl folic acid was not significantly different between subjects with the CC (64%; 52%, 76%) and CT genotypes (70%; 49%, 91%).

CONCLUSIONS

The 1561T allele of the GCPII gene does not impair the bioavailability of polyglutamyl folic acid. However, the allele is associated with higher folate status. This association may be explained by yet unidentified factors controlling the expression of the GCPII gene.