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1.
Nutrients ; 13(11)2021 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-34836112

RESUMEN

Folate deficiency is associated with various health issues, including anemia, cardiovascular disease, and birth defects. Low folate intake and suboptimal folate status were found in several countries; however, this topic has not yet been investigated in Slovenia. Dietary folate intake and serum folate status were investigated through the nationally representative food consumption study SI.Menu/Nutrihealth. Folate intake was estimated using a sample of N = 1248 subjects aged 10-74 years, stratified in three age groups (adolescents, adults, elderly population), through two 24 h-dietary recalls and food propensity questionnaire. Data on serum folate and homocysteine was available for 280 participants. Very low folate intake (<300 µg/day) was observed in 59% of adolescents, 58% of adults and 68% of elderlies, and only about 12% achieved the WHO recommended level of 400 µg/day. Major dietary contributors were vegetables and fruit, and cereal products. Living environment, education, employment status and BMI were linked with low folate intake in adults; BMI, and sex in adolescents; and sex in elderlies. Considering low serum folate (<7 nmol/L) and high serum homocysteine (>15 nmol/L), folate deficiency was found in 7.6 and 10.5% in adults and elderlies, respectively. Additional public health strategies should be employed to promote the consumption of folate-rich foods. With current folate intakes, supplementation with folic acid is relevant especially in specific vulnerable populations, particularly in women planning and during pregnancy.


Asunto(s)
Dieta/estadística & datos numéricos , Deficiencia de Ácido Fólico/epidemiología , Ácido Fólico/sangre , Homocisteína/sangre , Adolescente , Adulto , Anciano , Biomarcadores/sangre , Niño , Dieta/efectos adversos , Ingestión de Alimentos , Femenino , Deficiencia de Ácido Fólico/etiología , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/etiología , Prevalencia , Puntaje de Propensión , Eslovenia/epidemiología , Adulto Joven
2.
Br J Nutr ; 123(3): 264-272, 2020 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-31656209

RESUMEN

The present study aimed at analysing how dietary folic acid (FA) and Fe deficiency, followed by supplementation with these nutrients, affects the expression of folate and Fe transporters in the duodenum, as well as FA and Fe status. After a deficiency period, Wistar rats were randomised to a group fed with a diet deficient in FA and supplemented with Fe (DFE), a diet deficient in Fe and supplemented with FA, a diet supplemented with Fe and FA (FEFOL), a diet deficient in Fe and FA (D) or a control diet (C). Tissue collection was performed after 2, 10 or 21 d of these diets. Group D had higher Slc11a2 mRNA levels than the DFE group at every time point and there were differences in mRNA levels of Slc46a1 between the DFE and the FEFOL groups at the third time point, but we observed no differences in protein levels between the groups. The DFE and D groups not only had lower serum folate concentrations at every time point but also had the highest homocysteine concentrations. Total Fe binding capacity concentrations were the lowest in the DFE group at the first time point and in the DFE and the FEFOL groups at the final time point. Simultaneous supplementation with FA and Fe resulted in significantly higher Hb concentrations than did supplementation with these nutrients alone. Our findings indicate that dietary FA and Fe deficiency, and subsequent supplementation with these nutrients, affects transcription but not the protein levels of FA and Fe transporters in the duodenum.


Asunto(s)
Anemia Ferropénica/genética , Suplementos Dietéticos , Deficiencia de Ácido Fólico/genética , Ácido Fólico/administración & dosificación , Hierro/administración & dosificación , Anemia Ferropénica/sangre , Anemia Ferropénica/etiología , Animales , Proteínas de Transporte de Catión/metabolismo , Dieta/efectos adversos , Duodeno/metabolismo , Ácido Fólico/sangre , Deficiencia de Ácido Fólico/sangre , Deficiencia de Ácido Fólico/etiología , Hierro/sangre , Estado Nutricional , Transportador de Folato Acoplado a Protón/metabolismo , Ratas , Ratas Wistar , Transcripción Genética/efectos de los fármacos
3.
Arch Toxicol ; 93(2): 227-251, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30499019

RESUMEN

Folate is vital for cell development and growth. It is involved in one-carbon transfer reactions essential for the synthesis of purines and pyrimidines. It also acts in conjunction with cobalamin (vitamin B12) as a fundamental cofactor in the remethylation cycle that converts homocysteine to methionine. A deficiency in folate or vitamin B12 can lead to elevated homocysteine level, which has been identified as an independent risk factor in several health-related conditions. Adequate folate levels are essential in women of childbearing age and in pregnant women, and folate deficiency is associated with several congenital malformations. Low folate levels can be caused by dietary deficiencies, a genetic predisposition or treatment with medicines that affect folate concentration. Women who are pregnant or of child-bearing age commonly use medicines, so it is important to identify the basic biochemical mechanisms by which medicines interfere with the folate-homocysteine-methionine pathway. This review focuses on prescription medicines associated with folate disruption. It also summarizes their undesirable/toxic effects. Recommendations regarding folate supplementation during medical therapy are also reviewed.


Asunto(s)
Inhibidores Enzimáticos/efectos adversos , Antagonistas del Ácido Fólico/efectos adversos , Deficiencia de Ácido Fólico/etiología , Ácido Fólico/metabolismo , Homocisteína/metabolismo , Metionina/metabolismo , Inhibidores Enzimáticos/uso terapéutico , Femenino , Ácido Fólico/farmacología , Deficiencia de Ácido Fólico/complicaciones , Humanos , Embarazo , Tetrahidrofolato Deshidrogenasa/metabolismo , Timidilato Sintasa/antagonistas & inhibidores , Deficiencia de Vitamina B 12/etiología
4.
Scand J Gastroenterol ; 53(8): 917-922, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30231804

RESUMEN

OBJECTIVES: Patients are at risk of anemia post Roux-en-Y gastric bypass (RYGB). We sought to determine the prevalence of anemia and related nutritional deficiencies 5 years after RYGB and to evaluate adherence to nutritional supplements with iron, vitamin B12, and folate. MATERIAL AND METHODS: Patients operated with RYGB 2004-2006 were eligible for evaluation. Blood samples were collected and use of nutritional supplements was recorded preoperatively, and at outpatients' consultations 1, 2, and 5 years postoperatively. Of 203 patients operated, 184 (91%) completed the 5 year follow-up and were included in the study. Of these, 97% had valid measurements of hemoglobin both at baseline and after 5 years. RESULTS: During the 5 years after RYGB, the prevalence of anemia increased from 4% preoperatively to 24% in females, and from 0% to 7% in males. Ferritin levels decreased gradually in both genders. Iron deficiency increased from 6% preoperatively to 42% at 5 years in females, and from 0% to 9% in males. Vitamin B12 deficiency was not altered while folate deficiency decreased from 10% preoperatively to 1% at 5 years. Five years after surgery 25% reported the use of supplements with iron, while 83% used vitamin B12 and 65% used multivitamins with folate. CONCLUSIONS: We observed a long-term increase in anemia and iron deficiency after RYGB in both genders, but most pronounced in women. Our postoperative protocol for prevention of vitamin B12 and folate deficiencies appear acceptable. Iron status and iron supplementation seems to need stronger emphasis during follow-up after RYGB.


Asunto(s)
Anemia Ferropénica/epidemiología , Deficiencia de Ácido Fólico/epidemiología , Derivación Gástrica/efectos adversos , Obesidad Mórbida/cirugía , Deficiencia de Vitamina B 12/epidemiología , Adulto , Anemia Ferropénica/etiología , Anemia Ferropénica/prevención & control , Suplementos Dietéticos , Femenino , Ácido Fólico/sangre , Deficiencia de Ácido Fólico/etiología , Deficiencia de Ácido Fólico/prevención & control , Estudios de Seguimiento , Humanos , Hierro/sangre , Modelos Lineales , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Noruega/epidemiología , Periodo Posoperatorio , Distribución por Sexo , Vitamina B 12/sangre , Deficiencia de Vitamina B 12/etiología , Deficiencia de Vitamina B 12/prevención & control
5.
Nutrients ; 9(4)2017 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-28406440

RESUMEN

BACKGROUND: Inflammatory bowel disease (IBD) patients may be at risk of vitamin B12 and folate insufficiencies, as these micronutrients are absorbed in the small intestine, which is affected by IBD. However, a consensus has not been reached on the association between IBD and serum folate and vitamin B12 concentrations. METHODS: In this study, a comprehensive search of multiple databases was performed to identify studies focused on the association between IBD and serum folate and vitamin B12 concentrations. Studies that compared serum folate and vitamin B12 concentrations between IBD and control patients were selected for inclusion in the meta-analysis. RESULTS: The main outcome was the mean difference in serum folate and vitamin B12 concentrations between IBD and control patients. Our findings indicated that the average serum folate concentration in IBD patients was significantly lower than that in control patients, whereas the mean serum vitamin B12 concentration did not differ between IBD patients and controls. In addition, the average serum folate concentration in patients with ulcerative colitis (UC) but not Crohn's disease (CD) was significantly lower than that in controls. This meta-analysis identified a significant relationship between low serum folate concentration and IBD. CONCLUSIONS: Our findings suggest IBD may be linked with folate deficiency, although the results do not indicate causation. Thus, providing supplements of folate and vitamin B12 to IBD patients may improve their nutritional status and prevent other diseases.


Asunto(s)
Deficiencia de Ácido Fólico/etiología , Ácido Fólico/sangre , Enfermedades Inflamatorias del Intestino/fisiopatología , Estado Nutricional , Deficiencia de Vitamina B 12/etiología , Vitamina B 12/sangre , Colitis Ulcerosa/sangre , Colitis Ulcerosa/inmunología , Colitis Ulcerosa/metabolismo , Colitis Ulcerosa/fisiopatología , Enfermedad de Crohn/sangre , Enfermedad de Crohn/inmunología , Enfermedad de Crohn/metabolismo , Enfermedad de Crohn/fisiopatología , Suplementos Dietéticos , Ácido Fólico/metabolismo , Ácido Fólico/uso terapéutico , Deficiencia de Ácido Fólico/dietoterapia , Deficiencia de Ácido Fólico/prevención & control , Humanos , Enfermedades Inflamatorias del Intestino/sangre , Enfermedades Inflamatorias del Intestino/inmunología , Enfermedades Inflamatorias del Intestino/metabolismo , Absorción Intestinal , Mucosa Intestinal/inmunología , Mucosa Intestinal/metabolismo , Vitamina B 12/metabolismo , Vitamina B 12/uso terapéutico , Deficiencia de Vitamina B 12/dietoterapia , Deficiencia de Vitamina B 12/prevención & control
6.
Br J Nutr ; 115(12): 2227-35, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27121118

RESUMEN

The International Clearinghouse for Birth Defects, Surveillance and Research reports a rise in the prevalence rate of spina bifida in Japan. We determined first-trimester folate status of Hokkaido women and identified potential predictors. Participants were 15 266 pregnant women of the Hokkaido Study on Environment and Children's Health Cohort. Data were extracted from self-reported questionnaires and biochemical assay results. Demographic determinants of low folate status were younger maternal age (adjusted OR (AOR) 1·48; 95 % CI 1·32, 1·66), lower educational level (AOR 1·27; 95 % CI 1·17, 1·39) and lower annual income (AOR 1·11; 95 % CI 1·01, 1·22). Plasma cotinine concentrations of 1·19-65·21 nmol/l increased the risk of low folate status (AOR 1·20; 95 % CI 1·10, 1·31) and concentrations >65·21 nmol/l further increased the risk (AOR 1·91; 95 % CI 1·70, 2·14). The most favourable predictor was use of folic acid (FA) supplements (AOR 0·19; 95 % CI 0·17, 0·22). Certain socio-demographic factors influence folate status among pregnant Japanese women. Modifiable negative and positive predictors were active and passive tobacco smoking and use of FA supplements. Avoiding both active and passive tobacco smoking and using FA supplements could improve the folate status of Japanese women.


Asunto(s)
Deficiencia de Ácido Fólico/etiología , Ácido Fólico/sangre , Estado Nutricional , Complicaciones del Embarazo/etiología , Disrafia Espinal/sangre , Complejo Vitamínico B/sangre , Adolescente , Adulto , Cotinina/sangre , Suplementos Dietéticos , Femenino , Ácido Fólico/uso terapéutico , Deficiencia de Ácido Fólico/sangre , Deficiencia de Ácido Fólico/prevención & control , Humanos , Japón , Embarazo , Complicaciones del Embarazo/sangre , Primer Trimestre del Embarazo , Atención Prenatal , Factores de Riesgo , Autoinforme , Fumar/efectos adversos , Factores Socioeconómicos , Disrafia Espinal/etiología , Encuestas y Cuestionarios , Contaminación por Humo de Tabaco/efectos adversos , Complejo Vitamínico B/uso terapéutico , Adulto Joven
7.
Am J Clin Nutr ; 102(5): 1134-41, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26423386

RESUMEN

BACKGROUND: Observational data have suggested that intakes of nutrients involved in one-carbon metabolism are inversely associated with risk of colorectal carcinoma and adenomas. In contrast, results from some preclinical studies and cardiovascular and chemoprevention trials have raised concerns that high folate intake may promote carcinogenesis by facilitating the progression of established neoplasia. OBJECTIVE: We tested the hypothesis that higher total folate intake (including food folate and folic acid from fortified foods and supplements) or other one-carbon nutrient intakes might be associated with poorer survival after a diagnosis of colorectal cancer. DESIGN: We used rectal and colon cancer cases within the following 2 US prospective cohort studies: the Nurses' Health Study and the Health Professionals Follow-Up Study. Biennial questionnaires were used to gather information on medical history and lifestyle factors, including smoking and alcohol consumption. B-vitamin and methionine intakes were derived from food-frequency questionnaires. Data on tumor molecular characteristics (including microsatellite instability, CpG island methylator phenotype, KRAS, BRAF, and PIK3CA mutations, and long interspersed nucleotide element 1 methylation level) were available for a subset of cases. We assessed colorectal cancer-specific mortality according to postdiagnostic intakes of one-carbon nutrients with the use of multivariable Cox proportional hazards regression models. RESULTS: In 1550 stage I-III colorectal cancer cases with a median follow-up of 14.9 y, we documented 641 deaths including 176 colorectal cancer-specific deaths. No statistically significant associations were observed between postdiagnostic intakes of folate or other one-carbon nutrients and colorectal cancer-specific mortality (multivariate P-trend ≥ 0.21). In an exploratory molecular pathologic epidemiology survival analysis, there was no significant interaction between one-carbon nutrients or alcohol and any of the tumor molecular biomarkers examined. CONCLUSIONS: Higher postdiagnostic intakes of one-carbon nutrients are not associated with the prognosis in stage I-III colorectal cancer. Our findings do not support the hypothesis that higher folate intake after colorectal cancer diagnosis might increase risk of cancer-related death.


Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Neoplasias Colorrectales/diagnóstico , Dieta/efectos adversos , Deficiencia de Ácido Fólico/prevención & control , Ácido Fólico/administración & dosificación , Adulto , Consumo de Bebidas Alcohólicas/metabolismo , Estudios de Cohortes , Colon/metabolismo , Colon/patología , Neoplasias Colorrectales/metabolismo , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/patología , Bases de Datos Factuales , Suplementos Dietéticos/efectos adversos , Femenino , Ácido Fólico/efectos adversos , Ácido Fólico/metabolismo , Ácido Fólico/uso terapéutico , Deficiencia de Ácido Fólico/etiología , Deficiencia de Ácido Fólico/metabolismo , Estudios de Seguimiento , Alimentos Fortificados/efectos adversos , Humanos , Masculino , Estadificación de Neoplasias , Pronóstico , Estudios Prospectivos , Recto/metabolismo , Recto/patología , Encuestas y Cuestionarios , Análisis de Supervivencia , Estados Unidos/epidemiología
8.
J Nutr ; 145(10): 2207-11, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26269242

RESUMEN

BACKGROUND: Dihydrofolate reductase (DHFR) is essential for the conversion of folic acid to active folate needed for one-carbon metabolism. Common genetic variation within DHFR is restricted to the noncoding regions, and previous studies have focused on a 19 bp deletion/insertion polymorphism (rs70991108) within intron 1. Reports of an association between this polymorphism and blood folate biomarker concentrations are conflicting. OBJECTIVE: In this study, we evaluated whether the DHFR 19 bp deletion/insertion polymorphism affects circulating folate biomarkers in, to our knowledge, the largest cohort to address this question to date. METHODS: Healthy young Irish individuals (n = 2507) between 19 and 36 y of age were recruited between February 2003 and February 2004. Folic acid intake from supplements and fortified foods was assessed with the use of a customized food intake questionnaire. Concentrations of serum folate and vitamin B-12, red blood cell (RBC) folate, and plasma total homocysteine (tHcy) were measured. Data were analyzed with the use of linear regression models. RESULTS: Folic acid intake was positively associated with serum (P < 0.0001) and RBC (P = 0.0005) folate concentration and was inversely associated with plasma tHcy (P = 0.001) as expected. The DHFR 19 bp polymorphism was not significantly associated with either serum (P = 0.82) or RBC (P = 0.21) folate, or plasma tHcy (P = 0.20), even in those within the highest quintile of folic acid intake (>326 µg folic acid/d; P = 0.96). A nonsignificant trend toward lower RBC folate by genotype (P = 0.09) was observed in the lowest folic acid intake quintile (0-51 µg/d). CONCLUSION: In this cohort of healthy young individuals, the DHFR 19 bp deletion allele did not significantly affect circulating folate status, irrespective of folic acid intake. Our data rule out a strong functional effect from this polymorphism on blood folate concentrations.


Asunto(s)
Suplementos Dietéticos , Deficiencia de Ácido Fólico/genética , Ácido Fólico/administración & dosificación , Alimentos Fortificados , Estado Nutricional , Polimorfismo Genético , Tetrahidrofolato Deshidrogenasa/genética , Adulto , Biomarcadores/sangre , Estudios de Cohortes , Dieta/efectos adversos , Femenino , Ácido Fólico/sangre , Ácido Fólico/uso terapéutico , Deficiencia de Ácido Fólico/etiología , Deficiencia de Ácido Fólico/metabolismo , Deficiencia de Ácido Fólico/prevención & control , Estudios de Asociación Genética , Homocisteína/sangre , Humanos , Intrones , Irlanda , Masculino , Tetrahidrofolato Deshidrogenasa/metabolismo , Vitamina B 12/sangre , Adulto Joven
9.
Obes Surg ; 25(12): 2344-51, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25948283

RESUMEN

BACKGROUND: We evaluated dietary intakes, body composition, micronutrient deficiency, and response to micronutrient supplementation in 47 patients before and for 6 months after laparoscopic sleeve gastrectomy (LSG). METHODS: Before, 3, and 6 months after LSG, we measured dietary intakes with food-frequency questionnaires, body composition with bioimpedance analysis (BIA) and bioelectrical vector analysis (BIVA), and plasma concentrations of iron, Zn, water-, and lipo-soluble vitamins. RESULTS: After LSG, energy intake significantly decreased and patients lost weight, fat mass, and free-fat mass. BIVA showed a substantial loss of soft tissue body cell mass (BCM) with no change in hydration. Before surgery, 15 % of patients were iron deficient, 30 % had low levels of zinc and/or water-soluble vitamins, and 32 % of vitamin 25(OH)-D3. We treated iron deficiency with ferrous sulfate, isolated folate deficiency with N5-methyiltetrahydrofolate-Ca-pentahydrate, and deficiencies in vitamin B1, B12, or Zn, with or without concomitant folate deficiency, with multivitamin. No supplementation was given to vitamin 25(OH)-D3 deficient patients. At first follow-up, 7 % of patients developed new deficiencies in iron, 7 % in folic acid (n = 3), and 36 % in water-soluble vitamins and/or zinc whereas no new deficit in vitamin 25(OH)-D3 occurred. At final follow-up, deficiencies were corrected in all patients treated with either iron or folate but only in 32 % of those receiving multivitamin. Vitamin 25(OH)-D3 deficiency was corrected in 73 % of patients even though these patients were not supplemented. CONCLUSION: LSG-induced weight loss is accompanied by a decrease in BCM with no body fluid alterations. Deficiencies in water-soluble vitamins and Zn respond poorly to multivitamin supplementation.


Asunto(s)
Composición Corporal/fisiología , Suplementos Dietéticos , Micronutrientes/administración & dosificación , Obesidad Mórbida/dietoterapia , Obesidad Mórbida/cirugía , Adulto , Avitaminosis/epidemiología , Avitaminosis/etiología , Avitaminosis/prevención & control , Femenino , Ácido Fólico/sangre , Deficiencia de Ácido Fólico/etiología , Gastrectomía/efectos adversos , Humanos , Laparoscopía/efectos adversos , Masculino , Micronutrientes/farmacología , Persona de Mediana Edad , Terapia Nutricional , Obesidad Mórbida/epidemiología , Obesidad Mórbida/metabolismo , Complicaciones Posoperatorias/prevención & control , Periodo Posoperatorio , Estudios Retrospectivos , Oligoelementos/sangre , Vitaminas/sangre , Adulto Joven
10.
Surg Obes Relat Dis ; 10(5): 829-33, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25282192

RESUMEN

BACKGROUND: Roux-en-Y gastric bypass (RYGB) is considered the gold standard for the treatment of morbid obesity. There is no consensus over ideal limb length when the bypass is created and published studies do not take into account the influence of the common limb (CL) on weight loss. The objective was to study the influence of the common limb after RYGB. The setting was the Virgen de la Arrixaca University Clinical Hospital in Murcia, Spain. MATERIAL AND METHODS: This prospective study includes 151 patients undergoing laparoscopic RYGB surgery for morbid obesity. The patients were divided into 2 groups according to their body mass index. The small intestine (SI) was measured using micro forceps so that the percentage of common limb (%CL) could then be compared against the total SI in each patient. The percentage of excess weight loss (%EWL) in relation to the %CL was calculated at 3, 12, and 24 months. A series of tests was conducted simultaneously to analyze nutritional deficiencies and their relation to the %CL. RESULTS: The total jejunoileal segment and the %CL in the groups of both obese and super-obese patients had no influence on the %EWL in either group for any of the periods studied. The patients with a %CL<50% had greater nutritional deficiencies in the follow-up period and required supplements and more frequent laboratory tests. CONCLUSIONS: The %CL has no effect on weight loss in RYGB patients. A lower %CL is related to greater nutritional deficiencies.


Asunto(s)
Enfermedades Carenciales/etiología , Derivación Gástrica/métodos , Intestino Delgado/patología , Laparoscopía/métodos , Obesidad Mórbida/cirugía , Complicaciones Posoperatorias/etiología , Adulto , Anciano , Albúminas/deficiencia , Avitaminosis/etiología , Calcio/deficiencia , Enfermedades Carenciales/patología , Deficiencia de Ácido Fólico/etiología , Humanos , Masculino , Persona de Mediana Edad , Obesidad Mórbida/patología , Tamaño de los Órganos , Complicaciones Posoperatorias/patología , Estudios Prospectivos , Pérdida de Peso , Adulto Joven
11.
Br J Nutr ; 112(8): 1323-32, 2014 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-25313575

RESUMEN

Folate is essential for fetal development, and its deficiency during gestation causes behavioural deficits in the offspring. The present study investigated its influence during weaning on brain function in the pups of rats that were put on a folate-deficient (FD) diet on postnatal day (PND) 1. Systemic folate deficiency in pups on the FD diet (n 15) was evident from the dramatically lower hepatic folate concentrations (median 23·7, range 8·1-48·4 ng/mg protein) and higher homocysteine concentrations (median 27·7, range 14·7-45·5 pmol/mg protein), respectively, compared with those of pups on the normal diet (ND; n 9) (median 114·5, range 64·5-158·5 ng/mg protein and median 15·5, range 11·6-18·9 pmol/mg protein) on PND 23. Brain folate concentrations although low were similar in pups on the FD diet (median 10·5, range 5·5-24·5 ng/mg protein) and ND (median 11·1, range 7·1-24·2 ng/mg protein). There was a high accumulation of homocysteine in the brain of FD pups, mostly in the hippocampus (median 58·1, range 40·8-99·7 pmol/mg protein) and cerebellum (median 69·1, range 50·8-126·6 pmol/mg protein), indicating metabolic folate deficiency despite normal brain folate concentrations. Developmental deficits or autistic traits were more frequent in the FD group than in the ND group and repetitive self-grooming occurred, on average, three times (range 1-8) v. once (range 0-3) during 5 min, respectively. Long-term memory or spatial learning and set-shifting deficits affected 12 to 62% of rats in the FD group compared with none in the ND group. Post-weaning folic acid supplementation did not correct these deficits. These observations indicate that folate deficiency during weaning affects postnatal development even when gestational folate supply is normal.


Asunto(s)
Encéfalo/metabolismo , Dieta/efectos adversos , Deficiencia de Ácido Fólico/fisiopatología , Ácido Fólico/metabolismo , Discapacidades para el Aprendizaje/etiología , Trastornos de la Memoria/etiología , Neuronas/metabolismo , Animales , Conducta Animal , Encéfalo/patología , Cerebelo/metabolismo , Cerebelo/patología , Susceptibilidad a Enfermedades , Femenino , Ácido Fólico/uso terapéutico , Deficiencia de Ácido Fólico/dietoterapia , Deficiencia de Ácido Fólico/etiología , Deficiencia de Ácido Fólico/metabolismo , Hipocampo/metabolismo , Hipocampo/patología , Homocisteína/metabolismo , Lactancia , Discapacidades para el Aprendizaje/prevención & control , Hígado/metabolismo , Hígado/patología , Masculino , Fenómenos Fisiologicos Nutricionales Maternos , Trastornos de la Memoria/prevención & control , Memoria a Largo Plazo , Ratas Long-Evans , Aprendizaje Espacial , Destete
12.
Obes Surg ; 24(10): 1639-46, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24706197

RESUMEN

BACKGROUND: Obesity is associated with nutritional deficiencies. Bariatric surgery could worsen these deficiencies. Fewer nutritional deficiencies would be seen after sleeve gastrectomy compared to the Roux-en-Y gastric bypass, but sleeve gastrectomy would also cause further deterioration of the deficiencies. The aim of this study was to determine the amount of pre-operative nutrient deficiencies in sleeve gastrectomy patients and assess the evolution of the nutritional status during the first post-operative year. METHODS: Four hundred seven sleeve gastrectomy patients were assigned to a standardized follow-up program. Data of interest were weight loss, pre-operative nutrient status and evolution of nutrient deficiencies during the first post-operative year. Deficiencies were supplemented when found. RESULTS: Two hundred patients completed blood withdrawal pre-operatively and in the first post-operative year. pre-operatively, 5 % of the patients were anemic, 7 % had low serum ferritin and 24 % had low folic acid. Hypovitaminosis D was present in 81 %. Vitamin A had excessive levels in 72 %. One year post-operatively, mean excess weight loss was 70 %. Anemia was found in 6 %. Low-ferritin levels were found in 8 % of the patients. Folate deficiency decreased significantly and hypovitaminosis D was still found in 36 %. CONCLUSIONS: In this study, a considerable amount of patients suffered from a deficient micronutrient status pre-operatively. One year after surgery, micronutrient deficiencies persisted or were found de novo in a considerable amount of patients, despite significant weight loss and supplementation. Significant reductions were seen only for folate and vitamin D.


Asunto(s)
Cirugía Bariátrica/efectos adversos , Gastrectomía/efectos adversos , Desnutrición/etiología , Micronutrientes/deficiencia , Obesidad Mórbida/cirugía , Adulto , Cirugía Bariátrica/métodos , Suplementos Dietéticos , Femenino , Deficiencia de Ácido Fólico/etiología , Estudios de Seguimiento , Gastrectomía/métodos , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional , Obesidad Mórbida/fisiopatología , Periodo Posoperatorio , Deficiencia de Vitamina D/etiología , Pérdida de Peso/fisiología
13.
Public Health Nutr ; 17(7): 1447-53, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23835153

RESUMEN

OBJECTIVE: Mandatory folic acid fortification of breads in New Zealand was put on hold in 2009. At this time, bread manufacturers were requested to adopt greater voluntary fortification and agreed to add folic acid to approximately one-third of their bread range. We sought to evaluate the impact of increased voluntary fortification of bread and the proposed mandatory fortification programme on folate intake adequacy of reproductive-age women. DESIGN: Cross-sectional study conducted in 2008. Dietary data were collected using 3 d weighed food records and usual folate intakes were generated by modifying the food composition table as follows: (i) voluntary fortification of bread as of 2008 (six breads); (ii) increased voluntary fortification of bread as of 2011 (thirty-four breads); and (iii) mandatory fortification of all breads. The prevalence of inadequate folate intake was calculated for all three scenarios using the Estimated Average Requirement (320 µg dietary folate equivalents/d) cut-point method. SETTING: New Zealand. SUBJECTS: Healthy non-pregnant women (n 125) aged 18-40 years. RESULTS: Usual folate intake in 2008 was 362 µg dietary folate equivalents/d. Increased voluntary bread fortification led to a marginal increase in folate intakes (394 µg dietary folate equivalents/d) and a decline in inadequacy from 37 % to 29 %. Mandatory fortification resulted in an increase of 89 µg folic acid/d, which substantially shifted both the proportion of women with folic acid intakes above 100 µg/d and the distribution of overall folate intakes, producing a marked reduction in inadequacy to 5 %. CONCLUSIONS: Increased voluntary bread fortification efforts are far inferior to mandatory fortification as a reliable public health intervention.


Asunto(s)
Dieta , Deficiencia de Ácido Fólico/prevención & control , Ácido Fólico/administración & dosificación , Industria de Alimentos/legislación & jurisprudencia , Alimentos Fortificados , Defectos del Tubo Neural/prevención & control , Política Nutricional/legislación & jurisprudencia , Adolescente , Adulto , Pan , Estudios Transversales , Femenino , Ácido Fólico/uso terapéutico , Deficiencia de Ácido Fólico/etiología , Regulación Gubernamental , Humanos , Nueva Zelanda , Evaluación Nutricional , Necesidades Nutricionales , Salud de la Mujer , Adulto Joven
14.
Pediatr Hematol Oncol ; 31(1): 62-7, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24088029

RESUMEN

Low vitamin B12 and folate levels in expectant mothers may lead to low stores in babies. The aim of this study was to determine the frequencies of vitamin B12 and folate deficiencies in pregnant women and neonates, and to assess the effect of maternal vitamin status on babies' vitamin levels in the Aegean region of Turkey, where the Mediterranean diet (mainly fresh fruits and vegetables) is adopted. We studied 72 pregnant women and their singleton-term babies. Venous blood samples of expectant mothers were collected 1 h before delivery and cord blood of babies were obtained at birth. The mean vitamin B12 in maternal and cord blood serum was 163.1 ± 72.0 pg/mL and 146.2 ± 102.5 pg/mL, and the mean folate, 9.8 ± 4.8 ng/mL and 15.8 ± 3.8 ng/mL, respectively. There were statistically significant correlation between maternal and cord blood serum vitamin B12 (r = 0.61, P = .04) and folate levels (r = 0.65, P < .001). 70.8% of the mothers and 83.9% of the babies were vitamin B12 deficient (<200 pg/mL). Neither group showed folate deficiency. The mean level of vitamin B12 in mothers significantly varied by the type of diet (241.6 (72.1) pg/mL versus 155.9 (68.2) pg/mL; P = .012). Vitamin B12 deficiency in pregnant women and neonates may be a public health problem in our community. The Mediterranean diet in these vulnerable groups may be an aggravating factor for vitamin B12 deficiency. Prenatal screening of all expectant mothers, prenatal supplementation of vitamin B12, and an increase in animal-source food intake may improve expectant mother's vitamin B12 level.


Asunto(s)
Dieta Mediterránea , Deficiencia de Ácido Fólico/epidemiología , Ácido Fólico/sangre , Complicaciones del Embarazo/epidemiología , Deficiencia de Vitamina B 12/epidemiología , Vitamina B 12/sangre , Adulto , Femenino , Sangre Fetal/química , Deficiencia de Ácido Fólico/dietoterapia , Deficiencia de Ácido Fólico/etiología , Frutas , Humanos , Recién Nacido , Intercambio Materno-Fetal , Embarazo , Complicaciones del Embarazo/dietoterapia , Complicaciones del Embarazo/etiología , Turquía/epidemiología , Verduras , Deficiencia de Vitamina B 12/dietoterapia , Deficiencia de Vitamina B 12/etiología , Poblaciones Vulnerables , Adulto Joven
15.
J Pediatr Gastroenterol Nutr ; 58(2): 188-92, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24051483

RESUMEN

OBJECTIVES: The aim of this study was to define whether there was folate deficiency in hospitalized preterm infants, and, second, to define the effect of feeding modalities on serum folate levels. METHODS: Infants born ≤ 32 weeks of gestation were included in the study. Blood samples for the determination of serum folate levels were obtained on days 14 and 28 postnatally, as well as 36 weeks postconceptionally (or just before discharge if patients are discharged <36 weeks)--samples A, B, and C, respectively. Infants were divided into 3 groups based on mode of feeding; human breast milk (HBM), fortified HBM (fHBM), or preterm formula (PF). RESULTS: A total of 162 preterm infants were enrolled: 17 (10.5%) of whom received HBM alone, 94 (58%) received fHBM, and 51 (31.5%) were fed with PF. None of the preterm infants developed folate deficiency during the study period. Preterm infants in the fHBM and PF groups had significant higher serum folate levels in samples C when compared with those receiving HBM alone (P < 0.001 for both). Multivariate analysis to evaluate the effects of maternal supplementation, smoking habit, gestational age, birth weight, and cumulative folic acid intake in samples A, B, and C suggested that maternal smoking and maternal folic acid supplementation had significant effects on serum folate levels in sample A and B. CONCLUSIONS: Preterm infants receiving parenteral nutrition with high folic acid content have no risk of folate deficiency during the 2 months of age; however, preterm infants fed orally from birth with HBM or PF with a low folic acid content could be at risk for folate deficiency, especially when mothers are smokers and/or do not receive folic acid supplementation during pregnancy.


Asunto(s)
Suplementos Dietéticos , Deficiencia de Ácido Fólico/prevención & control , Ácido Fólico/administración & dosificación , Recien Nacido Prematuro , Necesidades Nutricionales , Fenómenos Fisiologicos de la Nutrición Prenatal , Complejo Vitamínico B/administración & dosificación , Peso al Nacer , Femenino , Ácido Fólico/sangre , Deficiencia de Ácido Fólico/sangre , Deficiencia de Ácido Fólico/etiología , Edad Gestacional , Humanos , Fórmulas Infantiles , Recién Nacido , Masculino , Leche Humana , Nutrición Parenteral , Soluciones para Nutrición Parenteral/química , Embarazo , Atención Prenatal , Factores de Riesgo , Fumar , Complejo Vitamínico B/sangre
16.
Ann Med ; 45(8): 522-31, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24195595

RESUMEN

Reduced levels of iron, folate, vitamin B12, vitamin D, zinc, and magnesium are common in untreated celiac disease (CD) patients probably due to loss of brush border proteins and enzymes needed for the absorption of these nutrients. In the majority of patients, removal of gluten from the diet leads to histological recovery and normalization of iron, vitamin, and mineral levels. Iron deficiency anemia is the most common extra-intestinal sign of CD and usually resolves with adherence to a gluten-free diet. However, deficiencies of both folate and vitamin B12 may persist in some patients on a gluten-free diet, thus requiring vitamin supplementation to improve subjective health status. Similarly, exclusion of gluten from the diet does not always normalize bone mineral density; in these cases, supplementation of vitamin D and calcium is recommended. Resolution of mucosal inflammation may not be sufficient to abrogate magnesium deficiency. Since gluten-free cereal products have a lower magnesium content as compared with gluten-containing counterparts, a magnesium-enriched diet should be encouraged in CD patients. In this article we discuss the frequency and clinical relevance of nutrient deficiency in CD and whether and when nutrient supplementation is needed.


Asunto(s)
Enfermedad Celíaca/complicaciones , Enfermedades Carenciales/tratamiento farmacológico , Suplementos Dietéticos , Micronutrientes/uso terapéutico , Anemia Ferropénica/tratamiento farmacológico , Anemia Ferropénica/etiología , Anemia Ferropénica/metabolismo , Biomarcadores/metabolismo , Calcio/deficiencia , Calcio/metabolismo , Enfermedad Celíaca/metabolismo , Enfermedad Celíaca/terapia , Enfermedades Carenciales/etiología , Enfermedades Carenciales/metabolismo , Dieta Sin Gluten , Deficiencia de Ácido Fólico/tratamiento farmacológico , Deficiencia de Ácido Fólico/etiología , Deficiencia de Ácido Fólico/metabolismo , Humanos , Deficiencia de Magnesio/tratamiento farmacológico , Deficiencia de Magnesio/etiología , Deficiencia de Magnesio/metabolismo , Deficiencia de Vitamina B 12/tratamiento farmacológico , Deficiencia de Vitamina B 12/etiología , Deficiencia de Vitamina B 12/metabolismo , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/etiología , Deficiencia de Vitamina D/metabolismo , Zinc/deficiencia , Zinc/metabolismo
17.
Am J Clin Nutr ; 98(6): 1450-8, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24108785

RESUMEN

BACKGROUND: Folic acid supplementation in those with a low vitamin B-12 intake or status may have adverse effects. These effects are unknown with regard to birth outcome in pregnant Indian women who are routinely supplemented with high doses of folic acid. OBJECTIVE: The objective was to examine the association of unbalanced vitamin B-12 and total folate (folic acid supplement + dietary folate) intakes during pregnancy with outcomes in small-for-gestational-age (SGA) infants. DESIGN: This was a prospective observational cohort study of 1838 pregnant women in South India. Low intake of dietary vitamin B-12 in the presence of high total folate intake was examined as the ratio of vitamin B-12 intake to total folate intake. RESULTS: The inadequacy of vitamin B-12 intake (<1.2 µg/d) assessed by a food-frequency questionnaire in the first, second, and third trimesters of pregnancy was 25%, 11%, and 10%, respectively. Multivariate log binomial regression showed that low vitamin B-12 and folate intakes in the first trimester were independently associated with a higher risk of SGA. In a subgroup of women with high supplemental folic acid intakes in the second trimester, those with the lowest tertile of vitamin B-12:folate ratio had a higher risk of SGA outcome than did those in the highest tertile (adjusted RR: 2.73; 95% CI: 1.17, 6.37). A similar trend was observed in the analysis of blood micronutrient status in a random subset (n = 316) of the sample. CONCLUSIONS: These findings suggest that, in addition to vitamin B-12 and folate deficiencies alone, there may be adverse birth outcomes associated with unbalanced vitamin B-12 and folate intakes or status during pregnancy. These findings have important implications for the antenatal B vitamin supplementation policy in India. This trial was registered at the Clinical Trial Registry of India as 2013/07/005342.


Asunto(s)
Suplementos Dietéticos/efectos adversos , Retardo del Crecimiento Fetal/etiología , Ácido Fólico/efectos adversos , Fenómenos Fisiologicos Nutricionales Maternos , Complicaciones del Embarazo/fisiopatología , Nacimiento Prematuro/etiología , Deficiencia de Vitamina B 12/fisiopatología , Adulto , Estudios de Cohortes , Dieta/efectos adversos , Femenino , Retardo del Crecimiento Fetal/epidemiología , Ácido Fólico/administración & dosificación , Ácido Fólico/uso terapéutico , Deficiencia de Ácido Fólico/dietoterapia , Deficiencia de Ácido Fólico/etiología , Humanos , Incidencia , India/epidemiología , Recién Nacido Pequeño para la Edad Gestacional , Masculino , Embarazo , Complicaciones del Embarazo/etiología , Nacimiento Prematuro/epidemiología , Riesgo , Vitamina B 12/administración & dosificación , Deficiencia de Vitamina B 12/etiología , Adulto Joven
18.
Eur J Nutr ; 52(3): 1157-67, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22832899

RESUMEN

PURPOSE: Folic acid (FA) is an emerging nutritional factor in the pathogenesis of diverse neurodegenerative disorders by still unknown mechanisms. The hippocampus is altered during the loss of cognitive abilities in humans and selectively affected when homocysteine increases. The aim was to evaluate the potential protective role of folic acid in the maintenance of biochemical markers related to the methionine cycle, as well as the integrity of the hippocampus as part of the brain in aged rats. METHODS: Male Sprague-Dawley rats (18 months old) were assigned to four different folic acid groups (0 mg FA/kg diet, deficient; 2 mg FA/kg diet, control; 8 mg FA/kg diet, moderate supplementation; 40 mg FA/kg diet, extra supplementation) for 30 days. We evaluated several parameters related to the methionine cycle. In addition, hippocampus areas were immunostained for specific neuronal markers and astrocytes. RESULTS: Serum folate levels increased according to FA dietary level (p < 0.01). There was a significant increase in the serum homocysteine concentrations in the folic acid-deficient diet group (p < 0.01). However, brain S-adenosylmethionine and S-adenosylhomocysteine did not differ significantly between the folic acid groups. Consequently, the methylation ratio was also unchanged. The morphometric analysis did not show any differences in the number of neurons and astrocytes between groups, except when comparing the folic acid-deficient diet versus folic acid-supplemented diet in the striatum of the hippocampus. CONCLUSIONS: Clearly, the dietary FA deficiency negatively affects the methionine metabolism biomarkers, while excessive supplementation seems to be unnecessary for optimal maintenance of the methylation cycle and hippocampus integrity.


Asunto(s)
Envejecimiento , Disfunción Cognitiva/prevención & control , Dieta , Ácido Fólico/uso terapéutico , Hipocampo/metabolismo , Metionina/metabolismo , Fármacos Neuroprotectores/uso terapéutico , Animales , Astrocitos/metabolismo , Astrocitos/patología , Biomarcadores/metabolismo , Disfunción Cognitiva/etiología , Disfunción Cognitiva/metabolismo , Disfunción Cognitiva/patología , Dieta/efectos adversos , Suplementos Dietéticos , Ácido Fólico/administración & dosificación , Ácido Fólico/sangre , Ácido Fólico/metabolismo , Deficiencia de Ácido Fólico/dietoterapia , Deficiencia de Ácido Fólico/etiología , Deficiencia de Ácido Fólico/fisiopatología , Hipocampo/patología , Hiperhomocisteinemia/etiología , Hiperhomocisteinemia/fisiopatología , Hiperhomocisteinemia/prevención & control , Masculino , Metilación , Neuronas/metabolismo , Neuronas/patología , Fármacos Neuroprotectores/administración & dosificación , Fármacos Neuroprotectores/sangre , Fármacos Neuroprotectores/metabolismo , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , S-Adenosilhomocisteína/metabolismo , S-Adenosilmetionina/metabolismo
19.
Rev. méd. Chile ; 140(11): 1464-1475, nov. 2012. ilus, tab
Artículo en Español | LILACS | ID: lil-674015

RESUMEN

During the past decade the role of folate and vitamin B12 in human nutrition have been under constant re-examination. Basic knowledge on the metabolism and interactions between these essential nutrients has expanded and multiple complexities have been unraveled. These micronutrients have shared functions and intertwined metabolic pathways that define the size of the "methyl donor" pool utilized in multiple metabolic pathways; these include DNA methylation and synthesis of nucleic acids. In Chile, folate deficiency is virtually nonexistent, while vitamin B12 deficiency affects approximately 8.5-51% depending on the cut-off value used to define deficiency. Folate is found naturally mainly in vegetables or added as folic acid to staple foods. Vitamin B12 in its natural form is present only in foods of animal origin, which is why deficit is more common among strict vegetarians and populations with a low intake of animal foods. Poorfolate status in vulnerable women of childbearing age increases the risk of neural tube birth defects, so the critical time for the contribution of folic acid is several months before conception since neural tube closure occurs during the first weeks of life. The absorption of vitamin B12 from food is lower in older adults, who are considered to have higher risk of gastric mucosa atrophy, altered production of intrinsic factor and acid secretion. Deficiency of these vitamins is associated with hematological disorders. Vitamin B12 deficiency can also induce clinical and sub-clinical neurological and of other disorders. The purpose of this review is to provide an update on recent advances in the basic and applied knowledge of these vitamins relative to human health.


Asunto(s)
Humanos , Ácido Fólico , Deficiencia de Ácido Fólico , Dieta , Deficiencia de Ácido Fólico/diagnóstico , Deficiencia de Ácido Fólico/etiología , Deficiencia de Ácido Fólico/terapia , Ácido Fólico/administración & dosificación , Ácido Fólico/química , Ácido Fólico/metabolismo , Alimentos Fortificados , /diagnóstico , /etiología , /terapia , /administración & dosificación , /química , /metabolismo
20.
Asia Pac J Clin Nutr ; 21(4): 519-25, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23017310

RESUMEN

Obesity and homocysteine (tHcy) are important risk factors for cardiovascular diseases (CVD). Plasma omega-3 fatty acids (ω-3 FAs) and omega-6 fatty acids (ω-6 FAs) are essential fatty acids with diverse biological effects in human health and disease. We have investigated the relation of plasma ω-3 FAs and ω-6 FAs levels with other cardiovascular risk factors including tHcy in severe obese subjects. This study was performed on 96 severe obese and 65 normal weight subjects. Plasma fatty acid composition was measured by GC/MS and serum tHcy level was measured by HPLC methods. There were no differences between groups in terms of concentrations of serum tHcy, plasma ω-3 FAs, ω-6 FAs and ω-3/ω-6 ratio, whereas serum vitamin B-12 (p<0.01) and folic acid (p<0.05) levels were lower than those of the normal weight subjects. Homocysteine positively correlated with ω-6 FAs and negatively correlated with ω-3 FAs in severe obese and normal weight subjects. Serum vitamin B-12 positively correlated with ω-3 FAs (p<0.01) and ω-3/ω-6 ratio (p<0.01) and negatively correlated with ω-6 FAs (p<0.05) in severe obese subjects. Serum folic acid positively correlated with ω-3 FAs (p<0.01) in severe obese subjects. Our results suggest an association between the plasma ω-3 FAs and ω-6 FAs and serum tHcy concentrations in severe obese and normal weight subjects. Low levels vitamin B-12 and folic acid may have been responsible for the elevated tHcy levels in severe obese subjects, increasing the risk for future development of cardiovascular diseases.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Ácidos Grasos Omega-3/sangre , Ácidos Grasos Omega-6/sangre , Homocisteína/sangre , Obesidad/sangre , Adulto , Algoritmos , Índice de Masa Corporal , Enfermedades Cardiovasculares/etiología , Femenino , Deficiencia de Ácido Fólico/etiología , Humanos , Hiperhomocisteinemia/etiología , Hiperlipidemias/etiología , Masculino , Persona de Mediana Edad , Obesidad/etnología , Obesidad/fisiopatología , Factores de Riesgo , Índice de Severidad de la Enfermedad , Turquía/epidemiología , Deficiencia de Vitamina B 12/etiología , Adulto Joven
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