Demographic, physiologic, and lifestyle characteristics observed with serum total folate differ among folate forms: cross-sectional data from fasting samples in the National Health and Nutrition Examination Survey 2011–2016

Details

• Alternative Title:
  J Nutr
• Personal Author:
  Fazili, Zia ; Sternberg, Maya R ; Potischman, Nancy ; Wang, Chia-Yih ; Storandt, Renee J ; Yeung, Lorraine ; Yamini, Sedigheh ; Gahche, Jaime J ; Juan, WenYen ; Qi, Yan Ping ; Paladugula, Neelima ; Gabey, Gwendolyn ; Pfeiffer, Christine M
• Description:
  Background:
  
  Serum folate forms were measured in the US population during recent National Health and Nutrition Examination Surveys (NHANES) to assess folate status.
  
  Objective:
  
  We describe post-folic acid-fortification concentrations of serum folate forms in the fasting US population ≥1 y from the NHANES 2011–2016.
  
  Design:
  
  We measured 5 biologically active folates and 1 oxidation product (MeFox) of 5-methyltetrahydrofolate. We calculated geometric means of 5-methyltetrahydrofolate, unmetabolized folic acid (UMFA), non-methyl folate (sum of tetrahydrofolate, 5-formyltetrahydrofolate, and 5,10-methenyltetrahydrofolate), total folate (sum of above biomarkers), and MeFox by demographic, physiologic, and lifestyle variables; estimated the magnitude of variables on biomarker concentrations after covariate adjustment; and determined the prevalence of UMFA >2 nmol/L.
  
  Results:
  
  After demographic adjustment, age, sex, and race-Hispanic origin were significantly associated with most folate forms. MeFox increased with age, while 5-methyltetrahydrofolate, UMFA, and non-methyl folate displayed an U-shaped age pattern. Compared with non-Hispanic Whites, non-Hispanic Blacks had 23% lower predicted 5-methyltetrahyrofolate but comparable UMFA; non-Hispanic Asians had comparable 5-methyltetrahydrofolate but 28% lower UMFA; Hispanics, non-Hispanic Asians, and non-Hispanic Blacks had ~20% lower MeFox. After additional physiologic and lifestyle adjustment, predicted UMFA and MeFox concentrations were 43% and 112% higher, respectively in adults with chronic kidney disease and 17% and 15% lower, respectively in adults consuming daily 1–<2 alcoholic beverages; 5-methyltetrahydrofolate concentrations were 20% lower in adult smokers. The prevalence of UMFA >2 nmol/L was highest in persons ≥70 y (9.01%) and lowest in 12–19 y olds (1.14%). During 2011–2014, the prevalence was 10.6% in users and 2.22% in non-users of folic acid-containing supplements.
  
  Conclusions:
  
  In fasting persons ≥1 y, the demographic, physiologic, and lifestyle characteristics observed with serum total folate differed among folate forms, suggesting biological and/or genetic influences on folate metabolism. High UMFA was mostly observed in supplement users and older persons.
  
  
• Keywords:
  5-methyltetrahydrofolate Adolescent Adult Aged Aged, 80 And Over Biomarkers Child Child, Preschool Cross-Sectional Studies Female Folate Oxidation Product Folic Acid Humans Infant LC-MS/MS Life Style Male MeFox Middle Aged NHANES Nutrition Surveys Prevalence Tetrahydrofolates Unmetabolized Folic Acid Young Adult

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• Source:
  J Nutr. 150(4):851-860
• Pubmed ID:
  31875475
• Pubmed Central ID:
  PMC7138665
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  150
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:bf38e9872afc9409aa0dff0b92b27a5284b1a39e006f7107179b65c5e7dd4683
• Download URL:
  https://stacks.cdc.gov/view/cdc/88390/cdc_88390_DS1.pdf
• File Type:
  [PDF - 509.02 KB ]