Objectives: There is no mandatory folic acid fortification of food in Finland. We investigated the effects of mineral water fortified with folic acid, vitamins B6, B12, D and calcium on serum and erythrocyte folate concentrations, serum vitamin B12 and plasma homocysteine concentrations in pregnancy.
Design: A randomized, controlled, double-blind, parallel-group intervention study.
Methods: Seventy-four pregnant women were recruited from two health care units. The study began at the eleventh week with a two-week run-in period, followed by an eight-week intervention period. The diet was monitored by food records. During the intervention, subjects consumed 1000 mL/day fortified or normal mineral water. The pregnancies were monitored carefully.
Results: The folate intake was 255 μg/day in the study group and 274 μg/day in the controls. Serum folate concentrations increased in the study group by 10.3 nmol/L and decreased in the controls by 2.7 nmol/L (P<0.05) during the study. The erythrocyte folate concentrations increased in the study group by 360.9 nmol/L and in the controls by 195.6 nmol/L (P=0.004) and serum homocysteine concentrations fell by 1.1 μmol/L and by 0.3 μmol/L, respectively (P<0.05).
Conclusions: Finnish pregnant women have low dietary folate intake. Fortified mineral water improved folate status and reduced plasma homocysteine concentrations in the pregnant subjects.
1 Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group. Lancet 338 (1991) 131Search in Google Scholar
2 Andersson A, B Hultberg, L Brattstrom, A Isaksson: Decreased serum homocysteine in pregnancy. Eur J Clin Chem Clin Biochem30 (1992) 377Search in Google Scholar
3 Bonnette RE, MA Caudill, AM Boddie, AD Hutson, GP Kauwell, LB Bailey: Plasma homocyst(e)ine concentrations in pregnant and nonpregnant women with controlled folate intake. Obstet Gynecol92 (1998) 167Search in Google Scholar
4 Bronstrup A, M Hages, R Prinz-Langenohl, K Pietrzik: Effects of folic acid and combinations of folic acid and vitamin B-12 on plasma homocysteine concentrations in healthy, young women. Am J Clin Nutr68 (1998) 1104Search in Google Scholar
5 Brouwer IA, M van Dusseldorp, M Duran, CM Thomas, JG Hautvast, TK Eskes, et al.: Low-dose folic acid supplementation does not influence plasma methionine concentrations in young non-pregnant women. Br J Nutr82 (1999) 85Search in Google Scholar
6 Campbell S, S Vyas, KH Nicolaides: Doppler investigation of the fetal circulation. J Penat Med19 (1991) 21Search in Google Scholar
7 Coumans AB, PC Huijgens, C Jakobs, R Schats, JI de Vries, MG van Pampus, et al.: Haemostatic and metabolic abnormalities in women with unexplained recurrent abortion. Hum Reprod14 (1999) 211Search in Google Scholar
8 Czeizel AE, I Dudas: Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 327 (1992) 1832Search in Google Scholar
9 de Vries JI, GA Dekker, PC Huijgens, C Jakobs, BM Blomberg, HP van Geijn: Hyperhomocysteinaemia and protein S deficiency in complicated pregnancies. Br J Obstet Gynaecol104 (1997) 1248Search in Google Scholar
10 Dekker GA, JI de Vries, PM Doelitzsch, PC Huijgens, BM von Blomberg, C Jakobs, et al.: Underlying disorders associated with severe early-onset preeclampsia. Am J Obstet Gynecol173 (1995) 1042Search in Google Scholar
11 Diedrich M, CJ Brown, G Block: The effect of folate fortification of cereal-grain products on blood folate status, dietary folate intake, and dietary folate sources among adult non-supplement users in the United States. J Am Coll Nutr24 (2005) 266Search in Google Scholar
12 Ek J, EM Magnus: Plasma and red blood cell folate during normal pregnancies. Acta Obstet Gynecol Scand60 (1981) 247Search in Google Scholar
13 Goddijn-Wessel TA, MG Wouters, EF van de Molen, MD Spuijbroek, RP Steegers-Theunissen, HJ Blom, et al.: Hyperhomocysteinemia: a risk factor for placental abruption or infarction. Eur J Obstet Gynecol Reprod Biol66(1996) 23Search in Google Scholar
14 Hasunen K, M Kalavainen, H Keinonen, H Lagström, A Lyytikäinen, A Nurttila, et al.: Imeväis- ja leikki- ikäisten lasten, odottavien ja imettävien äitien ravitsemussuositus. Sosiaali- ja terveysministeriön julkaisuja. Helsinki 2004Search in Google Scholar
15 Hibbard ED, RW Smithels: Folic acid metabolism and human embryopathy. Lancet 1 (1965) 1254Search in Google Scholar
16 Hofmeyr G, A Atallah, L Duley: Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev 3: CD001059. (2006) 31:58Search in Google Scholar
17 Holmes VA, JM Wallace, HD Alexander, WS Gilmore, I Bradbury, M Ward, et al.: Homocysteine is lower in the third trimester of pregnancy in women with enhanced folate status from continued folic acid supplementation. Clin Chem51 (2005) 629Search in Google Scholar
18 Holmes-Siedle M, J Dennis, RH Lindenbaum, A Galliard: Long term effects of periconceptional multivitamin supplements for prevention of neural tube defects: a seven to 10 year follow up. Arch Dis Child67 (1992) 1436Search in Google Scholar
19 Leeda M, N Riyazi, JI de Vries, C Jakobs, HP van Geijn, GA Dekker: Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and a history of preeclampsia or fetal growth restriction. Am J Obstet Gynecol179 (1998) 135Search in Google Scholar
20 Lopez-Quesada E, MA Vilaseca, A Vela, JM Lailla: Perinatal outcome prediction by maternal homocysteine and uterine artery Doppler velocimetry. Eur J Obstet Gynecol Reprod Biol113 (2004) 61Search in Google Scholar
21 Männistö S, M-L Ovaskainen, L Valsta: The National Findiet Study. (2003) HelsinkiSearch in Google Scholar
22 Nelen WL, HJ Blom, EA Steegers, M den Heijer, CM Thomas, TK Eskes: Homocysteine and folate levels as risk factors for recurrent early pregnancy loss. Obstet Gynecol95 (2000) 519Search in Google Scholar
23 Owen EP, L Human, AA Carolissen, EH Harley, HJ Odendaal: Hyperhomocysteinemia – a risk factor for abruptio placentae. J Inherit Metab Dis20 (1997) 359Search in Google Scholar
24 Rajkovic A, PM Catalano, MR Malinow: Elevated homocyst(e)ine levels with preeclampsia. Obstet Gynecol90(1997) 168Search in Google Scholar
25 Silva HG, RP Tortora, ML Farias: Increased bone turnover during the third trimester of pregnancy and decreased bone mineral density after parturition in adolescents as compared to age-matched control patients. Gynecol Endocrinol21 (2005) 174Search in Google Scholar
26 Steegers-Theunissen RP, GH Boers, HJ Blom, FJ Trijbels, TK Eskes: Hyperhomocysteinaemia and recurrent spontaneous abortion or abruptio placentae. Lancet339 (1992) 1122Search in Google Scholar
27 Tapola NS, HM Karvonen, LK Niskanen, ES Sarkkinen: Mineral water fortified with folic acid, vitamins B6, B12, D and calcium improves folate status and decreases plasma homocysteine concentration in men and women. Eur J Clin Nutr58 (2004) 376Search in Google Scholar
28 Ubbink JB, A van der Merwe, WJ Vermaak, R Delport: Hyperhomocysteinemia and the response to vitamin supplementation. Clin Investig71 (1993) 993Search in Google Scholar
29 Wouters MG, GH Boers, HJ Blom, FJ Trijbels, CM Thomas, GF Borm, et al.: Hyperhomocysteinemia: a risk factor in women with unexplained recurrent early pregnancy loss. Fertil Steril60 (1993) 820Search in Google Scholar
©2007 by Walter de Gruyter Berlin New York