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Titolo:
Quantifying the effect of folic acid
Autore:
Wald, NJ; Law, MR; Morris, JK; Wald, DS;
Indirizzi:
Barts & London Sch Med & Dent, Wolfson Inst Prevent Med, Dept Environm & Prevent Med, London, England Barts & London Sch Med & Dent London Englandevent Med, London, England St Marys Hosp, Dept Cardiol, Portsmouth PO3 6AQ, Hants, England St Marys Hosp Portsmouth Hants England PO3 6AQ th PO3 6AQ, Hants, England
Titolo Testata:
LANCET
fascicolo: 9298, volume: 358, anno: 2001,
pagine: 2069 - 2073
SICI:
0140-6736(200112)358:9298<2069:QTEOFA>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEURAL-TUBE DEFECTS; PLASMA HOMOCYSTEINE CONCENTRATIONS; YOUNG-WOMEN; VITAMIN SUPPLEMENTATION; FOOD FORTIFICATION; RANDOMIZED TRIAL; FOLATE STATUS; SERUM FOLATE; PREVENTION; DISEASE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
42
Recensione:
Indirizzi per estratti:
Indirizzo: Wald, NJ Barts & London Sch Med & Dent, Wolfson Inst Prevent Med, Dept Environm & Prevent Med, Charterhouse Sq, London, England Barts & London Sch Med & Dent Charterhouse Sq London England nd
Citazione:
N.J. Wald et al., "Quantifying the effect of folic acid", LANCET, 358(9298), 2001, pp. 2069-2073

Abstract

Background Folic acid is known to prevent neural-tube defects (NTDs) but the size of the effect for a given dose is unclear. We aimed to quantify such an effect. Methods We used published data from 13 studies of folic acid supplementation on serum folate concentrations and results from a large cohort study of the risk of NTDs according to serum folate, to measure the preventive effect of specified increases in intake of folic acid. Findings Serum folate concentrations increase by 0.94 ng/mL (95% Cl 0.77-1.10) for every 0.1 mg/day increase in folic acid intake in women aged 20-35years, and about double that in people aged 40-65. Every doubling of serumfolate concentration roughly halves the risk of an NTD. These two effects can be combined to predict the reduction in risk according to intake of extra folic acid and background serum folate concentration. Such results predict that the preventive effect is greater in women with low serum folate than in those with higher concentrations. The results have also been used to predict direct observations from large randomised trials and the effect of food fortification. From a typical western background serum folate of 5 ng/mL, about 0.2 mg/day (the US level of folic acid fortification) would be expected to reduce NTDs by about 20%; a similar effect can be expected from the current British recommendation (0.24 mg/day). An increase of 0.4 mg/day would reduce risk by about 36%, of 1 mg/day by 57%, and taking a 5-mg tabletdaily would reduce risk by about 85%. Interpretation Folic acid fortification levels should be increased. Additionally women planning a pregnancy should take 5 mg folic acid tablets daily, instead of the 0.4 mg dose presently recommended.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/09/20 alle ore 23:30:51