Folic acid fortified milk increases blood folate to concentrations associated with a very low risk of neural tube defects in Singaporean women of childbearing age / Magdalin Cheong, Huang Ying Xiao, Vicky Tay, Crystal D. Karakochuk, Yazheng Amy Liu, Sarah Harvey, Yvonne Lamers, Lisa A. Houghton, David D Kitts, Tim J. Green

Background and Objectives: Folic acid (400 g/d) taken during the periconceptional period reduces neural tube defect (NTD) risk by >75%. Achieving red cell folate (RCF) or plasma folate (PF) >905 nmol/L and >35 nmol/L, respectively, has been associated with a low risk of NTDs. We determined whether daily consumption of folic acid fortified milk increases blood folate concentrations to levels associated with a low risk of NTDs in Singaporean women of childbearing age. Methods and Study Design: In this double-blind placebo-controlled trial, 70 non-pregnant women (21-35 y) were randomly assigned to receive fortified milk (FM) powder providing 400 g folic acid per day or unfortified placebo milk (PM) powder for 12 weeks. Blood samples were collected at baseline and at 6 and 12 weeks. Results: At 12 weeks, mean (95% CI) RCF and PF concentrations were 376 (240, 512) and 39 (26, 51) nmol/L higher in the FM group compared with the PM group (p<0.001). Of the women receiving FM, 71% (n=25) and 86% (n=30) achieved a RCF and PF associated with a very low risk of NTDs, respectively. Conclusion: Folic acid fortified milk increased blood folate concentrations in women of childbearing age to levels associated with a reduced risk of an NTD-affected pregnancy.

Nutrition