title: A comparison of the effect of advice to eat either '5-a-day' fruit and vegetables or folic acid-fortified foods on plasma folate and homocysteine.
abstract: OBJECTIVE
  To assess and compare the effects of natural folate (100 micro g) with those of folic acid from fortified sources (100 micro g/day) on plasma folate and homocysteine.
  
  
  METHODS
  Randomized controlled trial (parallel groups).
  
  
  METHODS
  Men and women living in South Wales, UK.
  
  
  METHODS
  A total of 135 healthy individuals recruited from the local workforce and blood donor sessions. All subjects possessed the 'wild-type' CC genotype for C677T polymorphism in methylenetetrahydrofolate reductase (MTHFR).
  
  
  METHODS
  Subjects underwent one of the following dietary interventions for 4 months: (1) fortified diet-usual diet plus 100 microg/day folic acid from fortified foods; (2) natural folate diet-usual diet plus 100 microg/day folate from natural sources; (3) control-usual diet.
  
  
  RESULTS
  The fortified group increased reported intake of folic acid from fortified foods compared to other groups (P<0.001) achieving an extra 98 microg/day (95% CI 88-108). The natural folate group increased reported intake of natural source folates compared with the other two groups (P<0.001), but achieved a mean increase of only 50 microg/day (95% CI 34-66). Plasma folate increased (P<0.01) by a similar amount in both intervention groups compared to controls (fortified group 2.97, 95% CI 0.8-5.1; natural group 2.76, 95% CI 0.6-4.9. Plasma homocysteine, vitamins B(6) and B(12) were not significantly changed.
  
  
  CONCLUSIONS
  Subjects achieved increases in folate intake using fortified foods more easily than by folate-rich foods, however both sources increased plasma folate by a similar amount. These levels of intake were insufficient to reduce homocysteine concentrations in MTHFR CC homozygotes, but may be more effective in other genotypes.
authors.affiliation: Cardiovascular Sciences Research Group, Wales Heart Research Institute, University of Wales College of Medicine, Cardiff, Wales, UK.
authors.forename: P A L
authors.initials: PA
authors.lastname: Ashfield-Watt
authors.forename: J M
authors.initials: JM
authors.lastname: Whiting
authors.forename: Z E
authors.initials: ZE
authors.lastname: Clark
authors.forename: S J
authors.initials: SJ
authors.lastname: Moat
authors.forename: R G
authors.initials: RG
authors.lastname: Newcombe
authors.forename: M L
authors.initials: ML
authors.lastname: Burr
authors.forename: I F W
authors.initials: IF
authors.lastname: McDowell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015930:Diet Records; D005260:Female; D005492:Folic Acid / Q000097:blood* / Q000494:pharmacology*; D005527:Food, Fortified; D005638:Fruit; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D012016:Reference Values; D006113:United Kingdom; D014675:Vegetables
chemical_list: D006710:Homocysteine; D005492:Folic Acid