title: [6S]-5-Methyltetrahydrofolate is at least as effective as folic acid in preventing a decline in blood folate concentrations during lactation.
abstract: BACKGROUND
  Studies in nonpregnant, nonlactating women suggest that folate supplementation in the form of 5-methyltetrahydrofolate ([6S]-5-methylTHF) is at least as effective as folic acid in increasing blood folate indexes. No data, however, are available on the effect of supplemental [6S]-5-methylTHF on blood folate concentrations during lactation.
  
  
  OBJECTIVE
  We assessed the relative effectiveness of [6S]-5-methylTHF, a placebo, and folic acid in maintaining blood folate indexes during lactation in a sample of healthy Canadian women consuming folic acid-fortified foods.
  
  
  METHODS
  This study was designed as a 16-wk, randomized, placebo-controlled intervention. Pregnant women (n = 72) advised to consume a folic acid-containing prenatal supplement (1000 microg/d) during pregnancy were enrolled at 36 wk gestation. After delivery, the women were randomly assigned to receive [6S]-5-methylTHF (416 microg/d, 906 nmol/d) or a placebo or were assigned to a folic acid (400 microg/d, 906 nmol/d) reference group.
  
  
  RESULTS
  At 16 wk of lactation, the mean red blood cell (RBC) folate concentration in women in the [6S]-5-methylTHF group (2178; 95% CI: 1854, 2559 nmol/L) was greater than that in the folic acid (1967; 1628, 2377 nmol/L; P < 0.05) and placebo (1390; 1198, 1613 nmol/L; P < 0.002) groups after adjustment for baseline concentrations (36 wk gestation). The distribution of folate forms in RBCs did not differ significantly between the [6S]-5-methylTHF and placebo groups. However, the folic acid group had greater amounts of 5-formylTHF (P < 0.03).
  
  
  CONCLUSIONS
  [6S]-5-MethylTHF appeared to be as effective as, and perhaps more effective than, folic acid in preserving RBC folate concentrations during lactation.
authors.affiliation: Department of Nutritional Sciences, University of Toronto, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Houghton
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Sherwood
authors.forename: Robert
authors.initials: R
authors.lastname: Pawlosky
authors.forename: Shinya
authors.initials: S
authors.lastname: Ito
authors.forename: Deborah L
authors.initials: DL
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D001682:Biological Availability; D001774:Blood Chemical Analysis; D019587:Dietary Supplements; D004311:Double-Blind Method; D004912:Erythrocytes / Q000737:chemistry*; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood* / Q000378:metabolism; D005494:Folic Acid Deficiency / Q000517:prevention & control*; D006801:Humans; D007774:Lactation / Q000097:blood* / Q000378:metabolism; D010919:Placebos; D011247:Pregnancy; D013763:Tetrahydrofolates / Q000008:administration & dosage* / Q000097:blood / Q000378:metabolism; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000008:administration & dosage* / Q000097:blood / Q000378:metabolism
chemical_list: D010919:Placebos; D013763:Tetrahydrofolates; D014803:Vitamin B Complex; D005492:Folic Acid; C005984:5-methyltetrahydrofolate