title: Red blood cell folate concentrations increase more after supplementation with [6S]-5-methyltetrahydrofolate than with folic acid in women of childbearing age.
abstract: BACKGROUND
  For the primary prevention of neural tube defects (NTDs), public health authorities recommend women of childbearing age to take 400 mug folic acid/d 4 wk before conception and during the first trimester. The biologically active derivate [6S]-5-methyltetrahydrofolate ([6S]-5-MTHF) could be an alternative to folic acid.
  
  
  OBJECTIVE
  We investigated the effect of supplementation with [6S]-5-MTHF compared with that of folic acid on red blood cell folate concentration, an indicator of folate status.
  
  
  METHODS
  The study was designed as a double-blind, randomized, placebo-controlled intervention trial. Healthy women (n = 144) aged 19-33 y received 400 microg folic acid, the equimolar amount of [6S]-5-MTHF (416 microg), 208 microg [6S]-5-MTHF, or placebo as a daily supplement for 24 wk. Red blood cell and plasma folate concentrations were measured at baseline and at 4-wk intervals.
  
  
  RESULTS
  The increase in red blood cell folate over time was significantly higher in the group receiving 416 microg [6S]-5-MTHF/d than in the groups receiving 400 microg folic acid/d or 208 microg [6S]-5-MTHF/d (P < 0.001). No plateau was reached in red blood cell folate concentration in the 3 treatment groups during 24 wk of intervention; however, plasma folate plateaued after 12 wk.
  
  
  CONCLUSIONS
  We showed that administration of [6S]-5-MTHF is more effective than is folic acid supplementation at improving folate status. In addition, the study indicates that the recommended period for preconceptional folic acid supplementation should be extended to >4 wk for maximal prevention of NTDs based on folate concentrations. [6S]-5-MTHF might be an efficient and safe alternative to folic acid.
authors.affiliation: Department of Nutrition and Food Sciences, Pathophysiology of Nutrition, University of Bonn, Bonn, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Lamers
authors.forename: Reinhild
authors.initials: R
authors.lastname: Prinz-Langenohl
authors.forename: Susanne
authors.initials: S
authors.lastname: Brämswig
authors.forename: Klaus
authors.initials: K
authors.lastname: Pietrzik
mesh_terms: D000328:Adult; D001682:Biological Availability; D019587:Dietary Supplements; D004311:Double-Blind Method; D004912:Erythrocytes / Q000737:chemistry*; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D006801:Humans; D007408:Intestinal Absorption; D009436:Neural Tube Defects / Q000517:prevention & control; D010919:Placebos; D013763:Tetrahydrofolates / Q000008:administration & dosage / Q000493:pharmacokinetics*
chemical_list: D010919:Placebos; D013763:Tetrahydrofolates; D005492:Folic Acid; C005984:5-methyltetrahydrofolate