title: 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.
abstract: OBJECTIVE
  Folic acid (400 μg/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
  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 μg 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Dietetic & Food Services Department, Changi General Hospital, Singapore.
authors.forename: Magdalin
authors.initials: M
authors.lastname: Cheong
authors.affiliation: Dietetic & Food Services Department, Changi General Hospital, Singapore.
authors.forename: Huang Ying
authors.initials: HY
authors.lastname: Xiao
authors.affiliation: Sprim Advanced Life Sciences Ltd, Singapore.
authors.forename: Vicky
authors.initials: V
authors.lastname: Tay
authors.affiliation: Food, Nutrition, and Health, the University of British Columbia, Vancouver, Canada.
authors.forename: Crystal D
authors.initials: CD
authors.lastname: Karakochuk
authors.affiliation: Food, Nutrition, and Health, the University of British Columbia, Vancouver, Canada.
authors.forename: Yazheng Amy
authors.initials: YA
authors.lastname: Liu
authors.affiliation: Food, Nutrition, and Health, the University of British Columbia, Vancouver, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Harvey
authors.affiliation: Food, Nutrition, and Health, the University of British Columbia, Vancouver, Canada.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Lamers
authors.affiliation: Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Houghton
authors.affiliation: Food, Nutrition, and Health, the University of British Columbia, Vancouver, Canada.
authors.forename: David D
authors.initials: DD
authors.lastname: Kitts
authors.affiliation: Food, Nutrition, and Health, the University of British Columbia, Vancouver, Canada. Email: tim.green@ubc.ca; tigreen@mail.ubc.ca.
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Green
mesh_terms: D000328:Adult; D000818:Animals; D004032:Diet; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood*; D005527:Food, Fortified; D006801:Humans; D008892:Milk; D009436:Neural Tube Defects / Q000517:prevention & control*; D010919:Placebos; D011247:Pregnancy; D012307:Risk Factors; D012846:Singapore
chemical_list: D010919:Placebos; D005492:Folic Acid