A comparison of (6S)-5-methyltetrahydrofolic acid vs folic acid and the effects on maternal folate status and the human milk folate profile : evidence from a randomized clinical trial
department or school: Land and Food Systems, Faculty of
data provider: DSpace
degree campus: UBCV
creator: Cochrane, Kelsey M.
issued: 2024-06-30T07:00:00Z
issued: 2023
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: Folic acid supplementation is recommended to support fetal development. However, folic acid is an oxidized form that must undergo reduction for use in the body, and unmetabolized folic acid (UMFA) is widely detected in circulation. (6S)-5-methyltetrahydrofolic acid (5-MTHF) is an alternative to folic acid which is reduced; however, the effect of (6S)-5-MTHF on maternal folate status during pregnancy is unknown. Thus, we conducted a pilot study to estimate the impact of supplementation with (6S)-5-MTHF versus folic acid on maternal folate status. Pregnant individuals (n=60) were randomized to 0.6 mg/day folic acid or (6S)-5-MTHF x 16-weeks, with the option to continue until 1-week postpartum. Fasting (3-hr) blood specimens were collected at baseline (8-21-weeks’ gestation) and after 16-weeks (endline); at 1-week postpartum, non-fasting blood and human milk specimens were collected. Red blood cell (RBC) and serum folate were quantified via microbiological assay and UMFA (plasma and human milk) via LC-MS/MS. Differences in blood folate markers were evaluated using multivariable linear/quantile regression, adjusting for dietary folate, baseline concentrations (endline concentrations for postpartum estimates), and weeks of gestation (total weeks’ supplementing for postpartum estimates). At endline, mean ± SD (or median, IQR) RBC folate, serum folate, and plasma UMFA (nmol/L) in the (6S)-5-MTHF and folic acid groups, respectively, were: 1826 ± 471 and 1998 ± 421 (adjusted difference: 161, 95% CI: -79, 400); 70 ± 13 and 78 ± 17 (adjusted difference: 7.4, 95% CI: -1.4, 16); 0.5 (0.4, 0.8) and 1.3 (0.9, 2.1) (adjusted difference: 0.6, 95% CI: 0.2, 1.1). Postpartum median (IQR) RBC folate concentrations (nmol/L) were 1724 (1474, 1877) and 1962 (1576, 2284) (adjusted difference: 11, 95% CI: -272, 294). The mean ± SD proportion of human milk UMFA as part of total milk folate was 2% (±2%) and 28% (±14%) in the (6S)-5-MTHF and folic acid groups, respectively. In conclusion, conce…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/85189
note: A COMPARISON OF (6S)-5-METHYLTETRAHYDROFOLIC ACID VS FOLIC ACID AND THE EFFECTS ON MATERNAL FOLATE STATUS AND THE HUMAN MILK FOLATE PROFILE: EVIDENCE FROM A RANDOMIZED CLINICAL TRIAL by Kelsey M Cochrane B.Sc., University of Saskatchewan, 2014 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Human Nutrition) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) June 2023 © Kelsey M Cochrane, 2023 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: A comparison of (6S)-5-methyltetrahydrofolic acid vs folic acid and the effects on maternal folate status and the human milk folate profile: Evidence from a randomized clinical trial submitted by Kelsey M Cochrane in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Human Nutrition Examining Committee: Crystal D Karakochuk, Assistant Professor, Department of Food, Nutrition and Health, UBC Supervisor Angela M Devlin, Professor, Department of Pediatrics, UBC Supervisory Committee Member Deborah L O’Connor, Professor, Temerty Faculty of Medicine, University of Toronto External Examiner Joel Singer, Professor Emeritus, School of Population and Public Health, UBC University Examiner David Kitts, Professor, Department of Food Science, UBC University Examiner Additional Supervisory Committee Members: Jennifer A Hutcheon, Associate Professor, Department of Obstetrics & Gynaecology, UBC Supervisory Committee Member Rajavel Elango, Associate Professor, Department of Pediatrics, UBC Supervisory Committee Member iii Abstract Folic acid supplementation is recommended to support fetal development. However, folic acid is an oxidized form that must undergo reduction for use in the body, and unmetabolized folic acid (UMFA) is widely detected in circulation. (6S)-5-methyltetrahydrofolic acid (5-MTHF)…
has type: Thesis/Dissertation
date issued: 2023-11
is shown at: 10.14288/1.0434130
language: eng
degree discipline: Human Nutrition
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Karakochuk, Crystal D.
type: Text
identifier URI: http://hdl.handle.net/2429/85189