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Division of Human Nutrition and Epidemiology, Wageningen Agricultural University, 6700 EV Wageningen;
Department of Obstetrics and Gynaecology,
**
Department of Epidemiology, and
Department of Chemical Endocrinology, University Hospital St. Radboud, 6500 HB Nijmegen;
§
Laboratory of Metabolic Diseases, Wilhelmina Children's Hospital, 3501 CA Utrecht and
¶
Unilever Research Vlaardingen, 3130 AC Vlaardingen, the Netherlands.
3To whom correspondence and requests for reprints should be addressed
Elevated total plasma homocysteine (tHcy) concentrations are considered a risk factor for neural tube defects (NTD) and cardiovascular disease. Supplementation with folic acid decreases the risk of women having children with NTD. In both sexes, it decreases tHcy levels. We investigated the efficacy of natural dietary folate in improving folate and homocysteine status. We performed a 4-wk dietary controlled, parallel design intervention trial with 66 healthy subjects (1845 y) divided into 3 treatment groups: the dietary folate group, the folic acid group and the placebo group. Each day each group was fed a different diet. The dietary folate group received a diet high in vegetables and citrus fruit (total folate content ~560 µg) plus a placebo tablet. The folic acid group received a diet naturally low in folate (~210 µg) plus 500 µg folic acid and placebo tablet on alternate days, i.e., 250 µg folic acid/d. And the placebo group received the same low-folate diet as the folic acid group plus a placebo tablet. After 4 wk of intervention, folate status improved, and tHcy concentrations decreased in both the dietary folate and the folic acid groups. From the amount of additional folate (350 µg/d) and folic acid (250 µg/d) consumed, the relative bioavailability of dietary folate compared to folic acid was calculated to be 6098%, depending on the endpoint used. In conclusion, increasing the consumption of vegetables and citrus fruit, both good sources of folate, will improve folate status and decrease tHcy concentrations. This may contribute to the prevention of cardiovascular disease and NTD in the general population
KEY WORDS: humans folate homocysteine vegetables fruit
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