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Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes
03:19

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Folate fortification and supplementation do not provide vascular health benefits in type 1 diabetes

Alexia Sophie Peña1, Oana Maftei, Kate Dowling

  • 1Department of Pediatrics, University of Adelaide, Adelaide, South Australia, Australia. alexiasophie@yahoo.com

The Journal of Pediatrics
|February 5, 2013
PubMed

Insights

Mandatory folate fortification improved folate status and vascular function in children with type 1 diabetes. Additional folic acid supplementation did not further enhance endothelial function in these children.

Area of Science:

  • Pediatric Endocrinology
  • Cardiovascular Health
  • Nutritional Science

Background:

  • Type 1 diabetes is associated with endothelial dysfunction.
  • Mandatory folate fortification in Australia may impact folate status and vascular health in children.
  • Previous studies suggested a potential benefit of folic acid on endothelial function.

Purpose of the Study:

  • To determine the lowest effective dose of folic acid for improving endothelial function in children with type 1 diabetes.
  • To assess the dose-response relationship of folic acid supplementation on endothelial function.
  • To compare endothelial function in children with type 1 diabetes before and after mandatory folate fortification.

Main Methods:

  • Randomized, double-blind, crossover, placebo-controlled trial.
  • 20 children with type 1 diabetes received folic acid (0.5, 2, 5 mg) or placebo.
  • Endothelial function assessed by flow-mediated dilatation (FMD) 2 hours post-intervention.

Main Results:

  • Folic acid supplementation increased serum and red blood cell folate levels.
  • No significant improvement in flow-mediated dilatation (FMD) was observed with any folic acid dose.
  • Children post-fortification had significantly higher baseline folate levels and improved vascular function compared to pre-fortification.

Conclusions:

  • Mandatory folate fortification has improved folate status and endothelial function in children with type 1 diabetes.
  • Additional folic acid supplementation does not provide further endothelial benefits in this population.
  • The established folate status likely saturates the beneficial effects of folic acid on vascular function.
Abstract

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