Effects of once-a-week or daily folic acid supplementation on red blood cell folate concentrations in women

Abstract

Objective: Our aim was to determine if a once-a-week folic acid supplement increases women's red blood cell folate to concentrations (>905 nmol/l) that are associated with a low risk of bearing a child with a neural tube defect.

Design: Randomized control trial.

Setting: General community.

Subjects: In total, 114 nonpregnant women (18-40 y) volunteers, with red blood cell folate concentrations between 295 and 905 nmol/l at screening.

Intervention: Women were randomized to receive a once-a-week 2800 microg folic acid supplement, a daily 400 microg folic acid supplement or a daily placebo for 12 weeks.

Results: The mean (95% CI) red blood cell folate concentrations increased during the 12-week intervention from 608 (553-668) to 900 (828-978) in the weekly folic acid group (P<0.05) and from 615 (560-677) to 1053 (957-1158) nmol/l in the daily group (P<0.05) during the trial. At week 12, 49% of women ingesting the weekly folic acid supplement had red blood cell folate concentrations greater than 905 nmol/l compared to 74% of women ingesting the daily supplement.

Conclusion: A once-a-week 2800 microg folic acid supplement can increase women's red blood cell folate to concentrations associated with a reduced risk of bearing a child with a neural tube defect, but is less effective than a 400 microg daily supplement. Use of a weekly folic acid supplement over at least 12 weeks before conception by women of child-bearing age may prevent neural tube defects.

Funding: The Otago Medical Research Foundation (Laurenson Award). Healtheries (New Zealand) provided the supplements.