Open AccessSystematic Review of Observational Studies with Dose-Response Meta-Analysis between Folate Intake and Status Biomarkers in Adults and the Elderly
Author(s) -
R Novaković,
Anouk Geelen,
Danijela RistićMedić,
Mariikolić,
Olga W. Souverein,
Helene McNulty,
Maresa Duffy,
Leane Hoey,
Carla Dullemeijer,
J.M.S. Renkema,
Mirjana Gurinović,
Marija Glibetić,
Lisette C. P. G. M. de Groot,
Pieter van’t Veer
Publication year - 2018
Publication title -
annals of nutrition and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.926
H-Index - 81
eISSN - 1421-9697
pISSN - 0250-6807
DOI - 10.1159/000490003
Subject(s) - medicine , homocysteine , observational study , meta analysis , endocrinology , zoology , biology
Background: Dietary reference values for folate intake vary widely across Europe. Methods: MEDLINE and Embase through November 2016 were searched for data on the association between folate intake and biomarkers (serum/plasma folate, red blood cell [RBC] folate, plasma homocysteine) from observational studies in healthy adults and elderly. The regression coefficient of biomarkers on intake (β) was extracted from each study, and the overall and stratified pooled β and SE (β) were obtained by random effects meta-analysis on a double log scale. These dose-response estimates may be used to derive folate intake reference values. Results: For every doubling in folate intake, the changes in serum/plasma folate, RBC folate and plasma homocysteine were +22, +21, and –16% respectively. The overall pooled regression coefficients were β = 0.29 (95% CI 0.21–0.37) for serum/plasma folate (26 estimates from 17 studies), β = 0.28 (95% CI 0.21–0.36) for RBC (13 estimates from 11 studies), and β = –0.21 (95% CI –0.31 to –0.11) for plasma homocysteine (10 estimates from 6 studies). Conclusion: These estimates along with those from randomized controlled trials can be used for underpinning dietary recommendations for folate in adults and elderly.