Gnosis touts Quatrefolic supplement when conceiving, UK warns there is insufficient research

02 Sep 2022 --- Supplementing with (6S)-5-methyltetrahydrofolic acid (MTH) may be preferable to folic acid in certain cases surrounding pregnancy, according to a Gnosis by Lesaffre-backed study. Currently, around 80 countries across the world fortify with folic acid.

NutritionInsight delves into the details surrounding the supplementation and speaks to the UK’s Department of Health and Social Care (DHSC), as the country prepares to amend regulations to fortify food and flour with folic acid.

“No scientific studies exist that show that supplements containing other forms of folate such as 5-MTHF can prevent neural tube defects (NTDs),” a spokesperson says. 

An alternative option?
Gnosis’ self-funded study is published in Alternative Therapies in Health and Medicine Journal, over its Quadrefolic product.

Before and at the early stages of pregnancy, maintaining high levels of folate in the body is crucial for child development. In the periconceptional period, insufficient folate levels may lead to infertility, and during pregnancy, it may causeNTD.

“This peer-review represents an important scientific tool to educate people, consumers, and partners. Today the integration of the science emerged on the active folate, like Quatrefolic, and the clinical practice by doctors and practitioners is the key, since those of them may be reluctant to change or adapt treatment protocols even if supported by science,” says Silvia Pisoni, global market manager, Gnosis by Lesaffre.

“Integration is also the key to better protect women and newborns and support fertility issues,” she adds.

Preconceptional and pregnant women are at the highest risk of folate deficiency, as well as those suffering from methylenetetrahydrofolate reductase (MTHFR) polymorphisms. 

Contradicting mainstay policiesThe Food and Nutrition Board at the US National Institute of Health recommends a daily dosage of folic acid for adults to be 400 micrograms.
The DHSC spokesperson highlights there is an absence of research on how other forms of folate can prevent NTDs.”

“Folic acid is more heat-stable than natural food folate, which is broken down easily by heat and light; therefore, folic acid is better suited for food fortification because many fortified products, such as bread, are baked.”

Gnosis by Lesaffre outlines that “supplementation of folic acid and (6S)5-MTHF is mandatory and prescribed by physicians in pregnant women and women of childbearing age for prophylaxis and treatment of folate deficiencies.”

The scientists behind the study argue that different forms of folate have entered the market space in recent years, and it is essential to differentiate them. “All grouped under the folate umbrella has emerged both from the scientific community and consumers,” the company notes.

The study, therefore, aims to clarify and distinguish between natural and synthetic forms of folic acid and drive consumers to question the supplements they consume.

Folic acid requires metabolic activation. The study argues that (6S)5-MTHF supplementation during pregnancy is preferred compared to folic acid. Additionally, it does not influence MTHFR gene mutations in the fetus.

“Supplementation of (6S)5-MTHF sidesteps the concerns about the risk of deleterious effects of unmetabolized folic acid due to folic acid supplementation and the high dosage required, especially in people with enzyme polymorphism,” Gnosis notes.

Folic acid in the headlinesFolate supplements have been grouped under one umbrella in recent years, the scientists highlight the importance of differentiation.
The Food and Nutrition Board at the US National Institute of Health recommends a daily dosage of folic acid for adults to be 400 micrograms, and to increase to 600 micrograms for pregnant women, then decrease slightly to 500 micrograms when lactating. 

Recently, the UK government has proposed to fortify flour with folic acid. The University College of London slammed this suggestion in a paper for the inadequate dosage to prevent birth defects.

“Mandatory fortification of flour with folic acid can greatly reduce the number of disabilities and early deaths caused by NTDs. However, what is currently proposed is only a token level of fortification,” professor Sir Nicholas Wald said previously.

The UK government announced its proposal to fortify flour and the amount for fortification is to be decided by the Department of Environment, Food and Rural affairs. The government is considering adding 250 micrograms of folic acid per 100 g of flour, holding a consultation between September 1 and November 23. 

Estimating that the initiative would prevent 200 birth defects annually, the suggestion might pose challenges for the wheat industry as mandatory folic acid in goods such as bread would impose an increased intake for the whole population that consumes such foods.

Prescribed supplementation linked to COVID-19 morbidities
A separate study published in BMJ Journal found a link between high folic acid levels and a higher risk of COVID-19 infection. Additionally, the study found that people prescribed folic acid supplementation were associated with higher death risk caused by the infection. 

The study included 26,033 participants who tested positive for COVID-19, operating as the intervention group, and the remaining 354,347 participants were perceived as the control group. 

The study stresses limitations in the research, such as not including a younger population and a broader ethnicity group, yet concludes that the findings are justified on the link between folic acid supplementation and a higher COVID-19 risk.

By Beatrice Wihlander

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