Folic acid is a small substance with great effects. How many health problems do you know?

1 Folic acid is a:

A. Vitamin B

B Vitamin E

C fatty acids

D Minerals

Correct answer: A

Folic acid, also known as vitamin B9, is a water-soluble vitamin. In 1941, scientists first isolated this substance from spinach leaves and named it "folic acid", which has been widely used. Folic acid participates in the process of cell DNA synthesis and amino acid metabolism in the body and is an essential nutrient for the human body.

2 Folic acid deficiency may cause:

A. Hyperhomocysteinemia

B Megaloblastic anemia

C Neural tube defects

D All of the above

Correct answer: D

Folic acid deficiency will manifest as decreased serum folate levels, which in turn will lead to decreased red blood cell folate levels and increased serum homocysteine ​​levels. Severe folate deficiency can lead to changes in giant cells in the bone marrow and other rapidly proliferating tissues and megaloblastic anemia. Insufficient folate levels in pregnant mothers may cause neural tube closure disorders in the fetus. More than 50% of newborn neural tube defects are related to insufficient folate in early pregnancy.

3. How much folic acid content is required in a food to be called “high or rich in folic acid”?

A Folate content ≥ 180 μg DFE/100g solid

B Folate content ≥ 120 μg DFE/100g solid

C Folic acid content ≥ 90 μg DFE/100g solid

D Folic acid content ≥ 60 μg DFE/100g solid

*DFE: dietary folate equivalent

Correct answer: B

According to my country's "General Rules for Nutrition Labeling of Pre-packaged Foods" (GB 28050-2011), foods with a folic acid content ≥ 120 μgDFE/100g (solid) or ≥ 60μgDFE/100ml (liquid) can be called "high or rich in folic acid" foods, and foods with a folic acid content ≥ 60 μgDFE/100g (solid) or ≥ 30μgDFE/100ml (liquid) can be called "containing folic acid" or "folate source" foods.

4In daily life, which of the following foods is rich in folic acid?

A. Quinoa

B. Pork liver

C. Spinach

D All of the above

Correct answer: D

In the case of folic acid deficiency, it is first recommended to improve folic acid nutrition through a balanced diet. Foods rich in folic acid include quinoa, dried soybeans or mixed beans, bean curd sticks, spinach, fennel, amaranth, animal liver, lean meat, duck eggs, etc. [1].

5Which of the following statements about folic acid is correct?

A Natural folic acid and synthetic folic acid are used in the body at the same rate

The folic acid in B nutrient supplements is natural folate

C The structure of folic acid in natural foods is unstable

D The human body can synthesize folic acid

Correct answer: C

The human body cannot synthesize folic acid on its own, so we can only take it from the outside. The folic acid we ingest includes natural folic acid in ordinary foods and chemically synthesized folic acid in fortified foods and nutrient supplements. Although folic acid in natural foods is relatively safe, its bioavailability is low due to its unstable structure (it is easily destroyed during food processing) and its absorption and utilization in the body is affected by factors such as drugs, alcohol, and other nutrient deficiencies. Even for the general population, it is difficult to meet the recommended folic acid intake. For people at high risk of folic acid deficiency, further measures such as folic acid supplementation or fortified foods should be adopted to improve the folic acid deficiency.

6 In my country, the incidence of neural tube defects in newborns is approximately:

A 1.2/100,000

B 1.2/10,000

C 1.2/million

D 1.2/thousand

Correct answer: B

Neural tube defects, also known as neural tube malformations, are a type of congenital defect caused by incomplete closure of the neural tube in early embryonic development. The main clinical manifestations include anencephaly, encephalocele, spina bifida, and myelomeningocele. Anencephaly and severe encephalocele often cause stillbirth and fetal death. Although a few can be born alive, their survival time is very short. Although spina bifida and mild encephalocele can survive, they cannot be cured and often lead to lifelong disability. The formation mechanism of neural tube defects is very complex and is the result of the combined action of genetic and environmental factors. A large number of studies have shown that folic acid supplementation before and during pregnancy can significantly reduce the risk of neural tube defects. After years of national preventive intervention, the incidence of neural tube defects has dropped from 11.96/10,000 in 2000 to 1.2/10,000 in 2019 [2].

7 In general, most women who are preparing for pregnancy need to supplement folic acid every day:

A 400 μg per day

B400 mg daily

C200 mg daily

D200 μg daily

Correct answer: A

For women without high-risk factors, it is recommended to supplement folic acid by 0.4 mg or 0.8 mg per day starting from the time of pregnancy or at least 3 months before pregnancy[3]. It is also recommended that women who are preparing for pregnancy or in early pregnancy should eat more foods rich in folic acid, such as green leafy vegetables and fresh fruits, and develop a healthy lifestyle. For women with neural tube defects, diabetes, obesity, epilepsy, hyperhomocysteinemia and other diseases, they may need to increase the amount of folic acid supplementation or extend the time of supplementation during the period of preparing for pregnancy. It is recommended to consult a doctor for specific plans and make personalized folic acid supplementation according to the specific situation.

8In order to prevent neural tube defects in newborns, when should we start taking folic acid supplements?

A After discovering pregnancy

BAfter the first prenatal check-up

C may be pregnant or started at least 3 months before pregnancy

D. Mid- to late-pregnancy

Correct answer: C

For women without high-risk factors, it is generally recommended to start taking folic acid from the time of possible pregnancy or at least 3 months before pregnancy until the 3rd month of pregnancy. In addition, it is recommended that women in mid- and late-pregnancy and breastfeeding women continue to supplement folic acid at a dose of 0.4 mg per day in addition to regularly consuming foods rich in folic acid, which can further reduce the risk of megaloblastic anemia, preeclampsia, and gestational hypertension.

9. Hyperhomocysteinemia may increase the risk of:

A. Stroke

B. Hypertension

C. Complications of diabetes

D All of the above

Correct answer: D

Hyperhomocysteinemia is an independent risk factor for stroke. The risk of stroke increases by 4.2 times in people with blood homocysteine ​​levels higher than 10.50 μmol/L. In addition, studies have shown that hyperhomocysteinemia may also increase the risk of cardiovascular events, hypertension, diabetic microangiopathy, and fractures[4].

10 The optimal dose of folic acid supplementation to lower blood homocysteine ​​is:

A 400 μg per day

B800 μg daily

C400 mg daily

D800 mg daily

Correct answer: B

First of all, it is recommended that patients with hyperhomocysteinemia undergo healthy lifestyle interventions, including quitting smoking, limiting alcohol consumption, eating a healthy diet, and increasing exercise, which can help lower homocysteine ​​levels and prevent a variety of diseases. For nutritional treatment of hyperhomocysteinemia, daily supplementation of 0.8 mg of folic acid is the best dose to lower blood homocysteine. Other drugs include vitamin B12, vitamin B6, betaine, etc. It is recommended to follow the doctor's advice for relevant treatment.

By now, you have a deeper understanding of the role and supplementation of folic acid. It is important to maintain a healthy lifestyle and a balanced diet. You can eat more foods rich in folic acid, such as spinach and quinoa. If you are preparing to get pregnant or have diseases such as hyperhomocysteinemia or megaloblastic anemia, you may need additional folic acid supplementation. It is recommended that you follow the guidance of your doctor or pharmacist and take folic acid in moderation.

References:

[1] Chinese Medical Education Association Clinical Rational Drug Use Committee, China Medical Health International Exchange Promotion Association Hypertension Branch, China Maternal and Child Health Association Perinatal Nutrition and Metabolism Committee, etc. Multidisciplinary Expert Consensus on Rational Folic Acid Supplementation in Clinical Practice in China [J]. Chinese Journal of Medical Frontiers (Electronic Edition), 2020, 12(11): 19-37.

[2] National Maternal and Child Health Monitoring Office, National Maternal and Child Health Annual Report Office. National Maternal and Child Health Monitoring and Annual Report Newsletter 2021 Issue 3 [EB/OL]. (2021-06) [2021-06-

[3] Working Group on Guidelines for Peri-conceptional Folic Acid Supplementation to Prevent Neural Tube Defects, Ren Aiguo, Zhang Xuejuan, et al. Guidelines for Peri-conceptional Folic Acid Supplementation to Prevent Neural Tube Defects (2017)[J]. Chinese Journal of Reproductive Health, 2017, 28(05): 401-410.

[4] Kong Juan. Expert consensus on the diagnosis and treatment of hyperhomocysteinemia[J]. Electronic Journal of Tumor Metabolism and Nutrition, 2020, 7(03): 283-288.