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Mineral water fortified with folic acid, vitamins B6, B12, D and calcium improves folate status and decreases plasma homocysteine concentration in men and women

European Journal of Clinical Nutrition volume 58, pages 376–385 (2004)Cite this article

Abstract

Objective: We investigated the effects of mineral water fortified with folic acid, vitamins B6, B12, D and calcium on folate concentrations in serum and erythrocytes, serum vitamin B12 and plasma homocysteine concentrations in free-living subjects. In addition, we investigated the bioavailability of calcium added to mineral water by measuring urinary calcium excretion and serum alkaline phosphatase activity.

Design: Randomized, controlled, double-blinded, parallel design.

Setting: Outpatient dietary intervention with free-living subjects in Eastern Finland.

Subjects: Altogether, 66 subjects were recruited for the study. In all, 60 subjects completed the study.

Interventions: The study began with a 2-week run-in period followed by an 8-week intervention period. During the intervention study, subjects consumed mineral water fortified with folic acid (563 μg/day), vitamins B6 (1 mg/day), B12 (7.5 μg/day), cholecalciferol (0.6 μg/day) and calcium (563 mg/day) or placebo mineral water.

Results: The fortified mineral water increased serum and erythrocyte folate concentrations by 16.1±5.6 nmol/l (P<0.001) and 199±76 nmol/l (P<0.001), respectively, and decreased plasma homocysteine concentration by 1.6 μmol/l (P<0.001). Urinary calcium excretion and serum alkaline phosphatase activity for 24 h increased significantly (P<0.001 and P=0.01 respectively) in the intervention group.

Conclusions: Mineral water fortified with folic acid, vitamins B6, B12 and D and calcium enhanced folate status and reduced plasma homocysteine concentration in normohomocysteinemic subjects without folate deficiency. Indirect measures of calcium and bone metabolism indicated that the calcium used in the fortification of the mineral water was bioavailable.

Sponsorship: Olvi PLC, Iisalmi, Finland.

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Acknowledgements

We thank Päivi Huuskonen and Jouni Hodju for excellent technical assistance, and Leena Toppinen for nutrient-intake calculations.

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Authors and Affiliations

  1. Oy Foodfiles Ltd (Contract research organization), Kuopio, Finland

    N S Tapola, H M Karvonen & E S Sarkkinen

  2. Department of Medicine, University of Kuopio, Kuopio, Finland

    L K Niskanen

Authors
  1. N S Tapola
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  2. H M Karvonen
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  3. L K Niskanen
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  4. E S Sarkkinen
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Contributions

Contributors: Researchers of the contract research organization Oy Foodfiles Ltd were responsible for planning and carrying out the study in practice, and for reporting it with Dr Niskanen, MD serving as the medical adviser. All the authors have participated in writing the manuscript.

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Correspondence to N S Tapola.

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Tapola, N., Karvonen, H., Niskanen, L. et al. Mineral water fortified with folic acid, vitamins B6, B12, D and calcium improves folate status and decreases plasma homocysteine concentration in men and women. Eur J Clin Nutr 58, 376–385 (2004). https://doi.org/10.1038/sj.ejcn.1601795

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