SynthesisPublic health nutrition2015
The effect of folate fortification on folic acid-based homocysteine-lowering intervention and stroke risk: a meta-analysis.
Synthesis in Public health nutrition, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 7 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Folic acid for the primary prevention of stroke: a systematic review and meta-analysis.Frontiers in nutrition · 2024Pooled it
- The role of homocysteine levels as a risk factor of ischemic stroke events: a systematic review and meta-analysis.Frontiers in neurology · 2023Pooled it
- Omega-3 Polyunsaturated Fatty Acids and Stroke Burden.International journal of molecular sciences · 2019Pooled it
- Fortification of wheat and maize flour with folic acid for population health outcomes.The Cochrane database of systematic reviews · 2019Pooled it
- Homocysteine-lowering interventions for preventing cardiovascular events.The Cochrane database of systematic reviews · 2017Pooled it
- Folic Acid Supplementation and the Risk of Cardiovascular Diseases: A Meta-Analysis of Randomized Controlled Trials.Journal of the American Heart Association · 2016Pooled it
- Effect of B vitamin (folate, B6, and B12) supplementation on osteoporotic fracture and bone turnover markers: a meta-analysis.Medical science monitor : international medical journal of experimental and clinical research · 2015Pooled it
- Effect of Folic Acid, Betaine, Vitamin B₆, and Vitamin B12 on Homocysteine and Dimethylglycine Levels in Middle-Aged Men Drinking White Wine.Nutrients · 2016Trial
- Astrocytic Redox Homeostasis as a Metabolic Modulator of DNA Damage and Repair in the Ischemic Penumbra.Cells · 2026Review
- Folate and global health review series, part 3: syntheses on cardiovascular, cerebrovascular, and metabolic diseases.Journal of global health · 2026Review
- B vitamins and cardiovascular health: mechanisms, clinical evidence, and precision prevention strategies.Nutrition & metabolism · 2026Review
- Serine Hydroxymethyltransferase (SHMT) in biology and disease: molecular mechanisms and therapeutic targeting.Journal of translational medicine · 2026Review
- Role of hyperhomocysteinemia in atherosclerosis: from bench to bedside.Annals of medicine · 2025Review
- Genetic and epigenetic architectures of stroke: Insights from GWAS to precision medicine.Neurochemistry international · 2025Review
- Combined effect of hyperhomocysteinemia and mild-to-moderate chronic kidney disease on mortality and cardiovascular events in the Japanese general population: the Yamagata (Takahata) study.Clinical and experimental nephrology · 2025Observational
- Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022.Journal of atherosclerosis and thrombosis · 2024Article
- Deficiencies in one-carbon metabolism led to increased neurological disease risk and worse outcome: homocysteine is a marker of disease state.Frontiers in nutrition · 2024Review
- Review
- Intended and Unintended Benefits of Folic Acid Fortification-A Narrative Review.Foods (Basel, Switzerland) · 2023Review
- Need for a nutrition-specific scientific paradigm for research quality improvement.BMJ nutrition, prevention & health · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveFolate and vitamin B12 are two vital regulators in the metabolic process of homocysteine, which is a risk factor of atherothrombotic events. Low folate intake or low plasma folate concentration is associated with increased stroke risk. Previous randomized controlled trials presented discordant findings in the effect of folic acid supplementation-based homocysteine lowering on stroke risk. The aim of the present review was to perform a meta-analysis of relevant randomized controlled trials to check the how different folate fortification status might affect the effects of folic acid supplementation in lowering homocysteine and reducing stroke risk.
designRelevant randomized controlled trials were identified through formal literature search. Homocysteine reduction was compared in subgroups stratified by folate fortification status. Relative risks with 95 % confidence intervals were used as a measure to assess the association between folic acid supplementation and stroke risk.
settingThe meta-analysis included fourteen randomized controlled trials, SUBJECTS: A total of 39 420 patients.
resultsHomocysteine reductions were 26·99 (sd 1·91) %, 18·38 (sd 3·82) % and 21·30 (sd 1·98) %, respectively, in the subgroups without folate fortification, with folate fortification and with partial folate fortification. Significant difference was observed between the subgroups with folate fortification and without folate fortification (P=0·05). The relative risk of stroke was 0·88 (95 % CI 0·77, 1·00, P=0·05) in the subgroup without folate fortification, 0·94 (95 % CI 0·58, 1·54, P=0·82) in the subgroup with folate fortification and 0·91 (95 % CI 0·82, 1·01, P=0·09) in the subgroup with partial folate fortification.
conclusionsFolic acid supplementation might have a modest benefit on stroke prevention in regions without folate fortification.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.