Evidence map›Paper›PMID 41612855›Full record

SynthesisJournal of global health2026

Folate and global health umbrella review series, part 1: methodological framework and syntheses on anaemia and neural tube defects.

Samantha Yoo, Azita Montazeri, Derrick Bennett, Yacong Bo, Peizhan Chen, Susan Duthie, Natalie Jensen, Atipatsa Kaminga, Jun-Shi Lai, Xue Li and 18 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Samantha YooSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa.
Azita MontazeriSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa.
Derrick BennettNuffield Department of Population Health, University of Oxford, UK.
Yacong BoSchool of Public Health, Xinxiang Medical University, China.
Peizhan ChenClinical Research Centre, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Susan DuthieSchool of Pharmacy and Life Sciences, Robert Gordon University, Scotland, UK.
Natalie JensenSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa.
Atipatsa KamingaDepartment of Mathematics and Statistics, Faculty of Science, Technology and Innovation, Mzuzu University, Malawi.
Jun-Shi LaiSingapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.
Xue LiCentre for Population Health Sciences, University of Edinburgh, UK.
Amanda J MacFarlaneNutrition Research Division, Health Canada, Canada.
Homero MartinezResearch and Development Unit, Nutrition International, Canada.
Helene McNultyNutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK.
Franco MomoliSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa.
Peter MosseySchool of Dentistry, University of Dundee, Scotland, UK.
Patrick MullieInternational Prevention Research Institute, Lyon, France.
Ron MungerDepartment of Nutrition, Dietetics, and Food Sciences, College of Agriculture and Applied Sciences, Utah State University, USA.
Rajendra Prasad ParajuliHerbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, USA.
Monique Potvin KentSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa.
Michele RubiniDepartment of Neuroscience and Rehabilitation, University of Ferrara, Italy.
Marjanne SenekalDepartment of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa.
Lindsey SikoraHealth Sciences Library, University of Ottawa, Canada.
Alain StintziSchool of Pharmacy, Faculty of Medicine, University of Ottawa, Canada.
Evropi TheodoratouCentre for Global Health, Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, UK.
Hui WangSchool of Public Health, Faculty of Medicine, Shanghai Jiao Tong University, China.
Chittaranjan YajnikDiabetes Unit, KEM Hospital Research Centre, India.
Ann YaktineFood and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine, USA.
Julian LittleSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Folate is essential for normal growth and in human health throughout the lifecycle. Clinical deficiency of folate impairs DNA synthesis and results in megaloblastic anaemia, while suboptimal folate status before and in early pregnancy results in an elevated risk of neural tube defects (NTD). The evidence on the association of folate status with other health outcomes is largely fragmented and understudied. We conducted a series of umbrella reviews examining the association between folate and multiple health outcomes in various populations and settings. Methods: We searched MEDLINE, Embase, CINAHL, the Cochrane Library, and DARE from inception to February 2024 for systematic reviews with or without meta-analyses examining an association between folate intake/status and any health outcome. We performed screening and data extraction in duplicate and assessed the risk of bias using the ROBIS tool. Evidence was then characterised into unique associations (unique exposure measure - unique outcome measure - unique setting). For each category of unique associations, we identified the evidence based on the statistical power, recency of publication and the potential risk of bias. All unique associations were evaluated for credibility using predefined criteria. Results: We retrieved 3565 records and included 283 in the final synthesis. The evidence on anaemia consisted of four intervention trials demonstrating effectiveness of folic acid supplementation during pregnancy in reducing the risk of megaloblastic anaemia (relative risk (RR) = 0.21; 95% CI = 0.11, 0.38; I Conclusion: In NTDs and anaemia, we identified strong evidence supporting the protective role of folate status based on intervention trials and observational studies. More recent reviews examining the role of folate in other less well understood health conditions will be presented in the subsequent reports. Registration: PROSPERO: CRD42021265041.

Indexed as

AnemiaFolic AcidGlobal HealthNeural Tube DefectsDietary SupplementsFemaleFolic Acid DeficiencyHumansPregnancySystematic Reviews as TopicFolic Acid

Identifiers

PMID41612855
PMCPMC12856383

What OpenQuestion holds

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Registered trials

None linked

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.