Evidence map›Paper›PMID 42396914›Full record

ReviewJournal of global health2026

Folate and global health review series, part 4: syntheses on folate and autoimmune diseases and skeletal outcomes.

Samantha Yoo, Azita Montazeri, Derrick Bennett, Yacong Bo, Peizhan Chen, Susan Duthie, Natalie Jensen, Atipatsa Kaminga, Jun-Shi Lai, Xue Li and 16 more

Abstract readReview
In one paragraph

Review 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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

26 authors.

Samantha YooSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Canada.
Azita MontazeriSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Canada.
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, Canada.
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, Canada.
Peter MosseySchool of Dentistry, University of Dundee, Scotland, UK.
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, Canada.
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.
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, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Autoimmune diseases and bone density loss (osteopenia and osteoporosis) are chronic conditions of complex aetiology that affect diverse populations. Folate may be associated with a higher risk of these disorders due to its essential role in one-carbon metabolism required for nucleotide synthesis, homocysteine metabolism, and methylation processes. However, the evidence on this association is inconclusive. Methods: We searched MEDLINE, Embase, CINAHL, the Cochrane Library, and the Database of Abstracts of Reviews of Effects from inception to February 2024 for systematic reviews and meta-analyses investigating the associations between folate exposure (dietary intake, supplementation, or blood concentrations) and any autoimmune diseases or skeletal outcomes. Pairs of researchers screened the retrieved syntheses, extracted the relevant data, assessed their risk of bias using the ROBIS tool, and evaluated the credibility of the evidence using predefined criteria. Results: We found 19 reviews reporting 25 unique associations: 15 on autoimmune diseases (multiple sclerosis, inflammatory bowel disease, psoriasis, human immunodeficiency virus, vitiligo, and systemic lupus erythematosus) and 10 on skeletal outcomes (fractures and bone mineral density loss). Most of the syntheses consisted of small-scale case-control studies. The risk of bias in the included syntheses was high. Owing to the small sample sizes, all the unique associations were assessed to be at a weak level of credibility. Conclusions: The evidence on the relationship between folate status and autoimmune diseases or skeletal outcomes was limited in breadth and depth. Most of the 25 unique associations were reported by a single synthesis comprising small-scale studies. Subgroup analyses or dose-response analyses were severely limited or unavailable. More well-powered, prospective studies investigating the relationships between folate and autoimmune and skeletal conditions are warranted. Registration: PROSPERO: CRD42021265041.

Indexed as

Autoimmune DiseasesFolic AcidGlobal HealthOsteoporosisBone DensityDietary SupplementsHumansFolic Acid

Identifiers

PMID42396914
PMCPMC13329937

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.