ArticleCurrent developments in nutrition2026
Associations between Red Blood Cell Folate Forms and Demographic, Physiologic, and Lifestyle Factors in the United States Population: Cross-Sectional Data from the National Health and Nutrition Examination Survey August 2021-August 2023.
Article in Current developments in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Red blood cell (RBC) total folate (TFOL) is an indicator of long-term folate status. Data on RBC folate forms are lacking. They may inform associations with health-related indicators. Objectives: We aimed to describe associations between RBC folate forms and different factors in the United States population. Methods: We used data for 5 biologically active RBC folate forms [5-methyltetrahydrofolate (5-methylTHF), unmetabolized folic acid (UMFA), tetrahydrofolate (THF), 5-formyltetrahydrofolate (5-formylTHF), and 5,10-methenyltetrahydrofolate (5,10-methenylTHF); sum of which is TFOL] and 1 oxidation product of 5-methylTHF (MeFox) in persons aged ≥6 y participating in the National Health and Nutrition Examination Survey 2021-2023 cycle. We excluded pregnant or lactating females. We assessed bivariate associations between folate biomarkers [concentrations for TFOL, 5-methylTHF, THF, and MeFox; prevalences ≥limit of detection (LOD) for UMFA, 5-formylTHF, and 5,10-methenylTHF] and demographic, physiologic, and lifestyle variables in persons ≥20 y, accounting for the complex sample design. We estimated the impact of covariates on biomarker concentrations or odds ratios after covariate adjustment. Results: In persons ≥6 y ( Conclusions: Folic acid supplement use was the strongest predictor of RBC folate biomarker concentrations and detection. Differences in the methyl-to-nonmethyl makeup of RBC TFOL by race/Hispanic origin suggest potential biological and/or genetic influences.
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