This study will determine how folate supplementation affects both serum and red blood cell folate status in females ages 18 -24 years old. Additionally, this study will determine the effect of folate supplementation on mood, cognition, and sleep patterns. This study will fill a crucial gap in understanding how folate status affects a variety of health behaviors in order to better inform public health practice and prevention.
Preliminary studies conducted by the investigator's team indicate that 95.7% of previous participants (all alcohol consuming, ages 14-24), were below the threshold for red blood cell (RBC) folate status for women of childbearing potential. Understanding how the interaction of behaviors (alcohol use, nutrient supplementation, diet) contribute to sub-optimal folate status is critical to developing and expanding upon evidence-based FASD prevention programs. Notably, how nutrient supplementation might improve overall folate status in a group with poor folate status and other behaviors that confound the absorption of folate. Because the participants do not view themselves as being at risk for unwanted pregnancy, their motivation to take a supplement for a future pregnancy is very low. This team seeks to collect data on how folate supplementation might improve individually measured outcomes, like cognition and mood, so that interventions might be developed focusing on these individual outcomes. After becoming aware of the study, prospective participants will undergo a screening questionnaire for inclusion/exclusion criteria. Once the participant meets the inclusion criteria, the study will be fully explained and written informed consent will be handed out. Participants will be randomized in a single-blind manner (participant) in a 1:1 ratio to the Methyl Folate supplement (1,000 mcg, once daily) or placebo (once daily).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
20
1,000 mcg methyl folate and Microcrystalline Cellulose in a capsule
Microcrystalline Cellulose capsule
Oklahoma State University Center for Health Sciences
Tulsa, Oklahoma, United States
Red blood cell folate status
Red blood cell folate status will be analyzed through dried blood spot samples collected on Arrayit blood cards, which use linear flow chromatography to separate whole blood into erythrocyte and serum. Red blood cell folate values represent a longer-term reduction in folate consumption or increases in folate excretion. Overturn of red blood cells occurs every 4 months, therefore, red blood cell folate status will only be assessed at baseline. The WHO-recommended cutoff of \<340 nmol/L will be used to assess low red blood cell folate status.
Time frame: Baseline
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from baseline serum folate status at day 1
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 1 serum folate status at day 2
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 2 serum folate status at day 3
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Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 3 serum folate status at day 4
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 4 serum folate status at day 5
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 5 serum folate status at day 6
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 6 serum folate status at day 7
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 7 serum folate status at day 8
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 8 serum folate status at day 9
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 9 serum folate status at day 10
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 10 serum folate status at day 11
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 11 serum folate status at day 12
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 12 serum folate status at day 13
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 13 serum folate status at day 14
Change in serum folate status
Serum folate values will be analyzed through dried blood spot samples collected on Arrayit blood cards daily, which use linear flow chromatography to separate whole blood into erythrocyte and serum. The WHO-recommended cutoff of \<10 nmol/L will be used to assess low serum folate status. Results will be reported as a concentration with higher values indicating improved serum folate status.
Time frame: Change from day 14 serum folate status at day 15
Change in gastrointestinal symptoms
Gastrointestinal health symptoms will be assessed by a short questionnaire aimed at capturing side-effects commonly associated with oral supplementation such as nausea, vomiting, heartburn, abdominal pain, diarrhea, and constipation.
Time frame: Change from baseline gastrointestinal health status at day 7
Change in gastrointestinal symptoms
Gastrointestinal health symptoms will be assessed by a short questionnaire aimed at capturing side-effects commonly associated with oral supplementation such as nausea, vomiting, heartburn, abdominal pain, diarrhea, and constipation.
Time frame: Change from day 7 gastrointestinal health status at day 15
Change in dietary folate consumption
The Block Dietary Folate Equivalents (DFE) Screener: A 21-item measure validated specifically for folate. This screener measures folate intake within a 1-week time period and will be assessed throughout the study period. DFE results are given as an calculated average of micro-grams per day. DFE's above 400 micro-grams meet the RDA for the study population.
Time frame: Change from baseline dietary folate consumption at day 7
Change in dietary folate consumption
The Block Dietary Folate Equivalents (DFE) Screener: A 21-item measure validated specifically for folate. This screener measures folate intake within a 1-week time period and will be assessed throughout the study period. DFE results are given as an calculated average of micro-grams per day. DFE's above 400 micro-grams meet the RDA for the study population.
Time frame: Change from day 7 dietary folate consumption at day 15
Change in mood
The Patient Health Questionnaire (PHQ-9): 9-item self-report screening tool used to assess and identify symptoms related to depression. The PHQ-9 has potential scores of 0-27 with scores of 5, 10, 15, and 20 representing thresholds for mild, moderate, moderately severe, and severe depression, respectively. Positive and Negative Affect Schedule (PANAS-SF): 20-item self-report screening tool used to assess both positive and negative affect. Scores can range from 10-50, with higher scores representing higher levels of positive affect. Scores can range from 10-50, with lower scores representing lower levels of negative affect. Brief Mood Introspection Scale (BMIS): 16-adjective scale to assess pleasant-unpleasant mood (scale range of 16-64), arousal-calm mood (scale range of 12-48), positive-tired mood (scale range of 7-28), and negative-relaxed mood (scale range of 6-24). Adding up the scored items reveals where an individual lies on each of the 4 subscales.
Time frame: Change from baseline mood at day 7
Change in mood
The Patient Health Questionnaire (PHQ-9): 9-item self-report screening tool used to assess and identify symptoms related to depression. The PHQ-9 has potential scores of 0-27 with scores of 5, 10, 15, and 20 representing thresholds for mild, moderate, moderately severe, and severe depression, respectively. Positive and Negative Affect Schedule (PANAS-SF): 20-item self-report screening tool used to assess both positive and negative affect. Scores can range from 10-50, with higher scores representing higher levels of positive affect. Scores can range from 10-50, with lower scores representing lower levels of negative affect. Brief Mood Introspection Scale (BMIS): 16-adjective scale to assess pleasant-unpleasant mood (scale range of 16-64), arousal-calm mood (scale range of 12-48), positive-tired mood (scale range of 7-28), and negative-relaxed mood (scale range of 6-24). Adding up the scored items reveals where an individual lies on each of the 4 subscales.
Time frame: Change from day 7 mood at day 15
Change in cognition
The NIH Toolbox Cognition Battery assesses cognitive functioning. Cognitive reports include several calculated scores including Age-Corrected Standard Scores, Uncorrected Standard Scores, and Fully Corrected T-Scores. The higher the score on each cognitive test, the higher the cognitive functioning.
Time frame: Change from baseline cognitive functioning at day 7
Change in cognition
The NIH Toolbox Cognition Battery assesses cognitive functioning. Cognitive reports include several calculated scores including Age-Corrected Standard Scores, Uncorrected Standard Scores, and Fully Corrected T-Scores. The higher the score on each cognitive test, the higher the cognitive functioning.
Time frame: Change from day 7 cognitive functioning at day 15
Change in sleep patterns
The Oura Ring is a wellness tracker used to track an individual's nightly sleep cycle and physical activity 24 hours per day. All data is synced via a smartphone application.
Time frame: Change from baseline sleep patterns at day 7
Change in sleep patterns
The Oura Ring is a wellness tracker used to track an individual's nightly sleep cycle and physical activity 24 hours per day. All data is synced via a smartphone application.
Time frame: Change from day 7 sleep patterns at day 15
Change in hair, nails, and skin satisfaction
A 6 item self-report screening tool for assessing satisfaction of hair, nails, and skin. Scores can range from 0-6. Results are recorded using a likert scale and will indicate changes in physical attribute satisfaction as supplementation occurs. A higher score represents a greater satisfaction whereas a lower score represents a lower satisfaction.
Time frame: Change from baseline hair, nails, and skin satisfaction at day 7
Change in hair, nails, and skin satisfaction
A 6 item self-report screening tool for assessing satisfaction of hair, nails, and skin. Scores can range from 0-6. Results are recorded using a likert scale and will indicate changes in physical attribute satisfaction as supplementation occurs. A higher score represents a greater satisfaction whereas a lower score represents a lower satisfaction.
Time frame: Change from day 7 hair, nails, and skin satisfaction at day 15