DLM: Homocysteine, Folate, B-12 (2001)
Citation:
Study Design:
Class:
- Click here for explanation of classification scheme.
Quality Rating:
Research Purpose:
- To summarize "the non-hematologic manifestations of folate deficiency (neural tube defects, cardiovascular disease, colon cancer) and their implications for clinical practice"
- Dietary sources of folate are provided as well as suggested focus areas for future research.
Inclusion Criteria:
None described.
Exclusion Criteria:
None described.
Description of Study Protocol:
The authors provide a review of "seminal studies in the clinical applications of folate metabolism."
Data Collection Summary:
Study selection criteria were not described.
Description of Actual Data Sample:
The authors list five seminal studies related to folate research and have a total of 19 references encompassing the relationship between folate and neural tube defects, cardiovascular disease and colon cancer.
Summary of Results:
- Neural tube defects: Four controlled intervention trials demonstrated that higher intakes of folate during the first six weeks of pregnancy could lower the incidence of birth defects by ~80%; mechanism unknown
- Cardiovascular disease: Blood homocysteine levels can be decreased by increased intake of folate. However, it has not been demonstrated that decreasing homocysteine levels will result in a decreased incidence of cardiovascular events.
- Colon cancer: More than15 epidemiologic studies indicate an inverse relationship between the risk of colorectal neoplasia and dietary intakes of folate; mechanism unknown
- Sources of folate: Fortified cereals, lentils, chickpeas, black beans, beef liber, spinach, asparagus
Author Conclusion:
Folate has transformed itself from a vitamin formerly thought of just interms of prevention of anemia into a compound that has major implication as in regard to some of the most important public health problems (i.e., congenital birth defects, cardiovascular disease and cancer).
Funding Source:
University/Hospital: | Tuffs University |
Reviewer Comments:
- Methods of study selection are not described
- No indicators of precision of findings is provided.
Quality Criteria Checklist: Review Articles
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Relevance Questions | |||
1. | Will the answer if true, have a direct bearing on the health of patients? | Yes | |
2. | Is the outcome or topic something that patients/clients/population groups would care about? | Yes | |
3. | Is the problem addressed in the review one that is relevant to dietetics practice? | Yes | |
4. | Will the information, if true, require a change in practice? | Yes | |
Validity Questions | |||
1. | Was the question for the review clearly focused and appropriate? | No | |
2. | Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? | No | |
3. | Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? | No | |
4. | Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? | No | |
5. | Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? | No | |
6. | Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? | Yes | |
7. | Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? | No | |
8. | Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? | No | |
9. | Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? | No | |
10. | Was bias due to the review's funding or sponsorship unlikely? | ??? | |