Effect of Folate Supplementation on Inflammatory Markers in Individuals Susceptible to Depression: A Systematic Review

Helen Barnett, Nathan Martin D'CUNHA, Ekavi GEORGOUSOPOULOU, Jane KELLETT, Duane MELLOR, Andrew MCKUNE, Nenad NAUMOVSKI

Research output: Contribution to journalLiterature review

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Abstract

Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of neural tube defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p > 0.05). The single L-MTHF trial that explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton depression rating scale from adjunctive treatment with 15 mg/day of L-MTHF compared with placebo (−6.8 ± 7.2 vs. −3.7 ± 6.5; p = 0.017) and improvement with L-MTHF for most genetic markers. Currently, there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.
Original languageEnglish
Pages (from-to)1-15
Number of pages15
JournalExploratory Research and Hypothesis in Medicine
Volume2
Issue number4
DOIs
Publication statusPublished - 26 Dec 2017

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Folic Acid
Genetic Polymorphisms
Placebos
Leucovorin
Neural Tube Defects
Flour
Genetic Markers
Methylation
Antidepressive Agents
Libraries
Public Health
Clinical Trials
Databases
Guidelines

Cite this

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title = "Effect of Folate Supplementation on Inflammatory Markers in Individuals Susceptible to Depression: A Systematic Review",
abstract = "Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of neural tube defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p > 0.05). The single L-MTHF trial that explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton depression rating scale from adjunctive treatment with 15 mg/day of L-MTHF compared with placebo (−6.8 ± 7.2 vs. −3.7 ± 6.5; p = 0.017) and improvement with L-MTHF for most genetic markers. Currently, there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.",
keywords = "Folic Acid, Homocysteine, Depression, Epigenomics",
author = "Helen Barnett and D'CUNHA, {Nathan Martin} and Ekavi GEORGOUSOPOULOU and Jane KELLETT and Duane MELLOR and Andrew MCKUNE and Nenad NAUMOVSKI",
year = "2017",
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Effect of Folate Supplementation on Inflammatory Markers in Individuals Susceptible to Depression: A Systematic Review. / Barnett, Helen; D'CUNHA, Nathan Martin; GEORGOUSOPOULOU, Ekavi; KELLETT, Jane; MELLOR, Duane; MCKUNE, Andrew; NAUMOVSKI, Nenad.

In: Exploratory Research and Hypothesis in Medicine, Vol. 2, No. 4, 26.12.2017, p. 1-15.

Research output: Contribution to journalLiterature review

TY - JOUR

T1 - Effect of Folate Supplementation on Inflammatory Markers in Individuals Susceptible to Depression: A Systematic Review

AU - Barnett, Helen

AU - D'CUNHA, Nathan Martin

AU - GEORGOUSOPOULOU, Ekavi

AU - KELLETT, Jane

AU - MELLOR, Duane

AU - MCKUNE, Andrew

AU - NAUMOVSKI, Nenad

PY - 2017/12/26

Y1 - 2017/12/26

N2 - Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of neural tube defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p > 0.05). The single L-MTHF trial that explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton depression rating scale from adjunctive treatment with 15 mg/day of L-MTHF compared with placebo (−6.8 ± 7.2 vs. −3.7 ± 6.5; p = 0.017) and improvement with L-MTHF for most genetic markers. Currently, there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.

AB - Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of neural tube defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p > 0.05). The single L-MTHF trial that explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton depression rating scale from adjunctive treatment with 15 mg/day of L-MTHF compared with placebo (−6.8 ± 7.2 vs. −3.7 ± 6.5; p = 0.017) and improvement with L-MTHF for most genetic markers. Currently, there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.

KW - Folic Acid

KW - Homocysteine

KW - Depression

KW - Epigenomics

UR - http://www.mendeley.com/research/effect-folate-supplementation-inflammatory-markers-individuals-susceptible-depression-systematic-rev

U2 - 10.14218/ERHM.2017.00025

DO - 10.14218/ERHM.2017.00025

M3 - Literature review

VL - 2

SP - 1

EP - 15

JO - Exploratory Research and Hypothesis in Medicine

JF - Exploratory Research and Hypothesis in Medicine

SN - 2472-0712

IS - 4

ER -