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SYSTEMATIC REVIEW article

Front. Nutr.
Sec. Nutritional Epidemiology
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1288417
This article is part of the Research Topic Micronutrient Metabolism: Molecular Pathways and Pharmacology View all 8 articles

Folic acid for the primary prevention of stroke: a systematic review and meta-analysis

Provisionally accepted
Jianjian Yang Jianjian Yang 1Jia Wang Jia Wang 2Bo Li Bo Li 3Yaxi Zhang Yaxi Zhang 1*
  • 1 Wenzhou Central Hospital, Wenzhou, Zhejiang Province, China
  • 2 Weihai Maternal and Child Health Hospital, the Affiliated Weihai Second Municipal Hospital of Qingdao University, Weihai, China, Weihai, China
  • 3 Department of Health, Weihai, Huancui District, China, Weihai, China

The final, formatted version of the article will be published soon.

    Results from studies were inconsistent with regard to the effect of folic acid on the primary prevention of stroke. The aim of this study was to analyze the association between folic acid and the primary prevention of stroke using the data from observational studies and randomized controlled trials (RCTs).Eligible publications published until June 2024 were searched in the database of PubMed, Web of Science and Embase. This study included all observational studies and RCTs of folic acid with first stroke as the reporting endpoints. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled in the random-effects model to assess the effect of folic acid on the primary prevention of stroke.Results from 12 observational publications with 16 research, including 312,320 participants, were combined to explore the association between dietary folic acid intake and the primary prevention of stroke. The results showed that high dietary folic acid intake was associated with a 17% reduction in stroke incidence (RR:0.83; 95%CI: 0.73-0.94), and the effect of dietary folic acid was greater in areas without grain fortification (RR:0.80; 95%CI: 0.67-0.95). The pooled results from 12 RCTs, totaling 75,042 participants, indicated that folic acid supplementation was not associated with the stroke primary prevention (RR:0.92; 95%CI: 0.80-1.05), but folic acid supplementation was effective in areas without grain fortification (RR:0.78; 95%CI: 0.68-0.89).Our meta-analysis demonstrated that dietary folic acid is effective in stroke primary prevention, and folic acid supplementation is effective in stroke primary prevention only in areas without grain fortification.

    Keywords: Folic Acid, Folate, supplementation, Stroke, Primary Prevention, Meta-analysis

    Received: 21 Sep 2023; Accepted: 18 Jul 2024.

    Copyright: © 2024 Yang, Wang, Li and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yaxi Zhang, Wenzhou Central Hospital, Wenzhou, 325000, Zhejiang Province, China

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