HY-FOLIC® FOR PREGNANCY
Supplementation of Folat is very important during the pre-pregnancy and early pregnancy periods because the need of folate increases significantly during the periods. Folate is very important for supporting cell growth and division, DNA repair, and the formation of the fetal central nervous system.
According to research, low folate intake can increase the risk of birth defects, particularly neural tube defects (NTD) and poor fetal or placental growth. This is one of the early factors that contribute to stunting, a condition of growth failure in infants (children under five years of age) due to chronic malnutrition, resulting in children being too short for their age (Kemenkes, 2022).
Every women are advised to have Sufficient folate levels at least one month before conception and to maintain those levels during the first three months of pregnancy, childbirth and breastfeeding.
HY-FOLIC® as a source of 5-MTHF (active folate), it can meet folate requirements during pregnancy planning, pregnancy, and breastfeeding to support fetal development, prevent birth defects, and reduce the risk of stunting from an early age.
Prevention of Stunting Begins in the First 1000 Days of Life
Stunting is a condition of growth failure in children under five years of age due to chronic malnutrition and recurrent infections, especially during the first 1,000 days of life, calculated from the fetal period to 23 months of age. Stunting also hinders cognitive development, which will affect a child's intelligence and future productivity. Stunting and malnutrition are also among the leading causes of death in children under five years of age. Stunting and other nutritional issues are estimated to reduce Gross Domestic Product (GDP) by approximately 3% annually.
The 2016 Global Nutrition Report notes that Indonesia ranks 108 third out of 132 countries in terms of stunting prevalence. In Southeast Asia, Indonesia has the second highest prevalence of stunting after Cambodia. Prevention of stunting needs to focus on addressing the direct and indirect causes of malnutrition. Direct causes include inadequate nutritional intake and infectious diseases.
The effects of stunting can include delayed brain development, reduced intelligence, and an increased risk of chronic diseases in adulthood. Therefore, nutritional interventions during the first 1,000 days of life, from preconception to the age of 2 years, are crucial.
HY-FOLIC® containing 5-MTHF (Active Folate) plays a role in:
· Supports fetal and placental growth
· Ensuring optimal brain and nervous system development
· Reducing the risk of low birth weight, premature birth, and child growth disorders, which are the starting points for stunting
· Preventing congenital malformations
Prevention of Neural Tube Defect (NTD) in Fetus
Neural tube defects (NTDs) result from abnormal embryonic development of the nervous system. The two most common types of NTDs are spina bifida and anencephaly, which affect the central nervous system in the brain and spinal cord.
Generally, during the first month of pregnancy, the two sides of the fetal spine (backbone) join together to cover and protect the spinal cord, spinal nerves, and meninges (the tissue that covers the spinal cord). At this point, the developing brain and spine are called the neural tube. As it develops, the top of the neural tube becomes the brain, and the rest of the tube becomes the spinal cord. NTDs occur when the tube does not close completely.
Low levels of Folate in women before and during early pregnancy play a role in this type of NTD condition. For a woman who is thinking of getting pregnant or is currently pregnant, it is important to take prenatal vitamins to ensure adequate Folate intake.
Importance of Folate during Pregnancy
Folate helps reduce the risk of premature birth, low birth weight, developmental defects such as cleft lip and cleft palate, and neural tube defects such as spina bifida. These defects occur in the early stages of pregnancy, when the neural tube does not form properly, hindering the normal development of the baby's brain and spinal cord.
The human body cannot produce Folate on its own. Folate is found in many foods, including spinach, green leafy vegetables, and whole grains. Folate is an essential nutrient for women who are planning a pregnancy, during pregnancy, and breastfeeding, but Folate intake from food alone does not meet daily Folate needs so additional supplements are needed. Supplementation of 5-MTHF (active folate) could be a solution for increasing folate levels more efficiently.
Difference between Folic Acid and 5-MTHF (Active Folate)
Folic Acid and 5-MTHF (active folate) are not the same thing. Folic Acid is the inactive form of folate used in many supplements and fortified foods. Folic Acid must go through several metabolic stages in the body to be converted into the active form, which is 5-methyltetrahydrofolate (5-MTHF), as contained in HY-FOLIC® products.
Figure 1: Folic Acid Metabolism Process
In the body, everyone cannot metabolize Folic Acid into 5-MTHF (active folate) with the same efficiency. In other words, Folic Acid supplementation is not effective for some people. As a result, unmetabolized folic acid (UMFA) will be detected in the bloodstream, where UMFA is associated with several health problems.
This is caused by genetic variations of MTHFR (methylenetetrahydrofolate reductase), which is the gene that produces the enzyme to convert Folic Acid into 5-MTHF (active folate). Based on studies, 25% of the world population and 42% of the population in Southeast Asia, and 37,1% in Indonesia have genetic variations/polymorphisms of MTHFR enzymes C677>T and A1298>C that inhibit this process, so Folic Acid cannot be optimally utilized.
As a result, despite taking folic acid supplements, a person with the MTHFR polymorphism remains at high risk of folate deficiency.
HY-FOLIC® does not require this conversion process, as it is already in active form and can be used immediately.
What is MTHFR gene polymorphism?
MTHFR is an important enzyme involved in metabolizing folic acid into 5-MTHF (active folate). Slight variations in the MTHFR gene can cause the enzyme to does not work properly, hindering the conversion from folic acid to 5-MTHF (active folate).
Variations in the MTHFR gene vary worldwide. It is estimated that more than 40% of the world's population has genetic variations that affect folate conversion. Some common variants of the MTHFR gene have been identified, such as C677T and A1298C. Individuals with MTHFR polymorphisms have only 55-70% efficiency compared to individuals without these genetic variations.
MTHFR polymorphisms during pregnancy have a major impact given that pregnancy significantly increases folate requirements. Individuals with MTHFR polymorphism are at risk of not benefiting from folic acid supplementation, even in high doses.
HY-FOLIC® that contains 5-MTHF (active folate) is particularly instrumental as it does not require the metabolic processes that depend on the MTHFR gene.
The Dangers of UMFA (Unmetabolized Folic Acid)
Based on studies, Folic Acid at doses above 200 mcg per day can increase UMFA in the blood, and as a result can be detected in the human bloodstream. Increased UMFAs in the blood are associated with various health problems. Several studies have shown that UMFA levels can be detrimental to health, including:
HY-FOLIC® can be the best choice as a substitute for Folic Acid supplementation because it does not have the potential to form UMFA
Solution: HY-FOLIC as a Biologically Active Form of Folic Acid
HY-FOLIC® contains 5-MTHF (Active Folate) 1,100 mcg, is readily absorbed and utilized by the body, it dors not require metabolic activation and is directly available to the mother and the fetus, being not influenced by the possible MTHFR gene mutation. 5-MTHF (Active Folate) supplementation bypasses the UMFA issue of supplementing pregnant woman with a supraphysiological dose of folic acid, especially needed for woman who are planning a pregnancy, are pregnant, and are breastfeeding.
Figure 2. Percentage of folate forms in blood
Figure 3. Percentage of folate forms in maternal serum (mother's blood) and neonate cord serum
5-MTHF (active folate) in HY-FOLIC® is the most dominant physiological form of folate found in maternal blood serum (Figure 2), and neonate cord blood serum (Figure 3). The most dominant form of folate found in blood is5-MTHF (active folate), which is 91%. In addition, 5-MTHF (active folate) was also the most dominant form of folate in maternal blood serum (average 82.50% of total folate) and in neonate cord blood serum (average 89.40% of total folate). Therefore, active folate supplementation in the form of5-MTHF (active folate) during pregnancy is necessary as the main source of fetal folate needs. Consumption of the active biological form of folate directly can ensure that folate needs are met, both to support fetal development, prevent birth defects, and reduce the risk of early stunting.
Stunting is not only caused by a lack of food, but also by a lack of essential micronutrients such as folate from the beginning of life
PT. SIMEX PHARMACEUTICAL INDONESIA as one of the pharmaceutical companies in Indonesia presents HY-FOLIC® supplement product which contains the active form of folate (5-MTHF). HY-FOLIC® as active folate does not form UMFA which occurs in folic acid administration. HY-FOLIC® has better absorption compared to folic acid; has a dose that can be used for therapy in pregnancy and infertility; and is easy to take. HY-FOLIC® contains 5-MTHF (active folate) which has been approved by FDA and EFSA and HY-FOLIC® has halal certified.
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