Ukr.Biochem.J. 2022; Volume 94, Issue 5, Sep-Oct, pp. 40-46


Dietary intake of folate and the frequency of its deficiency in children with type 1 diabetes mellitus and healthy children

L. I. Dobrovolska*, O. R. Boyarchuk, M. I. Kinash

І. Horbachevsky Ternopil National Medical University,
Department of Children’s Diseases and Pediatric Surgery, Ternopil, Ukraine;

Received: 29 January 2022; Revised: 22 March 2022;
Accepted: 20 September 2022; Available on-line: 19 December 2022

Adequate folate intake is essential for a child’s growth. There is lack of information about the prevalence of this nutrient deficiency in the Ukrainian population, including children. The aim of the study was to evaluate the dietary intake of folate and determine the frequency of folate deficiency in children with Type 1 diabetes mellitus (T1D) and healthy children. Determination of folate in serum was performed by ELISA. Folate level <3 ng/ml was diagnosed as a folate deficiency. Among all observed children the folate deficiency was diagnosed in 23 (32.9%): in 6 (17.1%) patients with T1D and in 17 (48.6%) healthy children (P ≤ 0.01). The mean level of serum folate in patients with T1D was (5.09 ± 2.16) ng/ml and (3.72 ± 1.87) ng/ml in healthy children (P ≤ 0.01). The average daily intake of folate with food was (138.68 ± 70.37) µg, without difference between T1D (12.00 ± 3.51 yr.) and healthy groups (10.83 ± 3.24 yr.), and it was more than two times lower than age requirements (300 µg/day). However, it was self-reported that 15 (48.9%) children of T1D group received vitamin supplementation one time in six months, while in healthy children only 6 (17.1%) children received vitamins (P ≤ 0.01). In conclusion, the frequency of folate deficiency is high in the pediatric population. Nutrition does not provide the necessary intake of folate, which indicates the need for additional folate supplementation.

Keywords: , , , ,


  1. Haimi M, Lerner A. Nutritional deficiencies in the pediatric age group in a multicultural developed country, Israel. World J Clin Cases. 2014;2(5):120-125. PubMed, PubMedCentral, CrossRef
  2. Boyarchuk OR, Dobrovolska LI, Kinash MI, Shulhai OM, Hlushko KT, Horishnyi IM. Survey assesment of vitamin D and calcium dietary intake in children with somatic pathology. Vopr Pitan. 2019;88(5):53-62. (In Russian). PubMed, CrossRef
  3. Kinash M, Boyarchuk O, Dobrovolska L. Zinc: its impact on immune function in children. Pediatr Pol. 2021;96(4):263-269. CrossRef
  4. Bailey LB, Stover PJ, McNulty H, Fenech MF, Gregory JF, Mills JL, Pfeiffer CM, Fazili Z, Zhang M, Ueland PM, Molloy AM, Caudill MA, Shane B, Berry RJ, Bailey RL, Hausman DB, Raghavan R, Raiten DJ. Biomarkers of Nutrition for Development-Folate Review. J Nutr. 2015;145(7):1636S-1680S. PubMed, PubMedCentral, CrossRef
  5. de Benoist B. Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull. 2008;29(2 Suppl):S238-S244. PubMed, CrossRef
  6. Rusak E, Rotarska-Mizera A, Adamczyk P, Mazur B, Polanska J, Chobot A. Markers of Anemia in Children with Type 1 Diabetes. J Diabetes Res. 2018;2018:5184354. PubMed, PubMedCentral, CrossRef
  7. Los E, Wilt AS. Diabetes Mellitus Type 1 In Children. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. PubMed
  8. American Diabetes Association. 13. Children and Adolescents: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019;42(Suppl 1):S148-S164. PubMed, CrossRef
  9. MacKenzie KE, Wiltshire EJ, Gent R, Hirte C, Piotto L, Couper JJ. Folate and vitamin B6 rapidly normalize endothelial dysfunction in children with type 1 diabetes mellitus. Pediatrics. 2006;118(1):242-253. PubMed,CrossRef
  10. Bergström L. Nutrient losses and gains in the preparation of foods: NLG project. Food Chem. 1996;57(1):77-78. CrossRef
  11. Khan KM, Jialal I. Folic Acid Deficiency. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. PubMed
  12. Devalia V, Hamilton MS, Molloy AM, British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol. 2014;166(4):496-513. PubMed, CrossRef
  13. U.S. Department of Agriculture, Agricultural Research Service. FoodData Central, 2019. Regime of access :
  14. U.S. Food and Drug Administration. (2016, April 14). FDA approves folic acid fortification of corn masa flour. (Press Release).
  15. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998. CrossRef
  16. Gómez-Bueno S, Vázquez-López MA, García-Escobar I, Cabrera-Sevilla JE, Ortiz Pérez M, Bonillo-Perales A, Lendinez-Molinos F. Status of folate in healthy children in Almeria. Eur J Pediatr. 2021;180(6):1825-1832. PubMed, CrossRef
  17. Solvik BS, Strand TA, Kvestad I, Markhus MW, Ueland PM, McCann A, Øyen J. Dietary Intake and Biomarkers of Folate and Cobalamin Status in Norwegian Preschool Children: The FINS-KIDS Study. J Nutr. 2020;150(7):1852-1858. PubMed, PubMedCentral, CrossRef
  18. Theisen-Toupal J, Horowitz GL, Breu AC. Utility, charge, and cost of inpatient and emergency department serum folate testing. J Hosp Med. 2013;8(2):91-95. PubMed, CrossRef
  19. Asbaghi O, Ashtary-Larky D, Bagheri R, Moosavian SP, Olyaei HP, Nazarian B, Rezaei Kelishadi M, Wong A, Candow DG, Dutheil F, Suzuki K, Alavi Naeini A. Folic Acid Supplementation Improves Glycemic Control for Diabetes Prevention and Management: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021;13(7):2355. PubMed, PubMedCentral, CrossRef
  20. Lind MV, Lauritzen L, Kristensen M, Ross AB, Eriksen JN. Effect of folate supplementation on insulin sensitivity and type 2 diabetes: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2019;109(1):29-42. PubMed, CrossRef
  21. Hlushko K, Boyarchuk O, Kinash M, Burbela E, Rohalska Y, Dobrovolska L. Awareness of folic acid use and its effects among medical students in Ukraine. Wiad Lek. 2021;74(9 cz 1):2033-2038. PubMed
  22. Kovalchuk T, Boyarchuk O. Serum pyridoxine, folate, cobalamin, and homocysteine levels in children presenting with vasovagal syncope. Cardiol Young. 2022;32(5):762-768. PubMed, CrossRef

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License.