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Is folic acid for everybody? Present knowledge suggest that a substantial minority (10%) of people may have increased folate needs because of common genetic variants that interact with particular nutrients. Homozygosity for a 677C -> T mutation at the locus that codes for 5,10-methylenetetrahydrofolate reductase (MTHFR), a folate-dependent crucial enzyme in homocysteine metabolism, may render the enzyme thermolabile and less active and has been associated with increased levels of plasma total homocysteine (tHcy). Nevertheless, mutant MTHFR prevalence and its relation with birth defect occurrence in different population still is unknown.

Dally S, Mills JL, Molloy AM, Conley M, Lee YJ, Kirke PN, Weir DG, Scott JM (1997) Minimum effective dose of folic acid for food fortification to prevent neural tube defects. Lancet 350:1666-1669.