After the first positive assessment made by the China National Center for Food Safety Risk assessment (CFSA) on early 2016, the use of Quatrefolic® as Food Nutritional Fortification Substance now enters in force in China.

The published monograph defines dosage and intended use of Quatrefolic®, the 5-MTHF glucosamine salt, as a new active ingredient, introducing this innovative folate instead of the already known folic acid.

Here below the officially publication:

Quatrefolic® is the metabolically active folate that is not affected by the common impairments of folate metabolism since it does not require the complex absorption, metabolic and enzymatic steps that are required by folic acid. Contrary to folic acid, Quatrefolic® – being the metabolically active form of folate – is not influenced by the polymorphism of the MTHFR (methyltetrahydrofolate reductase) enzyme, a genetic defect with a high incidence in Chinese population.

In these part of the population folic acid is not effectively converted to the biologically active form 5-MTHF (methylfolate) due to the reduced enzymatic activity. Therefore, the beneficial effect of folic acid supplementation is not guaranteed in the folate deficiency related status of people, like Chinese.

Focus on Chinese incidence of MTHFR polymorphism

In the recent years, a wide numbers of clinical studies have investigated the incidence of this polymorphism in China. Of particular relevance, the very recent meta-analysis published in 2016 by Wang et al. where sixty-six studies were identified with a total of 92277 study participants, in 23 provinces in Mainland China.

The meta-analysis revealed that the frequencies of the MTHFR C677T allele and the 677TT genotype increased from lower values (5% and 17%, respectively) in Guangxi, to intermediate values (12% and 32%, respectively) in Anhui, to higher values (39% and 62%, respectively) in Shandong.

The frequency of the 1298C allele was found to be the lowest in northern China [18% (17%-19%)], intermediate in central China [18% (17%-19%)], and highest in southern China [28% (24%-31%)]. The mean frequency of the 1298C allele was 20% (18%-22%).