Ingestão de folato nos períodos pré e pós-fortificação mandatória: estudo de base populacional em São Paulo, Brasil

Marchioni, Dirce Maria Lobo; Verly, Eliseu; Steluti, Josiane; César, Chester Luís Galvão; Fisberg, Regina Mara

doi:10.1590/0102-311x00084712

Cited by 16 publications

(12 citation statements)

References 49 publications

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“…The prevalence of inadequate folate intake has dropped since the adoption of the mandatory fortification of flour with folic acid in Brazil [29], but, at the same time, the load of methionine in this population is supposed to be high, due to the high intake of meat [30] and beans [31]. In this situation, homocysteinemia may arise from impaired methionine metabolism, and, consequently, more folate, B12 and betaine are needed to remethylation Hcy back to methionine [3].…”

Section: Discussionmentioning

confidence: 99%

“…Considering the transmethylation demand due to the methionine load, and the high intake of folic acid from mandatory fortification and adequate status of other B vitamins [29], [30], [31], the possible mechanism underlying the reduction effects of FV intake below the 75 th percentile could be that the homocysteine metabolism is working well, but, above this level, folate acts indirectly to lower homocysteine levels and insures optimal functioning of the remethylation pathway. However, it is known that high oral doses of folic acid can bypass the normal folate absorption mechanism [36].…”

Section: Discussionmentioning

confidence: 99%

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A Quantile Regression Approach Can Reveal the Effect of Fruit and Vegetable Consumption on Plasma Homocysteine Levels

et al. 2014

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IntroductionA reduction in homocysteine concentration due to the use of supplemental folic acid is well recognized, although evidence of the same effect for natural folate sources, such as fruits and vegetables (FV), is lacking. The traditional statistical analysis approaches do not provide further information. As an alternative, quantile regression allows for the exploration of the effects of covariates through percentiles of the conditional distribution of the dependent variable.ObjectiveTo investigate how the associations of FV intake with plasma total homocysteine (tHcy) differ through percentiles in the distribution using quantile regression.Materials and MethodsA cross-sectional population-based survey was conducted among 499 residents of Sao Paulo City, Brazil. The participants provided food intake and fasting blood samples. Fruit and vegetable intake was predicted by adjusting for day-to-day variation using a proper measurement error model. We performed a quantile regression to verify the association between tHcy and the predicted FV intake. The predicted values of tHcy for each percentile model were calculated considering an increase of 200 g in the FV intake for each percentile.ResultsThe results showed that tHcy was inversely associated with FV intake when assessed by linear regression whereas, the association was different when using quantile regression. The relationship with FV consumption was inverse and significant for almost all percentiles of tHcy. The coefficients increased as the percentile of tHcy increased. A simulated increase of 200 g in the FV intake could decrease the tHcy levels in the overall percentiles, but the higher percentiles of tHcy benefited more.ConclusionsThis study confirms that the effect of FV intake on lowering the tHcy levels is dependent on the level of tHcy using an innovative statistical approach. From a public health point of view, encouraging people to increase FV intake would benefit people with high levels of tHcy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Quantile Regression Approach Can Reveal the Effect of Fruit and Vegetable Consumption on Plasma Homocysteine Levels

et al. 2014

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“…Another Brazilian study with adolescents, adults, and older adults found that breads and beans contribute most to dietary folate, and breads provided the highest contribution regardless of the subject's age 16 . The established folate requirement of pregnant women exceeds that of nonpregnant women, and it is challenging to meet the requirement without fortified foods and/or supplementation 30 .…”

Section: Discussionmentioning

confidence: 98%

Folate inadequacy in the diet of pregnant women

2014

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OBJECTIVE: To estimate food and dietary folate inadequacies in the diets of adult pregnant women. METHODS: A prospective study was conducted with 103 healthy pregnant adult users of the Public Health Care System of Ribeirão Preto, São Paulo, Brazil. The present study included the 82 women with complete food intake data during pregnancy, which were collected by three 24-hour dietary recalls. Food folate (folate naturally present in foods) and dietary folate (food folate plus folate from fortified wheat flour and cornmeal) inadequacies were determined, using the Estimated Average Requirement as cutoff. RESULTS: The diets of 100% and 94% of the pregnant women were inadequate in food folate and dietary folate, respectively. However, fortified foods increased the medium availability of the nutrient by 87%. CONCLUSION: The large number of pregnant women consuming low-folate diets was alarming. Nationwide population studies are needed to confirm the hypothesized high prevalence of low-folate diets among pregnant women.

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“…The results of a previous study showed that homozygotes (TT) for the MTHFR 677C>T mutation presented one-third of the expected activity for this enzyme [31]. It has been suggested that folic acid from fortified food primarily increases the intake and serum concentration of folate [32]. The synthetic form of folate, folic acid, needs to be converted into 5-methyltetrahydrofolate (5MeTHF) through the enzyme MTHFR.…”

Section: Discussionmentioning

confidence: 99%

“…Folic acid fortification considerably reduces the inadequacy of folate prevalence within levels considered to be safe in the inhabitant population of São Paulo [32]; however, the profile of genetic variability among this population remains unknown. Indeed, the presence of these polymorphisms modifies the metabolism and alters the concentrations of these metabolites, as differences in homocysteine concentrations were observed in individuals with genetic variants of MTHFR 677C>T. These effects in health and disease are inconclusive; therefore, the evaluation of such variants must be considered in future epidemiological studies.…”

Section: Discussionmentioning

confidence: 99%

Genetic Variants Involved in One-Carbon Metabolism: Polymorphism Frequencies and Differences in Homocysteine Concentrations in the Folic Acid Fortification Era

et al. 2017

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Folate and other B vitamins are essential co-factors of one-carbon metabolism, and genetic variants, such as polymorphisms, can alter the metabolism. Furthermore, the adoption of food fortification with folic acid showed a decrease of homocysteine concentration. The aim of this study was to investigate the frequencies of the polymorphisms of enzymes and carrier proteins involved in one-carbon metabolism, and to evaluate homocysteine concentrations in the presence of these genetic variants in a population exposed to mandatory food fortification with folic acid. Using data from a population-based cross-sectional study in São Paulo, Brazil, the study population comprised 750 participants above 12 years of age of both genders. A linear regression model was used to evaluate the homocysteine concentrations according to genetic variants and folate level. The results showed that the minor allelic frequencies were 0.33 for MTHFR (rs1801133), 0.24 for MTHFR (rs1801131), 0.19 for MTR (rs1805087), 0.42 for MTRR (rs1801394), 0.46 for RFC1 (rs1051266), and 0.47 for DHFR (19-bp deletion). The genetic variants of MTHFR 677C>T, MTRR 66A>G and RFC-1 80G>A were different according to race. The homocysteine concentrations increased in the CT and TT compared to CC genotypes of polymorphism MTHFR 677C>T in all populations, and differences between the homocysteine concentrations according to the genotypes of MTHFR 677C>T were observed regardless of folate level.

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Ingestão de folato nos períodos pré e pós-fortificação mandatória: estudo de base populacional em São Paulo, Brasil

Cited by 16 publications

References 49 publications

A Quantile Regression Approach Can Reveal the Effect of Fruit and Vegetable Consumption on Plasma Homocysteine Levels

A Quantile Regression Approach Can Reveal the Effect of Fruit and Vegetable Consumption on Plasma Homocysteine Levels

Folate inadequacy in the diet of pregnant women

Genetic Variants Involved in One-Carbon Metabolism: Polymorphism Frequencies and Differences in Homocysteine Concentrations in the Folic Acid Fortification Era

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