Dietary folate intake and metabolic syndrome in participants of PREDIMED-Plus study: a cross-sectional study

Abstract

Background: Folate is involved in different metabolic processes such as the homocysteine metabolism, regulatory changes in genes related to lipid metabolism and the endothelial function, and its deficiency has been related to the risk of Metabolic Syndrome (MetS). We examined the association between folate intake and a score of MetS and its components among older adults at higher cardiometabolic risk participating in the PREDIMED-Plus trial. Methods:A cross-sectional analysis with 6633 overweight/obesity participants with MetS was conducted. Folate intake (per 100 mcg/day and in quintiles) was estimated using a validated food frequency questionnaire. We calculated a MetS score using the standardized values as shown in the formula: [(body mass index + waist-to-height ratio)/2] + [(systolic blood pressure + diastolic blood pressure)/2] + plasma fasting glucose -HDL cholesterol + plasma triglycerides. The MetS score as continuous variable and its seven components were the outcome variables. Multiple robust linear regression using MM-type estimator was performed to evaluate the association adjusting for potential confounders. Results:We observed that an increase in energy-adjusted folate intake was associated with a reduction of MetS score (β for 100 mcg/day=-0.12; CI 95%: -0.19 to -0.05), and plasma fasting glucose (β=-0.03; CI 95%: -0.05 to -0.02) independently of the adherence to Mediterranean diet and other potential confounders. We also found a positive association with HDL-cholesterol (β=0.07; CI 95%:0.04 to 0.10). These associations were also observed when quintiles of energy-adjusted folate intake were used instead. Conclusion:This study suggests that a higher folate intake may be associated with a lower MetS score, a lower plasma fasting glucose, and a greater HDL cholesterol in high-risk cardio-metabolic subjects.

Inverse Association of Serum Folate Level with Metabolic Syndrome and Its Components in Korean Premenopausal Women: Findings of the 2016–2018 Korean National Health Nutrition Examination Survey

“…Our results, showing no association between serum folate and FPG levels, are consistent with the findings of this previous meta-analysis by Akbari et al A recent study of children and adolescents revealed significantly decreased folate levels observed in groups with obesity and MetS [38]. Moreover, a recent study of older adults suggested that higher folate intake may be related to a lower MetS score [32]. In addition, previous studies have shown that folate levels are associated with metabolic parameters in postmenopausal women.…”

“…Folate, a crucial source of the one-carbon group utilized in methylation reactions and RNA/DNA synthesis, was found to be related to insulin resistance in nondiabetic adults in the United States [31]. Moreover, higher folate intake has been linked with better metabolic parameters in overweight/obese older adults with MetS [32]. Furthermore, increased body mass index (BMI), absolute amount of fat, and percent body fat are significantly related to lower serum folate concentrations in postmenopausal women [33].…”

Dietary Patterns and Their Association with Metabolic Syndrome and Their Components in Middle-Class Adults from Damascus, Syria: A Cross-Sectional Study

“…Among the participants who presented three metabolic syndrome components, a higher intake of proteins, lipids, monounsaturated fatty acids, polyunsaturated fatty acids, and vitamin E was reported compared to those without any component. In the case of folic acid, the behavior was the opposite, which is consistent with studies in which it has been suggested that a higher intake of folate may be associated with a lower MetS score and that the early correction of the levels of folic acid could help prevent cardiovascular complications in patients with MetS [ 41 ].…”

Circulating Levels of the Short-Chain Fatty Acid Acetate Mediate the Effect of the Gut Microbiome on Visceral Fat

“…Regarding the shared KEGG metabolic pathways, all the genomes presented starch and sucrose metabolism and pentose phosphate pathway, which are necessary to produce SCFAs (Topping and Clifton, 2001;Basen and Kurrer, 2020), and metabolism of essential amino acids, which can be absorbed meeting the amino acids requirements (Fuller and Tomé, 2005). Furthermore, all the species might be able to metabolize several vitamins/nutrients; including vitamins B, which has been associated with protective pathways involved in CMH; folate levels, which have been correlated with a lower metabolic syndrome score, plasma fasting glucose and a higher plasma HDL cholesterol (Navarrete-Muñoz et al, 2020); biotin, which has been shown to be involved in the glucose and lipid homeostasis (Fernandez-Mejia, 2005); thiamine, which may attenuate hypertension (Alaei-Shahmiri et al, 2015); and pyridoxine, might decrease triglyceride levels (Mottaghian et al, 2020).…”