Plasma concentration of folate as a biomarker for the intake of fruit and vegetables: the Hordaland Homocysteine Study

Brevik, Asgeir; Vollset, Stein Emil; Tell, Grethe S.; Refsum, Helga; Ueland, Per Magne; Loeken, Elin Bjorge; Drevon, Christian A.; Andersen, Lene Frost

doi:10.1093/ajcn.81.2.434

Cited by 63 publications

(44 citation statements)

References 32 publications

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“…In populations who consume fortified foods, folate is not considered a good indicator of F&V consumption (42) . Data on consumption of flours were not collected in the present study but more than 80 % of children had consumed beans and meat daily.…”

Section: Discussionmentioning

confidence: 99%

Associations between low consumption of fruits and vegetables and nutritional deficiencies in Brazilian schoolchildren

Augusto

Cobayashi

Cardoso

2014

Public Health Nutr.

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Objective: We examined associations between the frequency of fruit and vegetable (F&V) consumption and nutritional deficiencies among Brazilian schoolchildren. Design: A cross-sectional, population-based study was performed. A short FFQ was used to assess consumption of fruits and vegetables (F&V) over the past month. The prevalence ratios (PR) and 95 % confidence intervals for stunting, obesity, anaemia, vitamin A and folate deficiencies, vitamin E and vitamin D insufficiencies were estimated for low F&V consumption frequency (vegetables ≤3 times/month and fruits ≤3 times/week) and compared with children with usual F&V consumption frequency (vegetables ≥1 time/week and fruits ≥4 times/week). Setting: Acrelândia, Western Brazilian Amazon. Subjects: A total of 702 children aged 4-10 years. Results: Only 5 % of children consumed F&V ≥5 times/d. Prevalence of deficiency was 31 %, 15 %, 9 % and 2 % for vitamins D, A, E and folate, respectively. Overall, 6·3 % of children were anaemic, 3·3 % were stunted, 2·7 % were obese and 33 % had multiple nutritional deficiencies. Low frequency of F&V consumption was associated with lower plasma concentrations of carotenoids and vitamin E. Nutritional deficiencies were higher among non-consumers of F&V when compared with usual consumers: anaemia (PR = 1·9; 95 % CI 1·0, 3·7), vitamin E insufficiency (PR = 2·5; 95 % CI 1·5, 4·2), vitamin D insufficiency (PR = 1·5; 95 % CI 1·1, 1·9) and stunting (PR = 2·6; 95 % CI 1·1, 6·1). Conclusions: In our study, the occurrence of nutritional deficiencies in children with low F&V consumption was twice as high as in children with usual F&V consumption, reinforcing the importance of effective actions to promote the consumption of F&V.

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Section: Discussionmentioning

confidence: 99%

Associations between low consumption of fruits and vegetables and nutritional deficiencies in Brazilian schoolchildren

Augusto

Cobayashi

Cardoso

2014

Public Health Nutr.

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“…that determined correlations between serum folate concentrations and folate intake estimated by a FFQ found correlation coefficients of 0·38 28 , 0·34 (crude) and 0·61 (adjusted) 29 , 0·06 30 , 0·42 31 and 0·13 32 . Previous studies that determined correlations between erythrocyte concentrations and folate intake found correlations coefficients of 0·25 28 , 0·08 30 and 0·20 31 .…”

Section: Discussionmentioning

confidence: 99%

Validation of a food frequency questionnaire to assess folate intake of Dutch elderly people

et al. 2007

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Folate is required for 1-carbon metabolism and deficiency in folate leads to megaloblastic anemia. Low levels of folate have been associated with increased risk of vascular disease. To investigate whether RDA of folate are met, habitual folate intake needs to be assessed reliably. We developed a FFQ to specifically measure folate intake over the previous 3 months in elderly people in the Netherlands. Major sources of folate intake, i.e. foods contributing to at least 80 % of the average folate intake, were identified through an analysis of the second Dutch Food Consumption Survey for the sub-population of men and women aged 50 -70. In 2000 and 2001, folate intake was estimated with this questionnaire in 1286 individuals aged 50-75 years. Concentrations of serum and erythrocyte folate served as biomarkers with which relative validity of the questionnaire was assessed. The same FFQ was repeated after 3 years in 803 subjects in order to assess long-term reproducibility. Mean folate intake was estimated to be 196 (SD 69) mg/d. Spearman correlation coefficients between folate intake and serum and erythrocyte concentrations were 0·14 (P,0·01) and 0·05 (P¼ 0·06) respectively. Spearman correlations between folate intakes measured at baseline and after 3 years were 0·58 (P,0·01). 47 % of the participants were classified in the same quartiles on the two occasions. Our FFQ showed a weak correlation between folate intake and blood folate concentrations and reproducibility was acceptable. This FFQ is able to rank subjects according to their folate intake. FFQ: Folate intake: Biomarkers: Validity: ReproducibilityFolate is a B vitamin that is essential for many aspects of human health. Deficiency of this B vitamin can lead to megaloblastic anemia 1 . A suboptimal folate status can increase the risk for women to have a child with a neural tube defect 2 . Furthermore, low folate status and subsequent elevated concentrations of plasma total homocysteine (tHcy) have been associated with neurocognitive dysfunction 3 , colon cancer 4 and vascular diseases 5 . Folate is found in foods such as liver, vegetables, bread, potatoes, dairy products and fruit 6 . In the Netherlands, the RDA of folate is 300 mg for adults 7 . However, many Dutch adults do not meet this recommendation 6 .There are different methods to assess habitual nutrient intake, but so far there is no gold standard. In large-scale epidemiological studies FFQ are preferred, because they are easy to administer and measure long-term intake. We developed a FFQ to assess folate intake over the past 3 months in Dutch elderly people. Here we describe the development of this questionnaire and subsequent comparison of the folate intake data with blood folate concentrations to assess the validity of the questionnaire. Furthermore long-term reproducibility was assessed. SubjectsBaseline data of subjects from three different folate supplementation studies undertaken by our group in the past years were combined: (1) The FACIT-study 8 , a double blind, randomised, placebo-controlled i...

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“…The low folate intake levels were reflected in a low folate status within the same study populations (de Bree et al, 2001a(de Bree et al, , 2003aBrevik et al, 2005;Van Guelpen et al, 2005). However, studies with data on folate status but not on intake, supported the notion that folate status in the abovementioned countries was low (Nurk et al, 2004;Hultdin et al, 2005).…”

mentioning

confidence: 85%

Dietary intake and status of folate and vitamin B12 and their association with homocysteine and cardiovascular disease in European populations

et al. 2007

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Background/Objectives: Folate and vitamin B12 have been suggested to play a role in chronic diseases like cardiovascular diseases. The objectives are to give an overview of the actual intake and status of folate and vitamin B12 in general populations in Europe, and to evaluate these in view of the current vitamin recommendations and the homocysteine concentration. Methods: Searches in Medline with 'folic acid', 'folate' and 'vitamin B12', 'B12' or 'cobalamin' as key words were combined with the names of the European countries. Populations between 18 and 65 years were included. Results: Sixty-three articles reporting on studies from 15 European countries were selected. Low folate intakes were observed in Norway, Sweden, Denmark and the Netherlands. Low intakes of vitamin B12 were not common and only seen in one small Greek study. In the countries with a low intake of folate, the recommended levels were generally not achieved, which was also reflected in the folate status. Vitamin B12 intake was not strongly associated with the vitamin B12 status, which can explain why in the Netherlands and Germany the vitamin B12 status was inadequate, despite sufficient intake levels. In countries with a low folate intake in particular, the Hcy concentration was higher than ideal. Conclusions: Populations from the Nordic countries, the Netherlands, Germany and Greece may need to improve their intakes of folic acid, B12 or both to either meet the recommendations or to optimize their statuses. This could be achieved via a foodbased approach, food fortification or supplements.

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Plasma concentration of folate as a biomarker for the intake of fruit and vegetables: the Hordaland Homocysteine Study

Abstract: Plasma folate concentration may be a useful biomarker for the intake of fruit and vegetables in populations consuming unfortified food products. The association can be attenuated by and should be corrected for individual intake of folic acid supplements.

Cited by 63 publications

References 32 publications

Associations between low consumption of fruits and vegetables and nutritional deficiencies in Brazilian schoolchildren

Associations between low consumption of fruits and vegetables and nutritional deficiencies in Brazilian schoolchildren

Validation of a food frequency questionnaire to assess folate intake of Dutch elderly people

Dietary intake and status of folate and vitamin B12 and their association with homocysteine and cardiovascular disease in European populations

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