Introduction
Subjects and methods
Study design and population
Dietary assessment
Blood sampling and analysis
Statistical analysis
Results
Basic demographic characteristics of participants are presented in Table 1
Folate intake
Folate intake | Folate status | |
---|---|---|
N
| 1797 | 300 |
Women (%) | 56 | 54 |
Age (years) | 49 (35–62) | 50 (37–64) |
BMI (kg/m2) | 24.7 (22.5–27.6) | 24.7 (22.6–27.5) |
PAL | 1.7 (1.6–1.8) | 1.7 (1.6–1.8) |
Vegetable intake (g/d) | 163 (109–224) | 186 (124–241) |
Fruit and berries intake (g/d) | 109 (38–191) | 113 (44–202) |
Intake of folic acid supplements number (%) | 20 (1) | 20 (8) |
Folate intake (µg/d) | Folate intake (µg/10 MJ) | DFE (µg/day) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
All | Low-energy reporters excluded | All | Low-energy reporters excluded | All | ||||||||
n
| Median (Q
1–Q
3) |
n
| Median (Q
1–Q
3) |
p
|
n
| Median (Q
1–Q
3) |
n
| Median (Q
1–Q
3) |
p
|
n
| Median (Q
1–Q
3) | |
All | 1797 | 246 (196–304) | 1467 | 261 (215–318) | 0.000 | 1797 | 302 (253–367) | 1467 | 298 (250–360) | 0.210 | 1797 | 257 (201–323) |
Male | 792 | 257 (204–316) | 627 | 276 (229–332) | 0.000 | 792 | 278 (232–336) | 627 | 273 (230–327) | 0.190 | 792 | 268 (210–336) |
Female | 1005 | 237 (189–294) | 840 | 249 (207–307) | 0.000 | 1005 | 326 (272–390) | 840 | 323 (271–383) | 0.360 | 1005 | 247 (195–211) |
Female aged 18–44 y | 450 | 227 (181–282) | 369 | 240 (199–294) | 0.002 | 450 | 301 (256–355) | 369 | 296 (254–345) | 0.400 | 450 | 239 (185–300) |
p (sex) < 0.001 |
p (sex) < 0.001 |
p (sex) < 0.001 |
p (sex) < 0.001 |
p (sex) < 0.001 | ||||||||
p (female) < 0.001 |
p (female) = 0.001 |
p (female) < 0.001 |
p (female) < 0.001 |
p (female) < 0.001 | ||||||||
Fruit and vegetable consumption
| ||||||||||||
Fruit and vegetables <200 g/d | 519 | 191 (152–235) | 354 | 211 (171–251) | 0.000 | 519 | 249 (213–293) | 354 | 236 (205–276) | 0.002 | 519 | 198 (155–248) |
Fruit and vegetables 200–350 g/d | 680 | 239 (201–284) | 569 | 250 (211–290) | 0.004 | 680 | 299 (261–347) | 569 | 294 (258–337) | 0.110 | 680 | 249 (206–298) |
Fruit and vegetables 350–500 g/d | 376 | 286 (242–328) | 331 | 292 (249–331) | 0.100 | 376 | 340 (287–395) | 331 | 333 (283–381) | 0.170 | 376 | 294 (248–344) |
Fruit and vegetables >500 g/d | 222 | 354 (304–412) | 213 | 355 (306–414) | 0.730 | 222 | 401 (347–471) | 213 | 396 (344–465) | 0.640 | 222 | 355 (309–435) |
p < 0.001 |
p < 0.001 |
p < 0.001 |
p < 0.001 |
p < 0.001 | ||||||||
Income
| ||||||||||||
Income < median | 840 | 237 (186–294) | 682 | 250 (209–307) | 0.000 | 840 | 303 (254–373) | 682 | 301 (250–367) | 0.450 | 840 | 248 (194–315) |
Income ≥ median | 957 | 255 (202–312) | 785 | 269 (221–324) | 0.000 | 957 | 300 (252–362) | 785 | 295 (250–355) | 0.290 | 957 | 265 (206–330) |
p < 0.001 |
p < 0.001 |
p = 0.420 |
p = 0.300 |
p < 0.001 | ||||||||
Level of education
| ||||||||||||
Elementary school | 214 | 230 (183–296) | 157 | 250 (200–313) | 0.007 | 214 | 305 (262–371) | 157 | 292 (252–351) | 0.190 | 214 | 243 (187–312) |
High school | 712 | 233 (190–286) | 573 | 249 (208–295) | 0.000 | 712 | 289 (244–349) | 573 | 288 (240–344) | 0.380 | 712 | 243 (196–299) |
College or university | 755 | 267 (214–326) | 663 | 277 (230–333) | 0.011 | 755 | 318 (263–381) | 663 | 316 (263–377) | 0.590 | 755 | 280 (221–344) |
p < 0.001 |
p < 0.001 |
p < 0.001 |
p < 0.001 |
p < 0.001 |
Folate status
Erythrocyte folate (nmol/L) | Plasma folate (nmol/L) | |||||||
---|---|---|---|---|---|---|---|---|
n
| Median |
Q
1
|
Q
3
|
n
| Median |
Q
1
|
Q
3
| |
All | 282 | 460 | 419 | 540 | 294 | 14 | 10 | 19 |
Malea
| 124 | 480 | 424 | 559 | 127 | 13 | 10 | 18 |
Femalea
| 141 | 450 | 390 | 500 | 150 | 15 | 11 | 19 |
Female aged 18–44 y | 61 | 440 | 380 | 481 | 66 | 14 | 11 | 18 |
p (sex) = 0.007 |
p (sex) = 0.019 | |||||||
p (female) = 0.070 |
p (female) = 0.380 | |||||||
Fruit and vegetable consumption
| ||||||||
Fruit and vegetables <200 g/d | 59 | 450 | 400 | 520 | 63 | 13 | 9.6 | 16 |
Fruit and vegetables 200–350 g/d | 104 | 460 | 400 | 535 | 110 | 14 | 10 | 19 |
Fruit and vegetables 350–500 g/d | 65 | 450 | 420 | 569 | 66 | 14 | 11 | 18 |
Fruit and vegetables >500 g/d | 37 | 490 | 460 | 670 | 38 | 16.5 | 13 | 22 |
p = 0.016 |
p = 0.009 | |||||||
Income
| ||||||||
Income < median | 133 | 460 | 419 | 530 | 137 | 13 | 10 | 17 |
Income ≥ median | 146 | 465 | 420 | 550 | 154 | 14 | 11 | 19 |
p = 0.260 |
p = 0.210 | |||||||
Level of education
| ||||||||
Elementary school | 26 | 445 | 420 | 540 | 30 | 12 | 9 | 17 |
High school | 117 | 460 | 419 | 530 | 122 | 13 | 10 | 18 |
College or university | 119 | 470 | 423 | 550 | 122 | 15 | 12 | 20 |
p = 0.600 |
p = 0.370 |
Dietary pattern associated with folate status
Discussion
Folate intake
Study type |
n
| Year | % (male) | Age (years) | Region | Plasma folate (nmol/L)a
| Fasting (yes/no) | Intake (µg/day) | Intake estimation method | References |
---|---|---|---|---|---|---|---|---|---|---|
Children and youths
| ||||||||||
Riksmaten barn | 590 | 2003 | 51 | 4 | National | n.d. | n.a. | 158 (129–193)a
| 4 day record | [9] |
889 | 50 | 8 | n.d. | n.a. | 186 (153–221)a
| |||||
1016 | 51 | 11 | n.d. | n.a. | 173 (139–218)a
| |||||
Cohort European Youth Heart Study | 194 | 1989–1999 | 0 | 16 ± 4b
| Stockholm and Örebro | n.d. | n.a. | 227 ± 104b
| 24-h recall | [26] |
185 | 100 | 16 ± 4b
| n.d. | n.a. | 285 ± 109b
| |||||
138 | 0 | 10 ± 4b
| n.d. | n.a. | 206 ± 76b
| 24-h recall and food record | ||||
163 | 100 | 10 ± 4b
| n.d. | n.a. | 205 ± 88b
| |||||
Pregnant
| ||||||||||
PregNut pregnant | 176 | 2006–2009 | 0 | <35 | Larger Umeå area | n.d. | n.a. | 277 (253–301)c
| 66 item FFQ | [27] |
PregNut pregnant incl suppl | 176 | n.d. | n.a. | 423 (386–460)d
| ||||||
PregNut non-pregnant | 103 | n.d. | n.a. | 300 (274–326)c
| ||||||
PregNut non-pregnant incl suppl | 103 | n.d. | n.a. | 353 (316–389)c,d
| ||||||
Case–control | 921 | 1996–1998 | 0 | Pregnancy week 6–12 | Uppsala | 8.7 ± 5.2b
| Yes | n.d. | n.a. | [28] |
Adults
| ||||||||||
Riksmaten | 625 | 1997–1998 | 0 | >17 | National | n.d. | n.a. | 211 (176–250)a
| 7 day record | [7] |
589 | 100 | >17 | n.d. | n.a. | 223 (185–266)a
| |||||
HULK 7 d record | 842 | 1989 | 0 | 15–74 | National | n.d. | n.d. | 187 (127–270)e
| 7 day record | [6] |
809 | 100 | 15–74 | n.d. | n.d. | 218 (146–321)e
| |||||
The Swedish Mammography Cohort | 61,433 | 1987–1990 | 0 | 41–74 | Västmanland/Uppsala county | n.d. | n.a. | 234 ± 50b
| 67 item FFQ | [5] |
Malmö Diet and Cancer cohort | 11,307 | 1991–1996 | 0 | ≥50 | Malmö | n.d. | n.a. | 287 ± 318f
| Diet-history method: 7 d record 168 item FFQ and interview | [4] |
408 | 0 | 62 ± 4.9 | 12.2 ± 8.1g
| No | 227 ± 62g
DFE = 307 ± 447d,g
| [29] | ||||
Cohort NSHDS
| 1791 | 1985– | 100 | 25–74 | Norrbotten/Västerbotten | 8.0 (5.9–10.9)a
| Yes and no | 244 (198–306)a
| 65–84 FFQ | [8] |
1055 | 1985– | 100 | >59 | 8.3 (6.3–11.5)a
| n.d. | n.a. | ||||
729 | 1985– | 100 | ≤59 | 7.6 (5.8–10.3)a
| n.d. | n.a. | ||||
826 | 1985– | 0 | 25–74 | 8.8 (6.3–12.2)a
| 226 (179–274)a
| 65–84 FFQ | ||||
497 | 1985– | 0 | >59 | 8.8 (6.2–13.0)a
| n.d. | n.a. | ||||
329 | 1985– | 0 | ≤59 | 8.8 (6.6–11.7)a
| n.d. | n.a. | ||||
Cohort Betula | 961 | n.d. | 47 | 35–80 | Umeå | 14.4 (7.6–46.8)h
| No | n.d. | n.a. | [30] |
Elderly
| ||||||||||
Cohort | 161 | n.d. | 43 | 77 ± 6 | Älvkarleby | 8.8 ± 4.4b
| Yes | n.d. | n.a. | [31] |