Total Folate Intake Research Articles

Folate intake post‐folic acid grain fortification and pancreatic cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Folate plays a critical role in DNA methylation, synthesis, and repair. Several epidemiologic studies suggest that higher folate intake is associated with reduced pancreatic cancer risk. We investigated the association between dietary folate intake and pancreatic cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort. Dietary data were collected using a food frequency questionnaire (1998–2005). Among the 51,988 male and 57,187 female participants, aged 55–74 years at enrollment, 162 men and 104 women developed pancreatic cancer during follow‐up (median 6.5 years). We used Cox proportional hazard regression to calculate hazard ratios (HR) and 95% confidence intervals (CI). The highest compared to the lowest quartile of food folate was associated with a significantly reduced pancreatic cancer risk among women, (≥ 253.3 vs. ≤ 179.1 μg/day, HR = 0.47, 95% CI 0.23, 0.94, ptrend = 0.09) but not among men (≥ 229.6 μg/day vs. ≤ 158.0 μg/day, HR = 1.20, 95% CI, 0.70, 2.04, ptrend = 0.67, p‐interaction by sex = 0.03). There was also a significant inverse trend in risk of pancreatic cancer across increasing quartiles of total folate in women (ptrend = 0.04) but not men (ptrend = 0.65). Folic acid supplements were not associated with pancreatic cancer. These findings support an association between higher food and total folate intakes and reduced risk of pancreatic cancer in women but not men.Grant Funding Source: NIH Cancer Research Training Award

Association of dietary and serum folate in a cohort of asymptomatic HIV+ patients in Botswana

ObjectiveDeficiency of folate is common in HIV infection and is associated with increased risk for cardiovascular disease, hypertension and anemia. We determined the variables associated with risk for folate deficiency in HIV infected antiretroviral naïve HIV infected adults in Botswana.MethodsAfter consenting, 140 HIV+ adults were administered medical, physical activity and 24‐hour recall questionnaires. Clinical exams were performed. Blood was drawn for CD4 cell count, viral load and serum folate levels.ResultsThe mean age was 34.0±8.21, 48% (n=67) were male and 15.2% had low serum folate (<5 ng/mL). Serum folate was significantly correlated with physical activity (r=0.244, p=0.011), BMI (r=−0.255, p=0.004), and female gender (r=−0.560, p<0.001). CD4 cell count and viral load were not significantly related to serum folate. Total folate intake was predictive of serum folate levels (β= 2.476, p=0.015) in a dose‐response relationship after controlling for physical activity, smoking, hypertension and gender.ConclusionFolate intake is reflected in serum levels in a dose response manner and is a good marker of folate intake from diet and from supplements in HIV+ adults. Serum folate levels may be used as an index of adherence in micronutrient supplementation trials that contain folate.Funded by NIDA

Acculturation factors and usual folate intakes among Mexican American women: National Health and Nutrition Examination Survey (NHANES), 2003–2006

MA women are at a higher risk for having a pregnancy affected by a neural tube defect which could be prevented by adequate folic acid consumption; however, research has suggested the acculturation could impact dietary intakes. We compared usual folate intakes in non‐Hispanic white (NHW) (n = 982) and Mexican American (MA) (n = 651) women aged 15–44 years by acculturation factors. We estimated usual folate intakes accounting for within‐individual variance using two 24 hour diet recalls and average daily supplement intake from NHANES 2003–2006. Median usual folic acid intakes from fortified foods alone did not differ between NHW and MA women, 173 and 183 ug/d, respectively. Median usual intake of natural food folate did not differ between NHW and MA women, 170 and 182 ug/d, respectively. Compared to NHW women, MA women had lower median usual total folic acid intakes (275 vs. 229 ug/d) and were less likely to report use of supplements with folic acid, 37% (95% confidence interval [CI]: 31%, 57%) vs. 20% (95% CI:15%, 25%). The reported use of supplements with folic acid was 34% (95% CI: 23%, 48%), 12% (95% CI: 4%, 28%), and 13% (95% CI: 7%, 23%) among MA women who reported speaking English, speaking English and Spanish, or speaking Spanish, respectively. Programs aimed at increasing folate intake should focus on reaching women who are less likely to use supplements with folic acid such as MA women who speak Spanish. Research funded by CDC.

Genotype‐based online nutrition guidance

The complexity of multiple gene‐nutrient interactions prevents consumers from making, on a daily basis, unassisted dietary choices that fit their personal needs. The objective therefore was to demonstrate the feasibility of personalized computer‐assisted menu selection.An online tool (http://www.nim.unc.edu/guidance/guidance.html) was developed to match daily menus to individual genetic profiles. The algorithm calculates the sum of normalized distances for all nutrients in a potential menu, using parabolic functions tailored to nutrients and user characteristics. The settings ensure the selection of menus that closely meet intake targets for energy and critical nutrients.Hypothetical scenarios used non‐pregnant 40 year‐old women, one with the full‐length DHFR gene with normal folic acid tolerance, and one with two copies of the 19del variant (rs70991108) with possibly low folic acid tolerance. The program found twenty well‐balanced one‐day menus for the first woman, all of which met her folate target with less than 6.7% deviation. Setting the folic acid to 25% of total folate intake for the carrier of the 19del variant yielded six one‐day menus that met the total folate target with up to 4.4% deviation, while keeping folic acid below the limit.This draft version of a nutrition guidance program establishes proof of concept. Ongoing development aims at expanding the database and adding functionalities.

Infant Birth Size Is Not Associated with Maternal Intake and Status of Folate during the Second Trimester in Norwegian Pregnant Women

Maternal folate status and smoking are potentially strong risk factors for infant birth size. We assessed the association of several folate indicators and smoking with birth outcomes in a subsample of participants in the Norwegian Mother and Child Cohort Study, consisting of 2934 singleton pregnancies in 2002–2003. Blood plasma folate and cotinine concentrations and self-reported intake of food folate and supplemental folic acid were measured during the second trimester (median 18 wk). Birth outcomes included gestational age, infant birth weight, head circumference, crown-heel length, and small for gestational age (SGA). Mean total dietary folate intake from foods (mean 268.0 μg/d) and supplements (mean 187.7 μg/d) was 455.7 μg/d. Smokers (plasma cotinine ≥85 nmol/L) had substantially lower supplemental folic acid intake than nonsmokers, but they did not differ regarding folate intake from food only. Nevertheless, smoking was correlated with plasma folate both before and after adjusting for total dietary folate intake (both P < 0.001). We found no significant associations of food folate intake, supplemental folic acid use, total dietary folate intake, or plasma folate with the various birth outcomes after adjustment for potential confounders. Consistent with previous studies, infant birth size was strongly predicted by maternal smoking (adjusted odds ratio for SGA: 2.3; 95% CI: 1.6, 3.3). This study of well-nourished Norwegian pregnant women suggests that dietary folate and plasma folate during the second trimester are not risk factors for infant birth size.

Folate intake, post–folic acid grain fortification, and pancreatic cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Folate plays a critical role in DNA methylation, synthesis, and repair. Several epidemiologic studies suggest that higher folate intake is associated with decreased pancreatic cancer risk. We investigated the association between dietary folate intake and pancreatic cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort. Dietary data were collected with the use of a self-administered food-frequency questionnaire (1998-2005). Among the 51,988 male and 57,187 female participants, aged 55-74 y at enrollment, with complete dietary and multivitamin information, 162 men and 104 women developed pancreatic cancer during follow-up (January 1998 to December 2006; median: 6.5 y). We used Cox proportional hazards regression with age as the time metric to calculate hazard ratios (HRs) and 95% CIs. The highest compared with the lowest quartile of food folate was associated with a significantly decreased pancreatic cancer risk among women (> or = 253.3 compared with < or = 179.1 microg/d; HR = 0.47; 95% CI: 0.23, 0.94; P for trend: 0.09) but not among men (> or = 229.6 compared with < or = 158.0 microg/d; HR = 1.20; 95% CI: 0.70, 2.04; P for trend: 0.67; P for interaction by sex: 0.03). There was also a significant inverse trend in risk of pancreatic cancer across increasing quartiles of total folate in women (P for trend: 0.04) but not in men (P for trend: 0.65). Folic acid supplements were not associated with pancreatic cancer. These findings support an association between higher food and total folate intakes and decreased risk of pancreatic cancer in women but not in men.

A prospective study of vitamin intake and the risk of hearing loss in men

Objective Hearing loss is the most common sensory disorder in the United States, afflicting more than 36 million people. Higher intakes of vitamins C, E, beta carotene, B12, and folate have been proposed to reduce the risk of hearing loss. Study Design We prospectively evaluated the association between intake from foods and supplements of vitamins C, E, beta carotene, B12, and folate, and the incidence of hearing loss. Setting Health Professionals Follow-up Study. Subjects and Methods A total of 26,273 men aged 40 to 74 years at baseline in 1986. Participants completed questionnaires about lifestyle and medical history every two years and diet every four years. Information on self-reported professionally diagnosed hearing loss and year of diagnosis was obtained from the 2004 questionnaire, and cases were defined as hearing loss diagnosed between 1986 and 2004. Cox proportional hazards multivariate regression was used to adjust for potential confounders. Results There were 3559 cases of hearing loss identified. Overall, there was no significant association between vitamin intake and risk of hearing loss. Among men aged ≥60 years, total folate intake was associated with a reduced risk of hearing loss; the relative risk for men aged ≥60 years old in the highest quintile compared with the lowest quintile of folate intake was 0.79 (95% confidence interval 0.65-0.96). Conclusions Higher intake of vitamin C, E, beta carotene, or B12 does not reduce the risk of hearing loss in adult males. Men aged ≥60 years may benefit from higher folate intake to reduce the risk of developing hearing loss.

Abstract A115: Alcohol use and molecularly defined colorectal cancer risks in a prospective study of older women

Abstract Background: Colorectal cancer (CRC) is the third most common incident cancer among women in the United States. Alcohol use has been proposed as a CRC risk factor, but existing observational data remain inconsistent. To date, relatively few studies have examined associations between alcohol use and CRC risk based on molecularly-defined subtypes. Aim: To evaluate associations between alcohol use and incident CRC overall, as well as by molecularly-defined subtypes including microsatellite instability (MSI), CpG island methylator phenotype (CIMP) and BRAF mutation status in the prospective, population-based, Iowa Women's Health Study (IWHS). Methods: The IWHS recruited 41,836 randomly selected Iowa women, ages 55–69 years at enrollment, in 1986. Women with prevalent cancers or no follow-up were excluded, leaving 38,001 eligible for this study. Alcohol use was obtained from a self-administered food frequency questionnaire at study baseline. Incident CRCs were identified through annual linkage with the State Health Registry of Iowa. Archived, paraffin-embedded tissue specimens were recently requested for incident CRC cases diagnosed through December 31, 2002. In the present study, useable tissue specimens were obtained and molecularly characterized for 563/1,255 cases (45%), whose baseline age, body mass index, physical activity level, total energy intake and alcohol use were similar to non-retrieved cases (p &amp;gt; 0.05 for each comparison). Alcohol use was categorized as never (n=21,464), &amp;lt; 3.4 g/day (n=8,313) and &amp;gt; 3.4 g/day (n=8,224), based on the median split among users. Molecularly-defined CRC subtypes were categorized as MSI-high (MSIH; n=148), MSI-low or microsatellite stable (MSI-L/MSS; n=400); CIMP-positive (n=167) or CIMP-negative (n=368); and BRAF-mutation (n=154) or BRAF-wildtype (n=391). Relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated for alcohol use compared to never drinkers, using multivariable Cox regression models adjusted for body mass index, waist-to-hip ratio, smoking status, physical activity level, exogenous estrogen use, and daily intakes of total energy, total fat, red meat, sucrose, calcium, folate, methionine and vitamin E. Results: There was no statistically significant association between alcohol use and overall CRC risk (RR=1.00; 95% CI = 0.86–1.15 for &amp;lt; 3.4 g/day versus none; RR=1.06; 95% CI=0.91–1.24 for &amp;gt;3.4 g/day versus none). Further, there were no associations with alcohol use for specific, molecularly-defined CRC subtypes (RRs shown for &amp;gt; 3.4 g/day versus none): MSI-H (RR=1.07; 95% CI=0.70–1.64); MSI-L or MSS (RR=1.12; 95% CI=0.85–1.47); CIMP-positive (RR=0.97; 95% CI=0.64–1.47); CIMP-negative (RR=1.13; 95% CI=0.85–1.50); BRAF-mutation (RR=0.94; 95% CI=0.61–1.45); and BRAF-wildtype (RR=1.20; 95% CI=0.91–1.57). Conclusion: In this cohort of older women, alcohol use did not appear to be a risk factor for incident CRC, overall or by the defined molecular subtypes. Citation Information: Cancer Prev Res 2010;3(1 Suppl):A115.

Total folate and folic acid intake from foods and dietary supplements in the United States: 2003–2006

The term total folate intake is used to represent folate that occurs naturally in food as well as folic acid from fortified foods and dietary supplements. Folic acid has been referred to as a double-edged sword because of its beneficial role in the prevention of neural tube defects and yet possible deleterious effects on certain cancers and cognitive function. Previous monitoring efforts did not include folic acid from dietary supplements and are therefore not complete. Our objective was to combine data on dietary folate (as measured by two 24-h recalls) and folic acid from dietary supplements (collected with a 30-d frequency questionnaire) with the use of the bias-corrected best power method to adjust for within-person variability. The National Health and Nutrition Examination Survey (NHANES) is a nationally representative, cross-sectional survey. Linear contrasts were constructed to determine differences in dietary and total folate intake for age and racial-ethnic groups by sex; prevalence of inadequate and excessive intakes is presented. In 2003-2006, 53% of the US population used dietary supplements; 34.5% used dietary supplements that contained folic acid. Total folate intake (in dietary folate equivalents) was higher for men (813 +/- 14) than for women (724 +/- 16) and higher for non-Hispanic whites (827 +/- 19) than for Mexican Americans (615 +/- 11) and non-Hispanic blacks (597 +/- 12); 29% of non-Hispanic black women had inadequate intakes. Total folate and folic acid intakes are highest for those aged > or =50 y, and 5% exceed the Tolerable Upper Intake Level. Improved total folate intake is warranted in targeted subgroups, which include women of childbearing age and non-Hispanic black women, whereas other population groups are at risk of excessive intake.

Comparison of nutrient intake, life style variables, and pregnancy outcomes by the depression degree of pregnant women

The aim of this study was to analyse effects that the degree of depression have on the life style variables, nutrient intake, iron indices and pregnancy outcome. Subjects were 114 pregnant women who were receiving prenatal care at a hospital in Seoul. We collected data for general characteristics and lifestyle variables from general survey instrument and for depression score from the questionnaire on depression. Dietary intakes of subjects were estimated by 24 hour dietary recall method. Also we analysed iron indices and pregnancy outcomes. We classified subjects by 10 point, which was the average depression score, into two groups [Low depression score group (LS) : High depression score group (HS)]. As to the intakes of total calcium, plant-calcium, plant-iron, potassium, total folate and dietary folate, LS group was far higher than HS group (P < 0.05, P < 0.05, P < 0.01, P < 0.001, P < 0.05, and P < 0.01, respectively). As to pre-pregnancy alcohol drinking, LS group had 41.9% in non-drinker, which was far higher than 28% in HS group in non-drinker (P < 0.05). As for drinking coffee during pre-pregnancy, pregnant women who don't drink coffee in LS group took 43.6%, which was higher than 38% in HS group (P < 0.01). Regarding delivery type, the cesarean section in LS group (18%) was significantly lower than that in HS group (45%) (P < 0.01). Bivariate analysis showed that birth weight was significantly associated with the gestational age (P < 0.01). The pregnant women with higher depression score tended to have undesirable life habit, which might affect negative pregnancy outcomes. A better understanding of how depression and intake of nutrients work together to modulate behavior will be benefit nutritional research.

Intakes of vegetables and related nutrients such as vitamin B complex, potassium, and calcium, are negatively correlated with risk of stroke in Korea

Consumption of vegetables and fruits is associated with a reduced risk of stroke, but it is unclear whether their protective effects are due to antioxidant vitamins or folate and metabolically related B vitamins. The purpose of the study was to test the hypothesis that intake of fruits and vegetables, which are major sources of antioxidant and vitamin B complex vitamins, reduces the risk of stroke. Cases consisted of patients diagnosed with first event of stroke (n = 69). Controls (n = 69) were age-, sex-, and body mass index-matched to cases. Multivariable-adjusted regression analysis showed that subjects who ate four to six servings of vegetable per day had a 32% reduction in the risk of stroke, and those with more than six servings per day had a reduction of 69% after adjusting for age, sex, BMI, and family history of stroke. Intakes of total fat, plant fat, calcium, potassium, vitamin B1, vitamin B2, vitamin B6, niacin, and folate were significantly and negatively associated with the risk of stroke. Although the trend was not significant, stroke risk was reduced in the second quartile (1.21-2.66 servings per week) of fish intake. However, intake of fruits (average daily intake of 1.0 serving) and antioxidant vitamins such as carotene, vitamin C, and vitamin E was not associated with the risk of stroke. In conclusion, our observational study suggests that intake of fat and vegetables, rich sources of vitamin B complex, calcium, and potassium may protect against stroke.

Genes involved with folate uptake and distribution and their association with colorectal cancer risk

Folate status is an important predictor of colorectal cancer risk. Common genetic variants in genes involved in regulating cellular folate levels might also predict risk, but there are limited data on this issue. We conducted a family-based case-control association study of variants in four genes involved in folate uptake and distribution: FOLR1, FPGS, GGH and SLC19A1, using 1,750 population-based and 245 clinic-based cases of pathologically confirmed colorectal cancer and their unaffected relatives participating in the Colon Cancer Family Registries. Standardized questionnaires, administered to all participants, collected information on risk factors and diet. Standard molecular techniques were used to determine microsatellite instability (MSI) status on cases. tagSNPs (n = 29) were selected based on coverage as assessed by pairwise r2. We found no evidence that tagSNPs in these genes were associated with risk of colorectal cancer. For the SLC19A1-rs1051266 (G80A, Arg27His) missense polymorphism, the A/A genotype was not associated with risk of colorectal cancer using population-based (OR = 1.00; 95% CI = 0.81-1.23) or clinic-based (OR = 0.75; 95% CI = 0.44-1.29) families compared to the G/A and G/G genotypes. We found no evidence that the association between any tagSNP and CRC risk was modified by multivitamin use, folic acid use and dietary folate intake and total folate intake. The odds ratios were similar, irrespective of MSI status, tumor subsite and family history of colorectal cancer. In conclusion, we found no significant evidence that genetic variants in FOLR1, GGH, FPGS and SLC19A1 are associated with the risk of colorectal cancer.

Folic acid food fortification prevents inadequate folate intake among preschoolers from Ontario

Folic acid food fortification has successfully reduced neural tube defect-affected pregnancies across Canada. The effect of this uncontrolled public health intervention on folate intake among Canadian children is, however, unknown. Our objectives were to determine folic acid intake from food fortification and whether fortification promoted adequate folate intakes, and to describe folic acid-fortified food usage among Ontario preschoolers. Cross-sectional data were used from the NutriSTEP validation project with preschoolers recruited using convenience sampling. Mean daily total folate and folic acid intakes were estimated from 3 d food records, which included multivitamin supplement use. Comparisons were made to Dietary Reference Intakes, accounting for and excluding fortificant folic acid, to determine the prevalence of inadequate and excessive intakes. Canada. Two hundred and fifty-four preschoolers (aged 3-5 years). All participants (130 girls, 124 boys) ate folic acid-fortified foods and 30% (n 76) used folic acid-containing supplements. Mean (SE) fortificant folic acid intake was 83 (2) microg/d, which contributed 30% and 50% to total folate intake for supplement users and non-users, respectively. The prevalence of total folate intakes below the Estimated Average Requirement was <1%; however, excluding fortificant folic acid, the prevalence was 32%, 54% and 47% for 3-, 4- and 5-year-olds, respectively. The overall prevalence of folic acid (fortificant and supplemental) intakes above the Tolerable Upper Intake Level was 2% (7% among supplement users). Folic acid food fortification promotes dietary folate adequacy and did not appear to result in excessive folic acid intake unless folic acid-containing supplements were consumed.

Folate intake and the risk of colorectal cancer in a Korean population

Folate, a water-soluble B vitamin and one of the major micronutrients in vegetables, is known as an essential factor for the de novo biosynthesis of purines and thymidylate, and it plays an important role in DNA synthesis and replication. Thus, folate deficiency results in ineffective DNA synthesis, and has been shown to induce the initiation and progression of colorectal cancer (CRC). Recently, the incidence of CRC in Korea has increased markedly in both men and women; this trend may be related to the adoption of a more 'westernized' lifestyle, including dietary habits. A hospital-based case-control study was conducted to examine the relationship between folate intake and the risk of CRC within a Korean population. A total of 596 cases and 509 controls, aged 30-79 years, were recruited from two university hospitals. Site- and sex-specific odds ratios (ORs) were estimated using logistic regression models. Cases were more frequently found to have a family history of CRC among first-degree relatives, to consume more alcohol, to be more likely current smokers and less likely to participate in vigorous physical activity than the controls. In the overall data for men and women combined, multivariate ORs (95% confidence interval (CI), P for trend) comparing the highest vs the lowest quartile of dietary folate intake were: 0.47 (0.32-0.69, <0.001) for CRC, 0.42 (0.26-0.69, <0.001) for colon cancer and 0.48 (0.28-0.81, 0.007) for rectal cancer. An inverse association was also found in women with dietary folate intake: 0.36 (0.20-0.64, <0.001) for CRC, 0.34 (0.16-0.70, 0.001) for colon cancer and 0.30 (0.12-0.74, 0.026) for rectal cancer, but not in men. In addition, the total folate intake of women was strongly associated with a reduced risk of rectal cancer (OR, 0.38; 95% CI, 0.17-0.88; P for trend=0.04). We found a statistically significant relationship between higher dietary folate intake and reduced risk of CRC, colon cancer and rectal cancer in women. A significant association is indicated between higher total folate intake and reduced risk of rectal cancer in women.

Dietary Folate and Folate Vitamers and the Risk of Pancreatic Cancer in the Netherlands Cohort Study

An association between high intake of folate and reduced risk of cancer has been suggested by previous research. However, epidemiologic data from cohort studies regarding the relationship between dietary folate and pancreatic cancer are sparse and inconsistent. We examined the association between dietary folate intake and risk of pancreatic cancer within the Netherlands Cohort Study on diet and cancer. Men and women (120,852), ages 55 to 69 years, were recruited. Information on diet was collected at baseline by means of food frequency questionnaires, and the cohort was followed for 13.3 years. Total folate and vitamer intake were calculated using folate contents of food items derived from a validated liquid chromatography trienzyme method. Cases (n = 363) were identified by record linkage with regional cancer registries and the Dutch National Database of Pathology Reports. A case-cohort approach was used using the follow-up data of a random subcohort (n = 5,000) identified at the onset of the cohort. Multivariable hazard ratios with 95% confidence intervals were estimated using Cox proportional hazards model. After adjusting for age, gender, smoking status, number of years smoked, number of cigarettes smoked per day, and intake of added sugar multivariate hazard ratio comparing the highest and lowest quintiles of folate intake for pancreatic cancer risk was 1.37 (confidence interval, 0.97-1.94; P(trend) = 0.07). When folate vitamers were analyzed separately, results did not show a difference in association. Our results do not support a protective association of total dietary folate or individual folate vitamers on the risk of pancreatic cancer.

Dietary folate intakes in the United States: Data from the National Health and Nutrition Examination Survey (NHANES) 2001‐2004

Relative contribution of folate from foods and dietary supplements (DS) was tabulated and compared to Dietary Reference Intakes. Diet was assessed via 2, 24‐hour recalls and DS use during the past 30 days including product type, name, frequency of use, and dose was collected via home interview; all data were adjusted for measurement error. Folate from food and folic acid from DS were converted to Dietary Folate Equivalents (DFE) to account for differences in bioavailability. Mean folate intakes from DS were 210 and 232 DFE (2001‐2) and 239 and 237 DFE (2003‐4) for males and females, respectively. DS folate contributed 5% (19‐30 yrs), 10% (31‐50 yrs), and 16% (51+ yrs) to folate intakes for males and 11 % (19‐30 and 31‐50 yrs) and 21% (51+ yrs) to folate intakes of females. DS use lowered the prevalence of "at risk" intakes by up to 8%, and increased the prevalence of intakes above the Upper Limit (UL) by up to 6%. Among females, 11% (19‐30 yrs) and 10% (31‐50 yrs) had total folate intakes below the Estimated Average Requirement (EAR). A high percentage of reproductive age females do not meet the EAR for folate, while other age groups exceed the UL. Without consideration of the form of nutrients from DS, errors may occur when calculating total nutrient intakes. DS use is important to consider when assessing the prevalence of inadequate and excessive folate intakes.

Dietary B Vitamin and Methionine Intakes and Plasma Folate Are Not Associated with Colorectal Cancer Risk in Chinese Women

Dietary factors involved in one-carbon metabolism may play a role in colorectal carcinogenesis ([1][1]). We evaluated whether dietary intakes of folate, methionine, and associated B vitamins were related to colorectal cancer risk using data from a large prospective cohort study of women in Shanghai

Folate concentrations in pediatric patients with newly diagnosed inflammatory bowel disease

Background:Folate is postulated to protect against cell injury and long-term risk of cancer. Folate deficiency has been shown to be associated with inflammatory bowel disease (IBD). However, folate concentrations are poorly delineated in children with IBD.Objective: The objective was to compare folate concentrations between children with newly diagnosed IBD and healthy controls.Design: Red blood cell folate (RBCF) and whole-blood folate (WBF) concentrations were measured in 78 children (mean age: 12.8 ± 2.7 y): 22 patients with newly diagnosed untreated Crohn disease, 11 patients with ulcerative colitis, 4 patients with indeterminate colitis, and 41 controls. Vitamin supplementation and dietary intakes determined by food-frequency questionnaire were recorded for 20 IBD patients and 28 controls.Results: RBCF concentrations were 19.4% lower in controls (587.0 ± 148.6 ng/mL) than in patients (728.7 ± 185.8 ng/mL; P = 0.0004), and WBF concentrations were 11.1% lower in controls (218.2 ± 49.7 ng/mL) than in patients (245.3 ± 59.1 ng/mL; P = 0.031). Total folate intake was 18.8% higher in controls (444.7 ± 266.7 μg/d) than in IBD patients (361.1 ± 230.6 μg/d), but this difference was not statistically significant (P = 0.264). Folate intakes were below the Recommended Dietary Allowance (200–400 μg/d), adjusted for age and sex, in 35.4% of study subjects.Conclusions: In contrast with previous evidence of folate deficiency in adult IBD patients, our data indicate higher folate concentrations in children with newly diagnosed untreated IBD than in controls. This finding was unexpected, especially in light of the higher dietary folate intakes and hematocrit values in children without IBD. The influence of IBD therapy on folate metabolism and the long-term clinical implications of high RBCF and WBF concentrations at the time of IBD diagnosis should be explored further.

Higher Intakes of Vegetables and Vegetable-Related Nutrients Are Associated with Lower Endometrial Cancer Risks

A limited number of studies have investigated diet in association with endometrial cancer (EC). We examined the association between intakes of selected food groups and nutrients with EC risk among 541 women with histologically confirmed EC and 541 women with an intact uterus and noncancer diagnoses seen at Roswell Park Cancer Institute between 1982 and 1998. Self-reported dietary and other epidemiologic data were collected by questionnaire. Unconditional logistic regression was used to estimate odds ratios (OR) and 95% CI, adjusting for age, BMI, hormone replacement therapy use, cigarette smoking, lifetime duration of menstruation, and total energy intake. We observed significant inverse associations for women in the highest vs. lowest quartiles of intake of total vegetables (OR, 0.51; 95% CI, 0.34-0.75), vitamin E (OR, 0.44; 95% CI, 0.27-0.70), dietary fiber (OR, 0.60; 95% CI, 0.39-0.94), beta-carotene (OR, 0.55; 95% CI, 0.37-0.82), lutein (OR, 0.52; 95% CI, 0.34-0.78), and folate (OR, 0.57; 95% CI, 0.36-0.91). Our results support that vegetables and related nutrients are associated with decreased risk of EC.

Predicted contribution of folic acid fortification of corn masa flour to the usual folic acid intake for the US population: National Health and Nutrition Examination Survey 2001–2004

BackgroundFolic acid can prevent up to 70% of neural tube defects (NTDs) if taken before pregnancy. Compared with other race-ethnicities, Hispanic women have higher rates of NTDs, lower rates of folic acid supplement use, and lower total folic acid intakes. ObjectiveThe objective was to assess potential effects of fortifying corn masa flour with folic acid on Mexican American women and other segments of the US population. DesignA model was developed by using data from the National Health and Nutrition Examination Survey 2001–2004 to estimate the folic acid content in foods containing corn masa flour if fortified at a level of 140 μg folic acid/100 g corn masa flour. ResultsHad corn masa flour fortification occurred, we estimated that Mexican American women aged 15–44 y could have increased their total usual daily folic acid intake by 19.9% and non-Hispanic white women by 4.2%. Among the US population, estimated relative percentage increases in total usual daily folic acid intake with corn masa flour fortification were greatest among Mexican Americans (16.8%) and lowest among children aged 1–3 y (2%) and adults aged >51 y (0–0.5%). ConclusionAnalyses suggest that corn masa flour fortification would have effectively targeted Mexican Americans, specifically, Mexican American women, without substantially increasing folic acid intake among other segments of the population. Such increases could reduce the disparity in total folic acid intake between Mexican American and non-Hispanic white women of childbearing age and implies that an additional NTD preventive benefit would be observed for Mexican American women.