title: Folate intake and folate serum levels in men and women from two European populations: The IMMIDIET project.
abstract: OBJECTIVE
  Folate status has been associated with neural tube defects and cerebrovascular disease. The aim of this study was to evaluate possible differences in folate status in two European Union countries and to assess their possible association with dietary patterns and/or other lifestyles.
  
  
  METHODS
  In the framework of the European Union-funded IMMIDIET Project, 1068 individuals (534 male-female pairs), ages 26 to 64 y, were enrolled in Italy and the United Kingdom. One-year-recall food frequency questionnaire was used to evaluate dietary intake. Reduced rank regression analysis was used to derive a dietary pattern better describing high dietary folate intake.
  
  
  RESULTS
  Of the total participants, 11.3% of the Italians and 45.1% of the British exceeded the optimal dietary folate intake of 400 μg/d (Recommended Dietary Allowance). Of the women, 66.7% and 22.1% of Italian and British women, respectively, all at childbearing age, had folate serum levels <6.62 ng/mL (P = 0.01). The percentage of total variance of dietary folate intake explained by food group consumption was 14.2% and 16.3% in Italy and the United Kingdom, respectively. Reduced rank regression analysis indicated a healthy pattern that was positively associated with folate serum levels in both countries (for all β-coefficients >0; P < 0.001): 100 μg/d increase in dietary folate intake was associated with 13.8% and 10.5% increase in folate serum levels in the Italian and British population, respectively (for 100 μg/d increase e(β-coef) = 1.138 and 1.105; P < 0.001). Smoking habit was negatively but physical activity positively associated with folate serum levels (P < 0.05).
  
  
  CONCLUSIONS
  An inadequate dietary folate intake and subsequent serum levels were observed in the Italian participants. High consumption of food sources of folate was positively associated with folate serum levels, explaining a good proportion of its variability.
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: George
authors.initials: G
authors.lastname: Pounis
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: Augusto F
authors.initials: AF
authors.lastname: Di Castelnuovo
authors.affiliation: Université Joseph Fourier-CNRS, Faculté de Médecine, La Tronche, France.
authors.forename: Michel
authors.initials: M
authors.lastname: de Lorgeril
authors.affiliation: Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Krogh
authors.affiliation: Institute of Food Sciences, CNR, Avellino, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Siani
authors.affiliation: Katholieke Universiteit Leuven, Flanders, Belgium.
authors.forename: Jozef
authors.initials: J
authors.lastname: Arnout
authors.affiliation: Warwick Medical School, Coventry, United Kingdom.
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Cappuccio
authors.affiliation: Maastricht University, Maastricht, The Netherlands.
authors.forename: Martien
authors.initials: M
authors.lastname: van Dongen
authors.affiliation: U.O.C. Laboratorio Analisi, Fondazione di Ricerca e Cura "Giovanni Paolo II," Università Cattolica del Sacro Cuore, Campobasso, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Zappacosta
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: Maria Benedetta
authors.initials: MB
authors.lastname: Donati
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Gaetano
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy. Electronic address: Licia.iacoviello@neuromed.it.
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
mesh_terms: D000328:Adult; D004032:Diet; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood*; D005494:Folic Acid Deficiency / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D009752:Nutritional Status; D015995:Prevalence; D012737:Sex Factors; D012907:Smoking; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D005492:Folic Acid
keywords: Cardiovascular disease; Diet; Dietary patterns; Folate; Folate status; Neurovascular disease