Folate intake and folate serum levels in men and women from two European populations: The IMMIDIET project

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 mg/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 ¼ 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 b-coefficients >0; P < 0.001): 100 mg/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 mg/d increase eb-coef ¼ 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.