Folate Nutritional Status among Psoriasis Patients not Exposed to Antifolate Drug

Background: Folic acid fortification program has been established to prevent tube defects. However, concern has been raised among patients using anti-folate drug, i.e. psoriatic patients, a common, chronic, autoimmune inflammatory skin disease associated with obesity and smoking. Objective: To investigate dietary and circulating folate, vitamin B12 (B12) and homocysteine (hcy) in psoriatic subjects exposed to the national mandatory folic acid fortification program. Methods: Cross-sectional study using the Food Frequency Questionnaire, plasma folate, B12, hcy and psoriasis severity using the Psoriasis Area and Severity Index score. Median, interquartile ranges (IQRs) and linear regression models were conducted to investigate factors associated with plasma folate, B12 and hcy. Results: 82 (73%) mild psoriasis, 18 (16%) moderate and 12 (11%) severe psoriasis. 58% female, 61% non-white, 31% former smokers, and 20% current smokers. Median (IQRs) were 51 (40, 60) years. Only 32% reached the Estimated Average Requirement of folate intake. Folate and B12 deficiencies were observed in 9% and 6% of the blood sample respectively, but hyperhomocysteinaemia in 21%. Severity of psoriasis was negatively correlated with folate and B12 concentrations. In a multiple linear regression model, folate intake contributed positively to 14% of serum folate, and negative predictors were psoriasis severity, smoking habits and saturated fatty acid explaining 29% of circulating folate. Conclusion: Only one third reached dietary intake of folate, but deficiencies of folate and B12 were low. Psoriasis severity was negatively correlated with circulating folate and B12. Stopping smoking and a folate rich diet may be important targets for managing psoriasis.

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Folic Acid Fortification and Women’s Folate Levels in Selected Communities in Brazil - A First Look

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000215 ◽

2014 ◽

Vol 84 (5-6) ◽

pp. 286-294 ◽

Cited By ~ 5

Author(s):

Hrishikesh Chakraborty ◽

Kwame A. Nyarko ◽

Norman Goco ◽

Janet Moore ◽

Danilo Moretti-Ferreira ◽

...

Keyword(s):

Folic Acid ◽

Folate Intake ◽

Serum Folate ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Folate Supplementation ◽

Folic Acid Fortification ◽

Folic Acid Supplements ◽

Two Samples ◽

Reproductive Aged Women

Abstract. Background: Several countries have implemented mandatory folic acid fortification of wheat flour and selected grain products to increase the folate intake of reproductive-aged women. Brazil implemented a folic acid fortification program in 2004. No previous studies have examined folate differences among Brazilian women following the mandate. Objective: We evaluate differences in serum and red blood cell (RBC) folate concentrations between two samples of women of childbearing age from selective communities in Brazil, one tested before (N = 116) and the other after the mandate (N = 240). Methods: We compared the baseline folate levels of women enrolled in a prevention study shortly before the fortification mandate was implemented, to baseline levels of women from the same communities enrolled in the same study shortly after fortification began. The participants were women enrolled in a folate supplementation clinical trial, at a hospital specializing in treating craniofacial anomalies in the city of Bauru from January 29, 2004 to April 27, 2005. We only compared baseline folate levels before the women received oral cleft prevention program (OCPP) folic acid supplements. Results: Women enrolled after the fortification mandate had higher means of serum folate (20.3 versus 11.2 nmol/L; p < 0.001) and RBC folate (368.3 versus 177.6 nmol/L; p < 0.001) than women enrolled before the mandate. Differences in folate levels between the two groups remained after adjusting for several co-variables. Conclusions: The results suggest that serum and RBC folate levels among women of childbearing age increased after implementing the folic acid fortification mandate in Brazil.

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Direct and Indirect Effects of Indoor Particulate Matter on Blood Indicators Related to Anemia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182412890 ◽

2021 ◽

Vol 18 (24) ◽

pp. 12890

Author(s):

Youngrin Kwag ◽

Shinhee Ye ◽

Jongmin Oh ◽

Dong-Wook Lee ◽

Wonho Yang ◽

...

Keyword(s):

Risk Factor ◽

Particulate Matter ◽

Linear Regression ◽

Multiple Linear Regression ◽

Multiple Linear Regression Model ◽

Folate Intake ◽

Serum Folate ◽

Gravimetric Analysis ◽

Indoor Particulate Matter ◽

Indoor Pm2.5

Exposure to indoor particulate matter (PM) is a potential risk factor that increases systemic inflammation and affects erythropoiesis. This study investigated the association between exposure to indoor PM and blood indicators related to anemia (BIRA) in housewives. Indoor PM and blood folate status are important factors in the risk of anemia. This was a housewife cohort study; we recruited 284 housewives in Seoul and Ulsan, Republic of Korea. Indoor exposure to PM2.5 and PM10 was measured by gravimetric analysis and sensors. We investigated the BIRA, such as hemoglobin (Hb), hematocrit, mean corpuscular volume (MCV), mean corpuscular Hb (MCH), and mean corpuscular Hb concentration (MCHC). Statistical analysis was performed by multiple linear regression model and mediation analysis. The association between BIRA and PM was assessed by multiple linear regression models fitted by mediation analyses. The increase in the level of indoor PM2.5 was associated with a decrease in MCV (Beta coefficient (B): −0.069, Standard error (SE): 0.022) and MCH (B: −0.019, SE: 0.009) in gravimetric measurements. The increase in the level of indoor PM2.5 was associated with a decrease in Hb (B: −0.024, SE: 0.011), hematocrit (B: −0.059, SE: 0.033), and MCV (B: −0.081, SE: 0.037) and MCH (B: −0.037, SE: 0.012) in sensor measurements (PM2.5-Lag10). Further, we identified a serum folate-mediated PM effect. The indoor PM exposure was significantly associated with decreased Hb, MCV, and MCH in housewives. Taken together, our data show that exposure to indoor PM is a risk factor for anemia in housewives. Blood folate concentration can be a mediating factor in the effect of indoor PM on BIRA. Therefore, folate intake should be recommended to prevent anemia in housewives. Moreover, indoor PM exposure should be managed.

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Obesity is associated with folate metabolism

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000602 ◽

2020 ◽

Vol 90 (3-4) ◽

pp. 353-364 ◽

Cited By ~ 1

Author(s):

Süleyman Köse ◽

Saniye Sözlü ◽

Hatice Bölükbaşi ◽

Nüket Ünsal ◽

Makbule Gezmen-Karadağ

Keyword(s):

Folic Acid ◽

Folic Acid Supplementation ◽

Normal Weight ◽

Folate Intake ◽

Serum Folate ◽

Systemic Review ◽

Lower Serum ◽

Cross Sectional ◽

Acid Supplementation ◽

Supplement Use

Abstract. Objective: The aim of the present study is to perform a systemic review of the previous studies executed on the association between obesity and folate. Method: In the present research, the selected keywords were scanned on the PubMed, Web of Science, Cochrane and Lilac databases between May and June, 2017 through Gazi University’s network. In total, 4236 clinical, randomized controlled, cross-sectional and prospective studies were determined and 17 of these that specifically fit the aims of the present research were reviewed. This study involved an electronic literature search of databases on folic acid and obesity published in the English language between 2000 and 2016. Results: Of the 17 studies, 5 were based on folic acid supplementation and 12 were related with participants’ folate status. As a general consequence of both intake and serum/status measurements of folic acid supplementation: It was found that obesity-associated metabolic changes might affect individual folate use and obese individuals had lower serum folate levels, although there was no change in folate intake. Conclusion: Overweight and obese individuals have lower serum folate concentrations when compared with individuals with normal weight. It is explained by increased use of folic acid, urinary excretion, dilution of blood volume, different levels in different tissues and changes in the endocrine functions of folate. Individuals with higher Body Mass Indexes have less supplement use, unhealthier diets and donot consume sufficient vegetables and fruits, all of which can affect decrease in folate levels. Furthermore, adiposity may affect folate absorption by intestinal epithelium.

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Folate and vitamin B12status in relation to cognitive impairment and anaemia in the setting of voluntary fortification in the UK

British Journal Of Nutrition ◽

10.1017/s0007114508958001 ◽

2008 ◽

Vol 100 (5) ◽

pp. 1054-1059 ◽

Cited By ~ 38

Author(s):

Robert Clarke ◽

Paul Sherliker ◽

Harold Hin ◽

Anne M. Molloy ◽

Ebba Nexo ◽

...

Keyword(s):

Cognitive Impairment ◽

Folic Acid ◽

Older People ◽

Serum Folate ◽

Vitamin B ◽

Cross Sectional ◽

Folic Acid Fortification ◽

Folate Status ◽

Cross Sectional Studies ◽

The Uk

Concerns about risks for older people with vitamin B12deficiency have delayed the introduction of mandatory folic acid fortification in the UK. We examined the risks of anaemia and cognitive impairment in older people with low B12and high folate status in the setting of voluntary fortification in the UK. Data were obtained from two cross-sectional studies (n2403) conducted in Oxford city and Banbury in 1995 and 2003, respectively. Associations (OR and 95 % CI) of cognitive impairment and of anaemia with low B12status (holotranscobalamin < 45 pmol/l) with or without high folate status (defined either as serum folate >30 nmol/l or >60 nmol/l) were estimated after adjustment for age, sex, smoking and study. Mean serum folate levels increased from 15·8 (sd14·7) nmol/l in 1995 to 31·1 (sd26·2) nmol/l in 2003. Serum folate levels were greater than 30 nmol/l in 9 % and greater than 60 nmol/l in 5 %. The association of cognitive impairment with low B12status was unaffected by highv.low folate status (>30 nmol/l) (OR 1·50 (95 % CI 0·91, 2·46)v.1·45 (95 % CI 1·19, 1·76)), respectively. The associations of cognitive impairment with low B12status were also similar using the higher cut-off point of 60 nmol/l for folate status ((OR 2·46; 95 % CI 0·90, 6·71)v.(1·56; 95 % CI 1·30, 1·88)). There was no evidence of modification by high folate status of the associations of low B12with anaemia or cognitive impairment in the setting of voluntary fortification, but periodic surveys are needed to monitor fortification.

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Demographic, Physiologic, and Lifestyle Characteristics Observed with Serum Total Folate Differ Among Folate Forms: Cross-Sectional Data from Fasting Samples in the NHANES 2011–2016

Journal of Nutrition ◽

10.1093/jn/nxz278 ◽

2019 ◽

Vol 150 (4) ◽

pp. 851-860 ◽

Cited By ~ 6

Author(s):

Zia Fazili ◽

Maya R Sternberg ◽

Nancy Potischman ◽

Chia-Yih Wang ◽

Renee J Storandt ◽

...

Keyword(s):

Folic Acid ◽

Biologically Active ◽

Alcoholic Beverages ◽

Serum Folate ◽

Cross Sectional ◽

Geometric Means ◽

Folic Acid Fortification ◽

Hispanic Origin ◽

The Us ◽

Age Patterns

ABSTRACT Background Serum folate forms were measured in the US population during recent NHANES to assess folate status. Objective We describe post-folic acid–fortification concentrations of serum folate forms in the fasting US population ≥1 y from the NHANES 2011–2016. Methods We measured 5 biologically active folates and 1 oxidation product (MeFox) of 5-methyltetrahydrofolate (5-methyl-THF). We calculated geometric means of 5-methyl-THF, unmetabolized folic acid (UMFA), nonmethyl folate (sum of tetrahydrofolate, 5-formyltetrahydrofolate, and 5,10-methenyltetrahydrofolate), total folate (sum of above biomarkers), and MeFox by demographic, physiologic, and lifestyle variables; estimated the magnitude of variables on biomarker concentrations after covariate adjustment; and determined the prevalence of UMFA >2 nmol/L. Results After demographic adjustment, age, sex, and race-Hispanic origin were significantly associated with most folate forms. MeFox increased with age, while 5-methyl-THF, UMFA, and nonmethyl folate displayed U-shaped age patterns. Compared with non-Hispanic whites, non-Hispanic blacks had 23% lower predicted 5-methyl-THF but comparable UMFA; non-Hispanic Asians had comparable 5-methyl-THF but 28% lower UMFA; Hispanics, non-Hispanic Asians, and non-Hispanic blacks had ∼20% lower MeFox. After additional physiologic and lifestyle adjustment, predicted UMFA and MeFox concentrations were 43% and 112% higher, respectively, in adults with chronic kidney disease and 17% and 15% lower, respectively, in adults consuming daily 1–<2 alcoholic beverages; 5-methyl-THF concentrations were 20% lower in adult smokers. The prevalence of UMFA >2 nmol/L was highest in persons aged ≥70 y (9.01%) and lowest in those aged 12–19 y (1.14%). During 2011–2014, the prevalence was 10.6% in users and 2.22% in nonusers of folic acid–containing supplements. Conclusions In fasting persons ≥1 y, the demographic, physiologic, and lifestyle characteristics observed with serum total folate differed among folate forms, suggesting biological and/or genetic influences on folate metabolism. High UMFA was mostly observed in supplement users and older persons.

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Association between tea drinking and plasma folate concentration among women aged 18–30 years in China

Public Health Nutrition ◽

10.1017/s1368980020004851 ◽

2020 ◽

pp. 1-8

Author(s):

Xiaoqian Jia ◽

Mengyuan Ren ◽

Yali Zhang ◽

Rongwei Ye ◽

Le Zhang ◽

...

Keyword(s):

Multiple Linear Regression Model ◽

Positive Association ◽

Folate Intake ◽

Tea Consumption ◽

Cross Sectional ◽

Folate Concentration ◽

Plasma Folate ◽

Han Ethnicity ◽

Tea Drinking ◽

The Relationship

Abstract Objective: Association was found between tea and neural tube defects. However, few studies investigated the relationship between tea consumption and blood folate levels. We aimed to investigate the association between tea consumption and plasma folate concentrations among women aged 18–30 years in different ethnicities of China. Design: Data were obtained from a national cross-sectional study conducted from 2005 to 2006 of women aged 18–30 years in China. Socio-demographic characteristics and lifestyle were obtained from a questionnaire. Dietary folate intake was determined by 24-h dietary recall. Plasma folate concentrations were measured by a microbiological assay. Multiple linear regression model was used to calculate partial regression coefficients after adjusting for confounding factors. Setting: Nine provinces or autonomous regions in China. Participants: A total of 2932 women aged 18–30 years in China. Results: After stratifying by ethnicity and tea type, tea consumption was significantly positively associated with plasma folate levels in Han women who drank unfermented tea weekly (β = 0·067, and P = 0·037) or daily (β = 0·119, and P = 0·031) and in Uighur women who drank fermented tea weekly (β = 0·325, and P = 0·028). For women who drank unfermented tea in Han ethnicity, weekly and daily tea drinkers had 6·77 % (95 % CI: 6·36 %, 7·21 %) and 7·13 % (95 % CI: 6·40 %, 7·96 %) increase in plasma folate concentration compared with no tea drinkers. Conclusions: There is a suggestion of possible positive association between unfermented tea drinking in Han ethnicity and plasma folate concentrations, for Chinese women aged 18–30 years. The relationship between tea drinking in other ethnic groups and plasma folate still needs to be further explored.

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Health and nutrition literacy in adults: Links with lifestyle factors and obesity

Mediterranean Journal of Nutrition and Metabolism ◽

10.3233/mnm-200471 ◽

2020 ◽

Vol 13 (4) ◽

pp. 361-370

Author(s):

Maria Michou ◽

Demosthenes B. Panagiotakos ◽

Christos Lionis ◽

Vassiliki Costarelli

Keyword(s):

Physical Activity ◽

Alcohol Consumption ◽

Linear Regression ◽

Smoking Status ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Lifestyle Factors ◽

Linear Regression Models ◽

Chi Square ◽

Cross Sectional

BACKGROUND: Low Health Literacy (HL) and Nutrition Literacy (NL) are associated with serious negative health outcomes. OBJECTIVES: The aim of this study was to investigate certain lifestyle factors and obesity, in relation to HL and NL. METHODS: This cross-sectional study was conducted in the urban area of the Attica region, in Greece. The sample consisted of 1281 individuals, aged ≥18 years. HL, NL sociodemographic characteristics and lifestyle factors (physical activity, smoking status, alcohol consumption,) were assessed. Mann-Whitney U, the Kruskall Wallis, Pearson chi-square tests and multiple linear regression models were used. RESULTS: Linear regression analysis has shown that smoking, alcohol consumption and physical activity, were associated with HL levels (–1.573 points for ex-smokers in comparison to smokers, p = 0.035, –1.349 points for alcohol consumers in comparison to non-consumers, p = 0.006 and 1.544 points for physically active individuals to non-active, p = 0.001). With respect to NL levels, it was also not associated with any of these factors. Obesity was not associated with HL and NL levels. CONCLUSIONS: Certain lifestyle factors, including physical activity, are predicting factors of HL levels, in Greek adults. The results contribute to the understanding of the relationship between lifestyle factors and HL and should be taken into account when HL policies are designed.

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Musculoskeletal symptoms, psychosocial factors and work ability in Brazilian labor justice workers

Work ◽

10.3233/wor-213524 ◽

2021 ◽

pp. 1-10

Author(s):

Fauzi El Kadri Filho ◽

Tha&ıs Moreira São-João ◽

Neusa Maria Costa Alexandre ◽

Sergio Roberto de Lucca ◽

Cristiane Helena Gallasch ◽

...

Keyword(s):

Linear Regression ◽

Multiple Linear Regression ◽

Psychosocial Factors ◽

Work Ability ◽

Multiple Linear Regression Model ◽

Female Gender ◽

Musculoskeletal Symptoms ◽

Judicial Process ◽

Cross Sectional ◽

Important Relationship

BACKGROUND: The implementation of the electronic judicial process (PJe) in recent years is associated with an increase in workload and stricter control through productivity targets in the Brazilian labor judiciary. OBJECTIVES: To evaluate the relations between musculoskeletal symptoms, psychosocial factors and work ability in civil servants of a labor justice body in the context of the PJe. METHODS: A cross-sectional exploratory study with a quantitative approach involving 449 workers. Sociodemographic, occupational and related data were collected through questionnaires validated in the Brazilian context. Data analysis was conducted by descriptive and inferential statistics: Mann-Whitney test, Spearman’s correlation coefficient and multiple linear regression. RESULTS: There was a correlation between musculoskeletal symptoms and psychosocial factors (p < 0.05), as well as between both musculoskeletal symptoms and psychosocial factors with reduced work ability (p < 0.05). The multiple linear regression model pointed to the female gender and the dimensions “demands”, “control” and “peer support” as related to the musculoskeletal symptoms. CONCLUSION: We highlight the importance of a broader approach, involving psychosocial factors in preventive actions related to musculoskeletal disorders considering the important relationship with work ability.

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Isotonic quadriceps endurance is better associated with daily physical activity than quadriceps strength and power in COPD: an international multicentre cross-sectional trial

Scientific Reports ◽

10.1038/s41598-021-90758-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Erik Frykholm ◽

Sarah Gephine ◽

Didier Saey ◽

Arthur Lemson ◽

Peter Klijn ◽

...

Keyword(s):

Physical Activity ◽

Linear Regression ◽

Multiple Linear Regression ◽

Regression Models ◽

Sedentary Time ◽

Quadriceps Strength ◽

Linear Regression Models ◽

Cross Sectional ◽

Quadriceps Function ◽

Multiple Linear Regression Models

AbstractKnowledge about modifiable determinants of daily physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is crucial to design effective PA interventions. The present study aimed to determine the contribution of quadriceps strength, power and endurance to daily PA in COPD. Additionally, for quadriceps endurance, we also aimed to determine to what extent the association varies according to the mode of movement (isotonic, isometric, or isokinetic). Using a multicentre cross-sectional trial design we determined the contribution of quadriceps function to daily PA (steps, sedentary time and time spent doing moderate-to-very-vigorous physical activity [MVPA]) using bivariate and partial Pearson correlation analysis (r) and multiple linear regression models (ΔR2). Pre-determined controlling factors were sex, age, body mass index (BMI), COPD-assessment test, forced expiratory volume in one second in percent of the predicted value (FEV1pred), and distance walked on the 6-minute walk test. Eighty-one patients with COPD (mean ± SD: age 67 ± 8 years, FEV1pred 57 ± 19%, daily steps 4968 ± 3319, daily sedentary time 1016 ± 305 min, and MVPA time 83 ± 45 min) were included. Small to moderate bivariate correlations (r = .225 to .452, p < .05) were found between quadriceps function and measures of PA. The best multiple linear regression models explained 38–49% of the variance in the data. Isotonic endurance was the only muscle contributor that improved all PA models; daily steps (ΔR2 = .04 [relative improvement 13%] p = .026), daily sedentary time (ΔR2 = .07 [23%], p = .005) and MVPA-minutes (ΔR2 = .08 [20%], p = .001). Isotonic endurance was also independently associated with most PA variables, even when controlling for strength, power or isometric-isokinetic endurance properties of the muscle (r = .246 to .384, p < .05). In contrast, neither strength, power, isometric-or isokinetic endurance properties of the muscle was independently associated with PA measures when controlling for isotonic endurance (r = .037 to .219, p > .05). To conclude, strength, power, and endurance properties of the quadriceps were low to moderately associated with PA in patients with COPD. Isotonic quadriceps endurance was the only quadriceps property that was independently associated with the different measures of PA after controlling for a basic set of known determinants of PA, quadriceps strength or power, or isometric or isokinetic quadriceps endurance. Future longitudinal studies should investigate its potential as a modifiable determinant of PA.

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

Public Health Nutrition ◽

10.1017/s1368980008004667 ◽

2009 ◽

Vol 12 (9) ◽

pp. 1548-1555 ◽

Cited By ~ 5

Author(s):

Kathleen Hennessy-Priest ◽

Jill Mustard ◽

Heather Keller ◽

Lee Rysdale ◽

Joanne Beyers ◽

...

Keyword(s):

Folic Acid ◽

Public Health Intervention ◽

Folate Intake ◽

Food Fortification ◽

Folic Acid Intake ◽

Cross Sectional ◽

Dietary Folate ◽

Supplement Use ◽

Acid Intake ◽

Fortified Food

AbstractObjectiveFolic 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.DesignCross-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.SettingCanada.SubjectsTwo hundred and fifty-four preschoolers (aged 3–5 years).ResultsAll participants (130 girls, 124 boys) ate folic acid-fortified foods and 30 % (n76) used folic acid-containing supplements. Mean (se) fortificant folic acid intake was 83 (2) μg/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).ConclusionsFolic 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.

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