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| Author(s): |
Lana Carneiro Almeida
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR) |
| Defense date: | 2007-04-04 |
| Examining board members: |
Marly Augusto Cardoso;
Vania D'Almeida;
Luisa Lina Villa
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| Advisor: | Marly Augusto Cardoso |
| Abstract | |
Objective To examine whether measurements of dietary intakes, obtained with a validated quantitative food frequency questionnaire (FFQ), correlated with serum or plasma levels of folic acid, vitamins B12 and B6 and homocystein (hcy) measured in low-income women living in São Paulo, Brazil. Population and methods We analyzed dietary data from 1434 women aged 21-65 years enrolled in a case-control study of diet and cervical cancer carried out in three public hospitals of São Paulo. Data for women with invasive cervical cancer were excluded. All participants had their usual dietary intake assessed by interview, using a validated FFQ, and provided a fasting blood sample for serum and plasma separation. Serum concentrations of folic acid and vitamin B12 were measured by fluorimmunoassay, while serum levels of vitamin B6 and plasma levels of hcy were measured by reversed-phase high performance liquid chromatography. Correlations between estimates of food and energy-adjusted nutrient intakes and levels of folic acid, vitamins B12 and B6 and hcy were assessed using multiple linear regression models, adjusted for covariates such as age, body mass index, lifestyle (including smoking), past and current gynecologic morbidity and obstetric history, and use of oral contraceptives. Results Although only 6.2% of the study participants had serum folic acid levels below the reference value of 7 nmol/L, 45.7% and 97.1% had a dietary intake of folic acid estimated to be less than 180 g/day and 400 g/day, respectively. Multiple linear models showed serum folic acid levels to be positively correlated with the estimated intake of protein, iron, folate, vitamins B1, B3, B6, A and C, citrus fruits and juices and green vegetables, and negatively correlated with the estimated intake of fat, sweets and dairy products. Similar results were obtained after a further adjustment for fiber intake in the model, except for the estimated intake of folic acid and green vegetables, which lost their statistical significance as independent predictors of serum folic acid levels. Serum levels of vitamin B12 below the cut-off point of 148 pmol/L were found in 11.0% of study participants; most of them (70.4%) had their vitamin B12 intake estimated to be equal or greater than the reference value of 2 g/day. Serum levels of vitamin B12 were positively correlated with the estimated intake of dairy products and vitamins B2 and B12. The estimated intakes of fiber, vitamin E and beans were negatively correlated with serum levels of vitamin B12. Dietary vitamin B6 was estimated to be below the recommended levels of 1.3 mg/day (age  50 years) or 1.5 mg/day (age > 50 years) in 49.0% of study participants. No correlation was found between estimated intakes of foods and nutrients and plasma levels of vitamin B6. Hcy concentrations were positively correlated with the estimated intake of carbohydrates and sweets, and negatively correlated with the estimated intake of protein, cholesterol, iron, zinc of animal origin, vitamins A, B2, B12 and B6 and fishes. However, these correlations were no longer significant after additional adjustment for dietary protein, the strongest predictor of hcy plasma levels. Conclusion The estimated dietary intakes of selected foods and nutrients were shown to be independent predictors of measured serum levels of folic acid and vitamin B12, providing a basis for indentifying the main dietary sources of these nutrients in this and similar populations. The strong negative correlation between plasma levels of hcy and dietary protein provides a basis for future nutritional interventions. No correlation was found between plasma concentrations of vitamin B6 and estimated dietary intakes. (AU) | |