Prudent Dietary Pattern Influences Homocysteine Level More Than Folate, Vitamin B12, and Docosahexaenoic Acid: a Structural Equation Model Approach

Overview

Journal Eur J Nutr

Specialty Nutritional Sciences

Date 2019 Jan 17

PMID 30649595

Citations 6

Authors

Juliana Araujo Teixeira

Josiane Steluti

Bartira Mendes Gorgulho

Antonio Augusto Ferreira Carioca

Gizelton Pereira Alencar

Regina Mara Fisberg

Dirce Maria Marchioni

Affiliations

Soon will be listed here.

Abstract

Purpose: A structural equation model (SEM) was used to test multiple and simultaneous relationships between socio-demographic factors, dietary patterns, biochemical levels of folate, vitamin B12, docosahexaenoic acid (DHA), and its effects on homocysteine (Hcy) level.

Methods: Socio-demographic and lifestyle characteristics, blood sample, anthropometric measurements, and a food-frequency questionnaire (FFQ) were obtained from 281 individuals of ISA-Capital study (Sao Paulo, Brazil). The dietary patterns (DP) were estimated using factor analysis with principal component's estimation based on the frequency of daily intake derived from the 38-item FFQ. The SEM considered a theoretical model where the DP were expected to be directly associated with Hcy level, and indirectly via biochemical levels of folate, vitamin B12, and DHA. The variables sex, age, ethnicity, and MTHFR C677T polymorphism were included in the model.

Results: The Prudent DP (- 0.12, p = 0.04) had a negative effect, while MTHFR C677T polymorphism (0.16, p = 0.01), age (0.22, p < 0.01), and being man (0.16, p = 0.01) had a positive effect on Hcy level. There were no indirect effects of any dietary patterns on Hcy level, neither via folate, vitamin B12, nor DHA. DHA was negatively associated with the Modern DP (- 0.12, p = 0.04) and positively associated with the Prudent DP (0.19, p < 0.01).

Conclusions: The DP mainly composed of fruits and vegetables, natural juices, potato/cassava/cooked cornmeal, fish, and chicken, which was negatively associated with the Hcy level in this population. These findings support the role of a healthy dietary pattern in health outcomes, rather than promoting specific foods or nutrients, for policy-based health promotion strategies.

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References

Kulkarni A, Dangat K, Kale A, Sable P, Chavan-Gautam P, Joshi S . Effects of altered maternal folic acid, vitamin B12 and docosahexaenoic acid on placental global DNA methylation patterns in Wistar rats. PLoS One. 2011; 6(3):e17706. PMC: 3053375. DOI: 10.1371/journal.pone.0017706. View

Khaire A, Rathod R, Randhir K, Kale A, Joshi S . A combined supplementation of vitamin B12 and omega-3 fatty acids across two generations improves cardiometabolic variables in rats. Food Funct. 2016; 7(9):3910-9. DOI: 10.1039/c6fo00148c. View

Iglesia I, Huybrechts I, Gonzalez-Gross M, Mouratidou T, Santabarbara J, Chajes V . Folate and vitamin B12 concentrations are associated with plasma DHA and EPA fatty acids in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Br J Nutr. 2017; 117(1):124-133. DOI: 10.1017/S0007114516004414. View

Li D, Mann N, Sinclair A . A significant inverse relationship between concentrations of plasma homocysteine and phospholipid docosahexaenoic acid in healthy male subjects. Lipids. 2006; 41(1):85-9. DOI: 10.1007/s11745-006-5074-x. View

de Benoist B . Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull. 2008; 29(2 Suppl):S238-44. DOI: 10.1177/15648265080292S129. View

Miller S, Dykes D, Polesky H . A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res. 1988; 16(3):1215. PMC: 334765. DOI: 10.1093/nar/16.3.1215. View

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007; 335(7624):806-8. PMC: 2034723. DOI: 10.1136/bmj.39335.541782.AD. View

Fodinger M, Buchmayer H, Heinz G, Papagiannopoulos M, Kletzmayr J, PERSCHL A . Association of two MTHFR polymorphisms with total homocysteine plasma levels in dialysis patients. Am J Kidney Dis. 2001; 38(1):77-84. DOI: 10.1053/ajkd.2001.25197. View

Selem S, de Castro M, Cesar C, Marchioni D, Fisberg R . Associations between dietary patterns and self-reported hypertension among Brazilian adults: a cross-sectional population-based study. J Acad Nutr Diet. 2014; 114(8):1216-22. DOI: 10.1016/j.jand.2014.01.007. View

10.

de Andrade L, Pellegrini Filho A, Solar O, Rigoli F, de Salazar L, Serrate P . Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries. Lancet. 2014; 385(9975):1343-51. DOI: 10.1016/S0140-6736(14)61494-X. View

11.

Huang T, Zheng J, Chen Y, Yang B, Wahlqvist M, Li D . High consumption of Ω-3 polyunsaturated fatty acids decrease plasma homocysteine: a meta-analysis of randomized, placebo-controlled trials. Nutrition. 2011; 27(9):863-7. DOI: 10.1016/j.nut.2010.12.011. View

12.

Bhatia P, Singh N . Homocysteine excess: delineating the possible mechanism of neurotoxicity and depression. Fundam Clin Pharmacol. 2015; 29(6):522-8. DOI: 10.1111/fcp.12145. View

13.

Refsum H, Smith A, Ueland P, Nexo E, Clarke R, McPartlin J . Facts and recommendations about total homocysteine determinations: an expert opinion. Clin Chem. 2004; 50(1):3-32. DOI: 10.1373/clinchem.2003.021634. View

14.

Zhong F, Zhuang L, Wang Y, Ma Y . Homocysteine levels and risk of essential hypertension: A meta-analysis of published epidemiological studies. Clin Exp Hypertens. 2017; 39(2):160-167. DOI: 10.1080/10641963.2016.1226888. View

15.

Kemse N, Kale A, Joshi S . A combined supplementation of omega-3 fatty acids and micronutrients (folic acid, vitamin B12) reduces oxidative stress markers in a rat model of pregnancy induced hypertension. PLoS One. 2014; 9(11):e111902. PMC: 4236044. DOI: 10.1371/journal.pone.0111902. View

16.

Jacobs Jr D, Gross M, Tapsell L . Food synergy: an operational concept for understanding nutrition. Am J Clin Nutr. 2009; 89(5):1543S-1548S. PMC: 2731586. DOI: 10.3945/ajcn.2009.26736B. View

17.

Numata S, Kinoshita M, Tajima A, Nishi A, Imoto I, Ohmori T . Evaluation of an association between plasma total homocysteine and schizophrenia by a Mendelian randomization analysis. BMC Med Genet. 2015; 16:54. PMC: 4557634. DOI: 10.1186/s12881-015-0197-7. View

18.

Baierle M, Vencato P, Oldenburg L, Bordignon S, Zibetti M, Trentini C . Fatty acid status and its relationship to cognitive decline and homocysteine levels in the elderly. Nutrients. 2014; 6(9):3624-40. PMC: 4179179. DOI: 10.3390/nu6093624. View

19.

Oki E, Norde M, Carioca A, Ikeda R, Souza J, Castro I . Interaction of SNP in the CRP gene and plasma fatty acid profile in inflammatory pattern: A cross-sectional population-based study. Nutrition. 2015; 32(1):88-94. DOI: 10.1016/j.nut.2015.07.015. View

20.

Konstantinova S, Vollset S, Berstad P, Ueland P, Drevon C, Refsum H . Dietary predictors of plasma total homocysteine in the Hordaland Homocysteine Study. Br J Nutr. 2007; 98(1):201-10. DOI: 10.1017/S0007114507691788. View