Dietary folate intake and metabolic syndrome in participants of PREDIMED-Plus study: a cross-sectional study

Navarrete-Muñoz, Eva-María; Fitó Colomer, Montserrat; Castañer, Olga; Zomeño Fajardo, María Dolores; Goday Arnó, Albert; García de la Hera, Manuela

doi:http://dx.doi.org/10.1007/s00394-020-02364-4

Dietary folate intake and metabolic syndrome in participants of PREDIMED-Plus study: a cross-sectional study

Citation

Navarrete-Muñoz EM, Vioque J, Toledo E, Oncina-Canovas A, Martínez-González MÁ, Salas-Salvadó J et al. Dietary folate intake and metabolic syndrome in participants of PREDIMED-Plus study: a cross-sectional study. Eur J Nutr. 2021;60(2):1125-36. DOI: 10.1007/s00394-020-02364-4

Abstract

Purpose: We examined the association between dietary folate intake and a score of MetS (metabolic syndrome) and its components among older adults at higher cardiometabolic risk participating in the PREDIMED-Plus trial. Methods: A cross-sectional analysis with 6633 with overweight/obesity participants with MetS was conducted. Folate intake (per 100 mcg/day and in quintiles) was estimated using a validated food frequency questionnaire. We calculated a MetS score using the standardized values as shown in the formula: [(body mass index + waist-to-height ratio)/2] + [(systolic blood pressure + diastolic blood pressure)/2] + plasma fasting glucose-HDL cholesterol + plasma triglycerides. The MetS score as continuous variable and its seven components were the outcome variables. Multiple robust linear regression using MM-type estimator was performed to evaluate the association adjusting for potential confounders. Results: We observed that an increase in energy-adjusted folate intake was associated with a reduction of MetS score (β for 100 mcg/day = - 0.12; 95% CI: - 0.19 to - 0.05), and plasma fasting glucose (β = - 0.03; 95% CI: - 0.05 to - 0.02) independently of the adherence to Mediterranean diet and other potential confounders. We also found a positive association with HDL-cholesterol (β = 0.07; 95% CI: 0.04-0.10). These associations were also observed when quintiles of energy-adjusted folate intake were used instead. Conclusion: This study suggests that a higher folate intake may be associated with a lower MetS score in older adults, a lower plasma fasting glucose, and a greater HDL cholesterol in high-risk cardio-metabolic subjects.