Folate intake, lifestyle factors, and homocysteine concentrations in younger and older women

Background: An elevated total homocysteine (tHcy) concentration is consider ed to be an independent risk factor for cardiovascular diseases and has als o been associated with an increased risk of neural tube defects. Objective: The objective of this study was to investigate folate intake, fo late status, and the association between folate intake. other dietary and l ifestyle factors, and tHcy concentrations in young and older women. Design: tHcy concentrations were measured in 290 young women aged 25-30 y a nd in 288 older women aged 60-65 y. All participants completed questionnair es about factors including lifestyle, health, and use of vitamin supplement s. Red blood cell folate was measured in 204 of the participants. A subgrou p of 258 participants completed dietary records. Results: Median tHcy was 7.6 mu mol/L (range: 6.5-8.9) in the younger women and 9.4 mu mol/L (7.7-11.1) in the older women. Folate intake from diet wa s 283 (224-348) and 268(210-326) mug/d, respectively, in the 2 age groups. Folic acid intake from supplements (P < 0.001 for the younger women and P = 0.026 for the older women) and total folate intake (P = 0.024 and P = 0.07 9) were inversely associated with log tHcy in multiple linear regression an alyses. Smoking status, coffee consumption, systolic blood pressure, and bo dy mass index were positively associated and estrogen replacement therapy a nd tea consumption were inversely associated with log tHcy in some of the m odels. Conclusions: According to the criteria used, between 1% and 36% of the wome n had suboptimal folate intake. Folic acid is a strong predictor of tHcy co ncentration; however, several dietary and other lifestyle factors seem to b e important as well.