Comparison of two dietary folate intake instruments and their validation by RBC folate

An optimal folate nutritional status is important in minimizing developmental and degenerative disease. Therefore, constant monitoring of folate intake and of biomarkers of folate nutritional status is essential. The objective of this research was to compare two folate intake instruments and validate each one against RBC folate measured by a high-throughput liquid chromatography tandem mass spectrometry (HT LC-MS/MS) method described in the companion paper (Owens, J. E.; Holstege, D. M.; Clifford, A. J. J. Agric. Food Chem. 2007, 55, 3292-3297). A food frequency questionnaire (FFQ) and a folate-targeted semiquantitative Block dietary folate equivalents (DFE) screener were compared and individually validated against an HT LC-MS/MS method. RBC folate was 1178 +/- 259 nmol/L (mean +/- SD) in a population of 337 normal adult subjects. Folate intakes were 556 +/- 265 microg/day by the FFQ and 524 +/- 276 microg/day by the DFE screener. Folate intakes by the DFE screener were approximately 34 microg less than by the FFQ (paired t test, p<0.01), but the intake instruments were highly correlated for total folate intake (r=0.608, p<0.01). Correlations between instruments and RBC folate were low (r<0.35) but strong (p<0.01). ROC curve analysis indicates that the measurement of RBC folate by the HT LC-MS/MS method is a better predictive tool than are intake instruments for the evaluation of marginal folate status.