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Biomarkers could provide a more accurate measure of long-term intake than questionnaires. Adipose tissue is considered the best indicator of long-term essential fatty acid intake, but other tissues may prove equally valid. The authors evaluated the ability of fasting whole blood, relative to fasting plasma and adipose tissue, to reflect fatty acid intake. Costa Rican men (n = 99) and women (n = 101) completed a 135-item food frequency questionnaire and provided adipose tissue and blood samples from 1999 to 2001. Fatty acids were identified by using capillary gas chromatography. Correlation coefficients adjusted for age, sex, and body mass index were calculated. Diet-tissue correlation coefficients for alpha-linolenic acid and linoleic acid, respectively, were 0.38 and 0.43 in whole blood, 0.51 and 0.52 in adipose tissue, and 0.39 and 0.41 in plasma. High correlations were observed between whole-blood alpha-linolenic and linoleic acid and adipose tissue (r = 0.59 and r = 0.67) and plasma (r = 0.96 and r = 0.88), respectively. Results show that fasting whole blood is a suitable biomarker of long-term essential fatty acid intake, and its performance is comparable to that of fasting plasma. Thus, fasting whole blood could be the sample of choice in epidemiologic studies because of its ability to predict intake, its accessibility, and minimum sample processing.

Intervention studies show that dietary composition altered low-density lipoprotein (LDL) particle size, but population studies are scarce, and the potential effects of trans fatty acids (FA) on LDL size are unknown. Trans FA intake has been associated with a more atherogenic lipid profile and increased coronary heart disease (CHD). We examined the association between dietary intake, including trans FA and LDL size, in 414 randomly selected subjects living in Puriscal, Costa Rica. Dietary intake was assessed by a validated food frequency questionnaire (FFQ). Women had larger LDL size (A) compared with men (263 v 261), and large LDL particles were correlated with increased intake (% energy) of protein (P =.005), animal fat (P =.041), trans FA (P <.0001), and decreased intake of carbohydrate (P =.052) in sex-, age-, and total energy intake-adjusted models. The correlation between trans FA intake and large LDL was significant in multivariate models that included dietary and nondietary factors; a 1% difference in trans FA was associated with a 2.44 A increase in LDL size (P =.004). In sum, it is possible that the effects of dietary factors, such as intake of trans FA on CHD are mediated through their effects on LDL size.

Objective: We studied the association between total plasma homocysteine (tHcy) concentrations and folate, B(12), and B(6) status in the urban and rural areas of Costa Rica., Subjects and Methods: We determined plasma tHcy concentrations and assessed dietary folate, B(12) and B(6) intake by a food frequency questionnaire in 462 subjects selected by stratified random sampling in the urban and rural areas of Puriscal, Costa Rica. Plasma folate and vitamin B(12) concentrations were measured in women., Results: THcy concentrations were higher (p < 0.01) in the rural compared with the urban area: 12.0 micro mol/L vs. 8.9 micro mol/L in men, and women 7.3 micro mol/L vs. 5.5 micro mol/L in women, respectively. The prevalence of hyperhomocysteinemia (greater than 15.0 micro mol/L) was twice as high in rural compared with urban men (19.8% vs. 10.8%, p = 0.06) and women (6.6% vs. 3.4%, p = 0.26). Most study subjects (98%) had folate intakes that were less than the recommended 400 micro g/day. In women, 31% of those living in the urban area and 40% of those in the rural area had plasma folate concentrations of less than 6.8 nmol/L, an indicator of folate deficiency. In women, age-adjusted mean tHcy concentrations ( micro mol/L) were higher in the lowest compared with highest quintiles for dietary vitamin B(6) (9.9 vs. 5.4, p < 0.05), B(12) (9.2 vs. 4.9, p < 0.01), and folate (7.0 vs. 5.7, p = 0.87). Similar results were found for plasma B(12) (9.9 vs. 5.4, p < 0.01) and folate (10.5 vs. 5.0, p < 0.0001)., Conclusions: Residents of the rural area in Puriscal, Costa Rica have higher plasma concentrations of tHcy and lower intake of B vitamins, particularly in women. Because these characteristics are associated with high risk of cardiovascular disease, the efficacy of food fortification program in rural areas should be carefully addressed.