{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:22:07Z","timestamp":1770888127464,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>A low intake of fruit and vegetables and a high intake of meat are associated with higher cardiometabolic disease risk; however much prior research has relied on subjective methods for dietary assessment and focused on Western populations. We aimed to investigate the association of blood folate as an objective marker of fruit and vegetable intake and holotranscobalamin (holoTC) as a marker of animal-sourced food intake with cardiometabolic risk factors. We conducted a population-based cross-sectional study on 578 adults (mean \u00b1 SD age = 38.2 \u00b1 8.6 years; 64% women). The primary outcome was a continuous metabolic syndrome score. The median serum folate was 12.9 (IQR: 8.6\u201320.5) nmol\/L and the mean holoTC was 75 (SD: 34.3) pmol\/L. Rural residents demonstrated higher serum folate concentrations (15.9 (9.8\u201325.9) nmol\/L) than urban residents (11.3 (7.9\u201315.8) nmol\/L), but lower holoTC concentrations (rural: 69.8 (32.9) pmol\/L; urban: 79.8 (34.9)) pmol\/L, p &lt; 0.001 for both comparisons. There was an inverse association between serum folate and metabolic syndrome score by \u22120.20 in the z-score (95% CI, \u22120.38 to \u22120.02) per 10.8 (1 SD) of folate) in a model adjusted for socio-demographic factors, smoking status, alcohol intake, BMI, and physical activity. HoloTC was positively associated with the metabolic syndrome score in unadjusted analysis (0.33 (95% CI, 0.10 to 0.56)) but became non-significant (0.17 (\u22120.05 to 0.39)) after adjusting for socio-demographic and behavioural characteristics. In conclusion, serum folate and holoTC were associated with the metabolic syndrome score in opposite directions. The positive association between serum holoTC and the metabolic syndrome score was partly dependent on sociodemographic characteristics. These findings suggest that, based on these biomarkers reflecting dietary intakes, public health approaches promoting a higher intake of fruit and vegetables may lower cardiometabolic risk factors in this population.<\/jats:p>","DOI":"10.3390\/nu14010178","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T23:29:07Z","timestamp":1640906947000},"page":"178","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Associations of Serum Folate and Holotranscobalamin with Cardiometabolic Risk Factors in Rural and Urban Cameroon"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6186-8944","authenticated-orcid":false,"given":"Camille M.","family":"Mba","sequence":"first","affiliation":[{"name":"MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK"},{"name":"Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 1, Yaound\u00e9 P.O. Box 1364, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9998-051X","authenticated-orcid":false,"given":"Albert","family":"Koulman","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK"},{"name":"Nutritional Biomarker Laboratory, National Institute for Health Research Biomedical Research Centre, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nita G.","family":"Forouhi","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiaki","family":"Imamura","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3301-6028","authenticated-orcid":false,"given":"Felix","family":"Assah","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 1, Yaound\u00e9 P.O. Box 1364, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9651-8653","authenticated-orcid":false,"given":"Jean Claude","family":"Mbanya","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9 P.O. Box 1364, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick J.","family":"Wareham","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2289","DOI":"10.2337\/diacare.28.9.2289","article-title":"The Metabolic Syndrome: Time for a Critical Appraisal: Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes","volume":"28","author":"Kahn","year":"2005","journal-title":"Diabetes Care"},{"key":"ref_2","unstructured":"GBD 2019 Diseases and Injuries Collaborators (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019. 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