Do dietary patterns determine levels of vitamin B6, folate, and vitamin B12 intake and corresponding biomarkers in European adolescents? The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

Nutrition. 2018 Jun:50:8-17. doi: 10.1016/j.nut.2017.10.017. Epub 2017 Nov 28.


Objectives: To determine dietary patterns (DPs) and explain the highest variance of vitamin B6, folate, and B12 intake and related concentrations among European adolescents.

Methods: A total of 2173 adolescents who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence study met the eligibility criteria for the vitamin B intake analysis (46% boys) and 586 adolescents for the biomarkers analysis (47% boys). Two non-consecutive, 24-h, dietary recalls were used to assess the mean intakes. Concentrations were measured by chromatography and immunoassay testing. A reduced rank regression was applied to elucidate the combined effect of food intake of vitamin B and related concentrations.

Results: The identified DPs (one per vitamin B intake and biomarker and by sex) explained a variability between 34.2% and 23.7% of the vitamin B intake and between 17.2% and 7% of the biomarkers. In the reduced rank regression models, fish, eggs, cheese, whole milk and buttermilk intakes were loaded positively for vitamin B intake in both sexes; however, soft drinks and chocolate were loaded negatively. For the biomarkers, a higher variability was observed in the patterns in terms of food loads such as alcoholic drinks, sugars, and soft drinks. Some food items were loaded differently between intakes and biomarkers such as fish products, which was loaded positively for intakes but negatively for plasma folate in girls.

Conclusions: The identified DPs explained up to 34.2% and 17.2% of the variability of the vitamin B intake and plasma concentrations, respectively, in European adolescents. Further studies are needed to elucidate the factors that determine such patterns.

Keywords: Adolescents; Dietary patterns; Europe; Reduced rank regression; Vitamin B.

Publication types

  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Cross-Sectional Studies
  • Diet / statistics & numerical data*
  • Diet Surveys
  • Eating
  • Europe
  • Female
  • Folic Acid / analysis*
  • Healthy Lifestyle
  • Humans
  • Male
  • Nutrition Assessment
  • Nutritional Status
  • Regression Analysis
  • Vitamin B 12 / analysis*
  • Vitamin B 6 / analysis*
  • Vitamin B Complex / analysis*


  • Biomarkers
  • Vitamin B Complex
  • Vitamin B 6
  • Folic Acid
  • Vitamin B 12