Assessment of Nutrient Intake and Diet Quality in Adolescent Dietary Supplement Users vs. Non-Users: The CRO-PALS Longitudinal Study.

Dietary supplement users tend to have a better diet quality and overall prudent lifestyle. The main goals of this research were to report the prevalence and type of dietary supplements among Croatian adolescents and to examine the differences in the diet quality among dietary supplement users vs. non-users at the beginning (15/16 y) and at the end of high school education (18/19 y). This research is based on results of the longitudinal CRO-PALS study in which 607 adolescents participated, who had complete dietary, anthropometric, and physical activity data at the beginning (15/16 y) and at the end of their high school education (18/19 y). The dietary assessment method used was a single multi-pass 24 h recall. Dietary supplement users were divided into two groups for the purposes of statistical analysis-users of vitamin and multivitamin preparations (VMV) and users of mineral and multivitamin preparations (MMV). As they aged, there was an increase in the consumption of dietary supplements, and the most frequently used preparation in both age groups was vitamin C (23.7% of users). Dietary supplement users had a higher intake of non-carbonated sweetened drinks and a lower intake of fruits and vegetables in both genders and both age groups. Fast food intake was higher among dietary supplement girl users and boys who were not dietary supplements users in both age groups. Dietary supplement users had a higher achieved average intake of most micronutrients (values obtained only from food) in both genders and both age groups (with exceptions for certain vitamins and minerals). By observing other parameters for assessing the diet quality in this research, we can conclude that girls who do not use dietary supplements have a better diet quality in both age groups.

Is Better Knowledge about Health Benefits of Dietary Fiber Related to Food Labels Reading Habits? A Croatian Overview.

The aim of this cross-sectional study was to determine the associations between health dietary patterns, knowledge, and consumption of dietary fiber (DF) with frequency of food label reading on food products with special reference to DF. The study was conducted in 2536 Croatian adults using an original questionnaire. Multiple linear regression models were used to assess associations between food label reading habits and predictor variables. Our study confirms the association between habits regarding the reading of labels on food products, especially in relation to information about DF with the sociodemographic factors of respondents, dietary food patterns and DF consumption, as well as knowledge and sources of information about DF. Women, individuals with a university-level education, and those living in an urban environment had more frequent labels used. Food habits as well as eating outside of the home were positive predictors while eating fast food was a negative predictor of food label reading. Knowledge about DF, especially about its health benefits, was also associated with food label reading. The interpretation of associations could help with the design of effective public health programs. Targeted education campaigns to educate and sensitize the population about food labeling and monitoring may improve general knowledge about healthy food and its benefits, which include indirect effects on the prevention of non-communicable chronic diseases.

Cooking at Home and Adherence to the Mediterranean Diet During the COVID-19 Confinement: The Experience From the Croatian COVIDiet Study.

Introduction: The primary aims of this study were to evaluate the changes in dietary behavior among the Croatian adult population during the COVID-19 outbreak and to explore the impact of confinement on cooking habits. Methods: The study was based on results from COVIDiet_Int cross-sectional study-a part of COVIDiet project (NCT04449731). A self-administered online questionnaire was used to assess the frequency of food consumption, eating habits, and sociodemographic information. A total number of 4,281 participants (80.5% females and 19.4% males) completed the questionnaire. Results: The Mediterranean Diet Adherence Screener (MEDAS) score before the confinement was 5.02 ± 1.97, while during the confinement, the MEDAS score increased to 5.85 ± 2.04. Participants who had higher adherence to the Mediterranean diet (MedDiet) during the confinement were mostly females (88.8%), aged between 20 and 50 years, with the highest level of education (66.3%) and normal BMI (70.6%). The majority of participants maintained their dietary behavior as it was before COVID-19 confinement, while 36.9% decreased their physical activity. Participants with higher MEDAS score were more eager to increase their physical activity. Additionally, higher median values of MEDAS score were noted for participants with body mass index values below 24.9 kg/m2 (6.0 vs. 5.0 for participants with BMI above 25 kg/m2). Participants in all residence places increased their cooking frequency during the confinement (53.8%), which was associated with an increase in vegetables, legumes, as well as fish and seafood consumption. Conclusions: According to our findings, Croatian adults exhibited medium adherence to the MedDiet during the COVID-19 confinement. The results suggest that cooking frequency could be positively associated with overall dietary quality, which is of utmost importance in these demanding times.

Impact of COVID-19 confinement on eating behaviours across 16 European countries: The COVIDiet cross-national study.

We aimed to evaluate the changes in eating behaviours of the adult population across 16 European countries due to the COVID-19 confinement and to evaluate whether these changes were somehow related to the severity of the containment measures applied in each country. An anonymous online self-reported questionnaire on socio-demographic characteristics, validated 14-items Mediterranean diet (MedDiet) Adherence Screener (MEDAS) as a reference of a healthy diet, eating and lifestyle behaviours prior to and during the COVID-19 confinement was used to collect data. The study included an adult population residing in 16 European countries at the time of the survey. Aggregated Stringency Index (SI) score, based on data from the Oxford COVID-19 Government Response Tracker, was calculated for each country at the time the questionnaire was distributed (range: 0-100). A total of 36,185 participants completed the questionnaire (77.6% female, 75.2% with high educational level and 42.7% aged between 21 and 35 years). In comparison to pre-confinement, a significantly higher adherence to the MedDiet during the confinement was observed across all countries (overall MEDAS score prior to- and during confinement: 5.23 ± 2.06 vs. 6.15 ± 2.06; p < 0.001), with the largest increase seen in Greece and North Macedonia. The highest adherence to MedDiet during confinement was found in Spain and Portugal (7.18 ± 1.84 and 7.34 ± 1.95, respectively). Stricter contingency restrictions seemed to lead to a significantly higher increase in the adherence to the MedDiet. The findings from this cross-sectional study could be used to inform current diet-related public health guidelines to ensure optimal nutrition is followed among the population, which in turn would help to alleviate the current public health crisis.

Eveningness in Energy Intake among Adolescents with Implication on Anthropometric Indicators of Nutritional Status: The CRO-PALS Longitudinal Study.

Shifting of energy intake towards a later time in the day is associated with an increased risk of obesity in adults. However, there is a lack of data for adolescents. The aim of this study was to investigate adolescents eveningness in energy intake (EV) and its association with anthropometric indicators of nutritional status. This investigation was based on results from the Croatian physical activity in adolescence longitudinal study (CRO-PALS). The cohort included 607 adolescents (50.25% females and 49.75% males) who were assessed at the age of 15/16 and 18/19. A single multi-pass 24-h recall was used as a dietary assessment method, while anthropometric indicators of nutritional status included body mass index (BMI), waist to hip ratio (WHR) and the sum of four skinfolds. The School Health Action, Planning and Evaluation System (SHAPES) questionnaire was used to assess active daily energy expenditure and sedentary behaviors. EV was significantly higher at 18/19 years compared to 15/16 years in whole population (p < 0.01), among male adolescents (p < 0.01), but not among female adolescents (p > 0.05). Although a significant correlation between EV and WHR was found in females at the age of 15/16 (p < 0.01), the results of this study suggest that EV has no or a minor effect on anthropometric indicators of nutritional status in adolescence.

Obesity in Adolescents Who Skip Breakfast Is Not Associated with Physical Activity.

It has been hypothesized that breakfast consumption is generally associated with healthy lifestyle behaviors, such as increased physical activity. The aim of this study was to examine the relations between breakfast consumption, adiposity measures and physical activity among adolescents. This investigation is a part of the Croatian physical activity in adolescence longitudinal study (CRO-PALS). This investigation is based on 802 participants (48% girls and 52% boys), aged between 15.2 and 16.0 years. Physical activity level and sedentary behaviors were assessed using the SHAPES questionnaire. Adiposity measures included the sum of four skinfolds, and multi-pass 24-h recall was used as the dietary assessment method. Participants who consumed breakfast had significantly lower body fat % (p = 0.011 for boys; p ≤ 0.001 for girls) compared to breakfast non-consumers. Physical activity has no mediating effect in the association of breakfast consumption on adiposity in boys (Sobel's t = -0.541; p = 0.588) and girls (Sobel's t = 1.020; p = 0.307). Breakfast consumption was negatively associated with adiposity only in the boys at the highest tertile of physical activity (p = 0.04). Physical activity has no mediating effect on the associations between breakfast consumption and adiposity, but has a moderation effect only in the most active boys. Breakfast consumption might exert beneficial effects only in the most active male adolescents, but not in the inactive ones.

Consumer knowledge and attitudes toward healthy eating in Croatia: a cross-sectional study.

Unlike fast and restaurant food, diet rich in fibre is known to contribute significantly to health. The aim of our study was to assess eating habits such as consumption of fibre-rich, fast, and restaurant food of the general population in Croatia. For this purpose we used a validated survey designed by the Polytechnic Institute Viseu in Portugal, which includes questions about demographics, good eating habits related to the consumption of the main sources of dietary fibre (fruit, vegetables, and whole grains), and unhealthy eating habits related to the consumption of fast food and restaurant meals. Between October 2014 and March 2015 we received answers from 2,536 respondents aged between 18-70 years, of whom 67.4 % were women and 32.6 % were men. Most respondents reported consuming one serving of vegetables and one piece of fruit a day, and whole grains every other day. Women and urban residents reported consuming larger amounts of fruit, vegetables, and whole grains than men (p<0.001). Men, in turn, reported eating out and eating fast food more often than women (p<0.001). Eating out highly correlated with eating fast food, which translates to lower consumption of dietary fibre (p<0.001). Higher education correlated positively with the consumption of fibre-rich food, but it also correlated positively with the consumption of fast and restaurant food (p<0.001). While eating fast food is not the predominant dietary practice in Croatia, over 50 % of respondents have reported eating fast food at least once a week. Our data also indicate that consumption of fruit, vegetables, and whole grains falls below the national and international dietary recommendations.

Knowledge about dietary fibre and its health benefits: A cross-sectional survey of 2536 residents from across Croatia.

This cross-sectional study is aimed at identifying the level of understanding of the health benefits of dietary fibre in the prevention of disease, as well as the association between that understanding and fibre consumption in the Croatian population. We believe that nutritional knowledge is important for the consumption of healthy food which includes also a positive reflection on food habits and health. Only well-informed consumers can shop effectively for food rich in dietary fibre and thereby derive the health benefits that fibre can offer. We suppose the association between that understanding and fibre consumption in the Croatian population. However, this knowledge is not the only important determinant; food purchases are influenced by socioeconomic and demographic factors. Our hypothesis is that the level of knowledge about fibre and fibre consumption varies with age, gender, education level and urban or rural environment. It is our assumption that life styles, environmental conditions and education can affect the level of knowledge and perception about healthy eating habits. If this assumption is accurate, targeted education campaigns to educate and sensitise the population about fibre-rich foods and the health benefits of fibre is a priority. Public health programmes are urgently needed, particularly in rural areas, to sensitise the population to fulfill the recommended fibre intake, high-fibre food sources and the mechanisms by which fibre can help prevent disease.

Knowledge about dietary fibre: a fibre study framework.

The objective of this work was to study the degree of knowledge about dietary fibre (DF), as influenced by factors such as gender, level of education, living environment or country. For this, a descriptive cross-sectional study was undertaken on a non-probabilistic sample of 6010 participants from 10 countries in different continents (Europe, Africa and America). The results showed that the participants revealed on average a positive but still low global level of knowledge, which alerts for the need to take some actions to further inform the population about DF and its role as a component of a healthy diet. The results also indicated differences between genders, levels of education, living environments and countries. The highest level of knowledge was revealed by the participants from female gender, with higher education and living in urban areas. Concerning the country, the best informed were the participants from Romania, followed by those from Portugal and Turkey while the least informed were from Egypt.

Improving nutrition surveillance and public health research in Central and Eastern Europe/Balkan Countries using the Balkan Food Platform and dietary tools.

The objective of this paper is to share experience and provide updated information on Capacity Development in the Central and Eastern Europe/Balkan Countries (CEE/BC) region relevant to public health nutrition, particularly in creation of food composition databases (FCDBs), applying dietary intake assessment and monitoring tools, and harmonizing methodology for nutrition surveillance. Balkan Food Platform was established by a Memorandum of Understanding among EuroFIR AISBL, Institute for Medical Research, Belgrade, Capacity Development Network in Nutrition in CEE - CAPNUTRA and institutions from nine countries in the region. Inventory on FCDB status identified lack of harmonized and standardized research tools. To strengthen harmonization in CEE/BC in line with European research trends, the Network members collaborated in development of a Regional FCDB, using web-based food composition data base management software following EuroFIR standards. Comprehensive nutrition assessment and planning tool - DIET ASSESS & PLAN could enable synchronization of nutrition surveillance across countries.

Professional training in nutrition in Central and Eastern Europe: current status and opportunities for capacity development.

OBJECTIVE: To examine the availability of academic programmes in nutrition and identify nutrition training needs in Central and Eastern Europe (CEE). DESIGN: A questionnaire with close-ended and open-ended questions was distributed to the members of the United Nations University Standing Committee on Nutrition, Regional Network for Capacity Development in Nutrition in CEE (NCDN CEE). SETTING: Participants' responses to the questionnaire including the comments of their colleagues from home institutions were obtained in group discussions during NCDN CEE meetings in 2010-2013. SUBJECTS: Sixteen CEE countries' experts and their colleagues from home institutions involved in NCDN CEE activities 2007-2013. RESULTS: The responses were obtained from fourteen out of sixteen participating countries; five countries have established Bachelor, Master and PhD studies in nutrition (Croatia, Czech Republic, Poland, Slovak Republic and Slovenia), whereas in Latvia and Republic of Macedonia only Bachelor and Master studies are set up. Seven countries have no Bachelor, Master or PhD studies: Bosnia and Herzegovina, Bulgaria, Estonia, Lithuania, Montenegro, Romania and Serbia. Introduction to data analysis and Nutritional epidemiology are the most needed nutrition trainings that would increase working competence of nutritionists and nutrition-related professionals in CEE. CONCLUSIONS: Availability of academic programmes in nutrition in CEE countries is limited. Opportunities for improving the competence of existing and future nutrition-related professionals should be addressed at national and regional level; distance learning courses and creation of a regional centre for nutrition training were seen as opportunities for sustainable capacity development in nutrition in CEE.

Adequacy of nutrient intakes in elite junior basketball players.

PURPOSE: The aim of this study was to assess the nutrient intakes of elite junior basketball players in comparison with nonathletes. METHODS: A previously designed food frequency questionnaire was undertaken by 57 male elite junior basketball players 15 to 16 years of age and 53 nonathlete peers. RESULTS: Mean estimated energy intake was more than 700 kcal higher in basketball players than in the nonathletes (p = .002). In both groups estimated energy intake was ~14% from protein, 38% from fat, and ~48% from carbohydrates. For the basketball players, estimated protein intake was below 1.4 g/kg in 32% of the group and above 1.7 g/ kg in 51%, while carbohydrate intake was below 6 g/kg in 56%. Percentages of participants who apparently failed to meet the estimated average requirement for micronutrients were higher in the nonathlete group. The nutrients most likely to fail to meet the recommendations for nutrient density were vitamin A (~70%), zinc (49% in basketball players and 30% in nonathletes), niacin and calcium (~30% for both micronutrients in both groups). CONCLUSION: Within the limitations of the survey methodology, elite junior basketball players appear to consume higher absolute energy, macronutrient and micronutrient intakes than nonathletes, but the contribution of macronutrients to daily energy intake and the nutrient density of food choices was similar for both groups. Elite junior basketball players might benefit from nutrition education targeting carbohydrate and protein intake. Dietary modifications that increase intakes of vitamin A, zinc, calcium and niacin in the diets of both groups might also be of value.

Influence of nutrition and lifestyle on bone mineral density in children from adoptive and biological families.

BACKGROUND: The precise contributions of hereditary and environmental factors to bone density are not known. We compared lifestyle predictors of bone density among adopted and biological children. METHODS: The study comprised 18 adopted children (mean [SD] age, 14.0 [4.1] years) with their non-biological parents and 17 children with their biological parents. Bone mineral density (BMD; g/cm(2)) was measured at the lumbar spine, total femur, and distal radius. Nutritional intake was assessed by food frequency questionnaire. Information on smoking and physical activity was obtained by questionnaire. RESULTS: Intakes of all nutrients, corrected for energy intake, and all lifestyle characteristics except sleep duration were similar in biological children and their parents. As compared with their parents, adopted children had significantly different energy, protein, and calcium intakes and physical activity levels. In a regression model, BMD z scores of adopted children and their parents were significantly inversely associated at the spine and total femur, whereas BMD z scores of biological children and their parents were significantly positively associated at all measurement sites. The greatest proportion of total variance in BMD was accounted for by calcium intake among adopted children and by parental BMD among biological children. CONCLUSIONS: For some lifestyle characteristics and nutrient intakes, the differences between parents and children were more obvious among adoptive families than among biological families. The most important lifestyle predictor of bone density was calcium intake.

Micronutrient intake and status in Central and Eastern Europe compared with other European countries, results from the EURRECA network.

OBJECTIVE: To compare micronutrient intakes and status in Central and Eastern Europe (CEE) with those in other European countries and with reference values. DESIGN: Review of the micronutrient intake/status data from open access and grey literature sources from CEE. SETTING: Micronutrients studied were folate, iodine, Fe, vitamin B12 and Zn (for intake and status) and Ca, Cu, Se, vitamin C and vitamin D (for intake). Intake data were based on validated dietary assessment methods; mean intakes were compared with average nutrient requirements set by the Nordic countries or the US Institute of Medicine. Nutritional status was assessed using the status biomarkers and cut-off levels recommended primarily by the WHO. SUBJECTS: For all population groups in CEE, the mean intake and mean/median status levels were compared between countries and regions: CEE, Scandinavia, Western Europe and Mediterranean. RESULTS: Mean micronutrient intakes of adults in the CEE region were in the same range as those from other European regions, with exception of Ca (lower in CEE). CEE children and adolescents had poorer iodine status, and intakes of Ca, folate and vitamin D were below the reference values. CONCLUSIONS: CEE countries are lacking comparable studies on micronutrient intake/status across all age ranges, especially in children. Available evidence showed no differences in micronutrient intake/status in CEE populations in comparison with other European regions, except for Ca intake in adults and iodine and Fe status in children. The identified knowledge gaps urge further research on micronutrient intake/status of CEE populations to make a basis for evidence-based nutrition policy.

Personality traits, motivation and bone health in vegetarians.

Vegetarian diets attract more and more attention due to growing concerns about health, ecology and/or animal welfare in general population. The main purpose of this paper was to examine whether vegetarianism could be associated with some specific personality characteristics, with the emphasis on the main motivational factors which determined acquiring the diet. Since the nutrition is also an important determinant of bone health we additionally analyzed the association between personal characteristics and bone density. On a sample of 109 adult vegetarians of both sexes we applied Eysenck Personality Questionnaire (including Psychoticism, Extraversion, Neuroticism and Lie scale), bone densitometry and questionnaire on dominant motives for dietary choices. The results on overall personality characteristics, bone density and basic anthropometric measures were within expected values for age. Vegetarian men had significantly more fractures during lifetime and lower neuroticism scores than women. Dominant motivational factors for acquiring vegetarianism were moral values. In addition "moral vegetarians" showed more pronounced introversion compared to "health vegetarians", lending further support to the argument that personality plays an important role in the structure of motivation.

Influence of heredity and environment on peak bone density: a review of studies in Croatia.

One of the main determinants of who will develop osteoporosis is the amount of bone accumulated at peak bone density. There is poor agreement, however, on when peak bone density occurs. Ethnic differences were observed in age at peak bone density and their correlates. Since the diagnosis of osteoporosis and osteopaenia is based on the comparison between patients' bone mineral density (BMD) and optimal peak bone density in healthy young people (T-score), it is of great importance that each country should provide its own reference peak bone density data.This review article presents our published results on peak bone density in Croatia and compares them with findings in other populations. Our research included 18 to 25-year-old students from Zagreb University and their parents. The results showed that peak bone mass in young Croatian women was achieved before the age of twenty, but BMD continued to increase after the mid-twenties in the long-bone cortical skeleton. BMD was comparable to the values reported by the National Health and Nutrition Examination Survey (NHANES) and other studies that included the same age groups, except for the cortical part of the radius, where it was significantly lower. Men achieved peak bone density in the spine later than women, which cannot be explained by different diet or physical activity. As expected, heredity was more important for peak bone density than the environmental factors known to be important for bone health. However, the influence of heredity was not as strong as observed in most other populations. It was also weaker in the cortical than in the trabecular parts of the skeleton. Future research should include young adolescent population to define the exact age of achieving peak bone density in different skeletal sites.

Diet quality in elderly nursing home residents evaluated by Diet Quality Index Revised (DQI-R).

The objective of this research was to evaluate diet quality in elderly nursing home residents and to point out the critical dietary components. The participants (277 females and 62 males) were recruited from all elderly nursing homes in Zagreb and each of elderly nursing homes was equally represented in this study. The age of subjects was ranging from 61 to 93 years; most of the females (53.4%) and males (53.2%) were between 70 and 80 years old. The dietary data from the multi pass 24-hour recall were used to compute the Diet Quality Index Revised (DQI-R). DQI-R is an instrument that provides a summary assessment of a diet's overall healthfulness and is based on ten different aspects, including recommendations for both nutrient and food types. Pearson correlation analysis was used to compare the total DQI-R score with dietetic parameters and t-test was calculated between mean values of all the components of DQI-R as well as for total DQI-R score for men and women. The mean DQI-R score for the 339 sample was 62.1 +/- 11.7. The biggest number of participants satisfied recommendations about dietary cholesterol intake (88.5% of participants) and dietary moderation score (71.1% of participants) but nobody satisfied recommendation about dietary diversity score. Only 3.2% of subjects had an adequate calcium intake (6.5% of male participants and only 2.5% of female participants). Recommended servings of fruit intake were satisfied by 19.8% of population, 30.4% satisfied vegetables recommendations and 38.6% recommendations for grains. According to DQI-R, beside positive dietary habits regarding dietary moderation and dietary cholesterol intake the population of elderly nursing home residents in the capital of Croatia needs improvement in other dietary habits in order to enhance successful aging.

Influence of heredity and environment on peak bone density: a parent-offspring study.

The aim of the study was to determine the relative influence of heredity and environment on peak bone density and also to estimate the risk of having low peak bone density if the bone density of parents is low. The study comprised 83 families (48 daughters and 35 sons and their parents). The children were at an age when bone density is at its peak at most skeletal sites (22.2+/-1.8 girls; 23.1+/-1.2 boys). Bone mineral density (BMD; g/cm(2)) was determined by dual-energy X-ray absorptiometry. Anthropometric measurements were made, and calcium intake and physical activity were assessed. Heredity accounted for 22-42% of the variation in BMD of the children, depending on the skeletal site. Heritability for cortical BMD of mid-radius was considerably lower than that for spinal trabecular BMD. Children whose parents had low BMDs (T-score< or =-1) were 1.1 times more likely to inherit low BMD. Child BMD depended significantly on parent BMD and also on physical activity. In our study, heredity accounted for the total BMD variation more than the environmental factors. This influence was lower in the cortical than in the trabecular parts of the skeleton. Optimal environmental factors, such as physical activity, may influence the risk of inheriting low BMD.

Differences in peak bone density between male and female students.

As an important determinant of osteoporotic fracture risk, peak bone density tends to be higher in men than in women. The aim of this study was to see whether young men and women differed in the time and skeletal region of peak bone density. We also investigated the influence of diet and physical activity on bone mass. The study group included 51 male and 75 female students aged 19 to 25 years. Bone mineral density was measured for the spine, total femur, and the distal third of the radius using dual energy x-ray absorptiometry. Dietary data were obtained using a specially designed semiquantitative food frequency questionnaire. Bone mineral density (BMD; g cm(-2)) was higher in boys than in girls at all measured sites, while bone mineral apparent density (BMAD; g cm(-3)) was higher in girls. Age negatively correlated with bone mineral density in all measured sites except in the boys' spine. Sodium, protein, and fibres were nutrients that significantly correlated with bone mineral density. The study suggests that boys achieve peak bone density later than girls, and that this delay is the most prominent in the spine. In our study group, this difference could not be explained by different nutrition or the level of physical activity.

Validation of the folate food frequency questionnaire in vegetarians.

Adequate folate status has an important role in the prevention of chronic and developmental diseases and is considered a potential public health issue. Therefore, valid tools for measuring the vitamin intake are needed. In our previous study a folate food frequency questionnaire (FFQ) designed to measure dietary folate equivalents was developed and validated among adult women against serum and erythrocyte (red blood cell) folate and plasma homocysteine. The aim of the present study was to validate the FFQ in vegetarians (n=75). The Pearson correlation for folate intake and biomarkers was 0.41, 0.36 and -0.15 for serum and red blood cell folate and plasma homocysteine, respectively. The quadratic weighted kappa value for biomarkers was above 0.2 and the gross misclassification of subjects into quartiles was less than 10%. The FFQ is a valid tool for measuring dietary folate equivalent intake in Croatian vegetarians.