Development of a Dietary Methyl Donor Food Frequency Questionnaire to Assess Folate and Vitamin B12 Status in Children with Chronic Hepatitis B Virus Infection

Douglas Bradford Mogul, Nga Brereton, Kathryn Anne Carson, Maria Pittarelli, Hubert Daniel, Michael Torbenson, Kathleen Schwarz

Research output: Contribution to journalArticle


Objective: To develop a dietary methyl donor food frequency questionnaire (DMD-FFQ) that is validated in a cohort of US children and to determine whether the consumption of folate and vitamin B12, principal DMDs, correlates with HBV DNA levels and its methylation density. Study design: We developed a semiquantitative DMD-FFQ to estimate intake of folate and vitamin B12 and validated this instrument against a 24-hour dietary recall and biomarkers—red blood cell folate, serum vitamin B12, and homocysteine—in 35 children with chronic HBV infection without other medical comorbidities. Estimates of DMD, as well as the serum biomarkers, were correlated with the methylation density of HBV CpG island 2 and HBV DNA levels. Results: Folate per kilogram of body weight by the DMD-FFQ correlated positively with 24-hour recall (r = 0.60; P < .001) and red blood cell folate (r = 0.40; P = .02), and negatively with homocysteine (r = -0.54; P < .001). Vitamin B12 per kilogram by DMD-FFQ also correlated positively with 24-hour recall (r = 0.57; P < .001) and serum vitamin B12 (r = 0.36, P = .04), and negatively with homocysteine (r = -0.44; P = .008). Neither DMD intake (from DMD-FFQ or 24-hour recall) nor serum biomarkers correlated with HBV DNA levels or its methylation density. Conclusions: Our DMD-FFQ correlates well with a 24-hour recall and circulating biomarkers. Although little evidence existed that consumption of these micronutrients correlated with HBV replication, this tool could prove useful for investigating epigenetic modification by diet for several pediatric diseases.

Original languageEnglish (US)
JournalJournal of Pediatrics
StateAccepted/In press - Jan 1 2018



  • dietary methyl donor
  • epigenetic
  • folate
  • food-frequency questionnaire
  • hepatitis B virus
  • methylation
  • validation
  • vitamin B

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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