Abstract
The potential protective roles of folate and the metabolically related B-vitamins (vitamins B12, B6 and riboflavin) in diseases of ageing are of increasing research interest. The most common cause of folate and riboflavin deficiencies in older people is low dietary intake, whereas low B12 status is primarily associated with food-bound malabsorption, while sub-optimal vitamin B6 status is attributed to increased requirements in ageing. Observational evidence links low status of folate and the related B-vitamins (and/or elevated concentrations of homocysteine) with a higher risk of degenerative diseases including cardiovascular disease (CVD), cognitive dysfunction and osteoporosis. Deficient or low status of these B-vitamins alone or in combination with genetic polymorphisms, including the common MTHFR 677 C → T polymorphism, could contribute to greater disease risk in ageing by causing perturbations in one carbon metabolism. Moreover, interventions with the relevant B-vitamins to optimise status may have beneficial effects in preventing degenerative diseases. The precise mechanisms are unknown but many have been proposed involving the role of folate and the related B-vitamins as co-factors for one-carbon transfer reactions, which are fundamental for DNA and RNA biosynthesis and the maintenance of methylation reactions. This review will examine the evidence linking folate and related B-vitamins with health and disease in ageing, associated mechanisms and public health implications.
Highlights
An estimated 900 million people are aged ≥65 years globally, equating with 8% of the world’s population, and by 2050, this is predicted to exceed two billion (16%) [1]
Specific genetic polymorphisms, including the common methylenetetrahydrofolate reductase (MTHFR) 677 C → T polymorphism can disrupt normal one-carbon metabolism and have an impact on diseases of ageing, independent of homocysteine, as a result of impairments in methylation activity; improved B-vitamin status could help to modulate this risk [13,225,226]
Folate and the metabolically related B-vitamins, B12, B6 and riboflavin, have a vital role in maintaining one-carbon metabolism and any perturbation in this pathway as a result of low/deficient B-vitamin status can impact on health through a number of related mechanisms
Summary
An estimated 900 million people are aged ≥65 years globally, equating with 8% of the world’s population, and by 2050, this is predicted to exceed two billion (16%) [1]. Osteoporotic fractures affect over nine million older people annually [4], while 46.8 million older people are reported to have dementia worldwide [5] The prevalence of these diseases of ageing is expected to substantially increase as a result of the ever-increasing ageing population. Poor nutrition is recognised as a modifiable risk factor in the development of degenerative diseases in ageing, and improved nutrition may prevent or delay the onset of adverse health outcomes as people age. In this context, the potential adverse effect of elevated homocysteine and/or the protective roles of folate and the metabolically related B-vitamins (B12 and B6), have received much attention. B-vitamin status in older people will be considered with particular emphasis on the role of food fortification
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