Abstract
Folate fortification of bread and grains has been directed to prevent neural tube birth defects. Research has also challenged previous concepts of folate nutritional status and suggested that folate may play a role in reducing the risk of vascular disease. Although folate status of many elderly people is adequate according to traditional, hematologic criteria, some elderly persons have elevated blood concentrations of the metabolite homocysteine, which indicates subclinical deficiency of folate or vitamin B-12. Higher homocysteine concentrations, even within the normal range, are associated with increased risk of vascular disease. Elderly people with better folate and vitamin B-12 status have lower homocysteine concentrations and may have lower risk for vascular disease. Although the new folate fortification rules provide the benefit of increasing folate in the food supply, they could be a risk for the elderly because excess folate intake can mask vitamin B-12 deficiency, thereby delaying diagnosis. Elderly people have a higher prevalence of vitamin B-12 deficiency as a result of absorption problems. Those deficient in vitamin B-12 should be treated to prevent irreversible neurologic damage. Modern approaches to screening the elderly include using higher cutoff points for serum vitamin B-12 and obtaining blood concentrations of the metabolite methylmalonic acid, which is elevated in deficiency of vitamin B-12 but not folate. To examine current folate intake and food sources, food frequency questionnaires were administered to 308 elderly volunteers aged 65 to 94 years. Mean (+/-standard error) folate intake from food was 299.6+/-5.8 microg/day. Supplements (median dose=400 microg/day) were consumed by 47% of participants. Only 3.2% of the sample had total folate intake greater than 1,000 microg/day, the recommended upper limit, and these were taking high-dose folate supplements (> or = 800 microg/day). Breakfast cereals provided 25.6% of folate intake; vegetables, 23.2%; fruit, 20.8%; refined breads/grains, 6.7%; dark bread, 5.0%; legumes/nuts, 5.9%; dairy products, 5.8%; meat/poultry/fish/eggs, 5.1%; other, 1.9%. Mean folate intake would increase 16.5% if enriched bread and grains were fortified. Such fortification could help some persons to lower serum homocysteine concentration and vascular disease risk. Dietitians should be aware of modern protocols for screening the elderly for vitamin B-12 deficiency.
Full Text
Topics from this Paper
Mean Folate Intake
Lower Homocysteine Concentration
Folate Intake
Deficiency Of Vitamin
Homocysteine Concentrations
+ Show 5 more
Create a personalized feed of these topics
Get StartedSimilar Papers
The Journal of Nutrition
Dec 1, 1996
Public health nutrition
Mar 19, 2020
British Journal of Nutrition
Nov 1, 2007
The American Journal of Clinical Nutrition
Jul 1, 2008
The Journal of Nutrition
Aug 1, 2002
European Journal of Clinical Nutrition
Jun 25, 2002
European Journal of Nutrition
May 25, 2019
Circulation
Mar 1, 2001
Journal of Nutritional Science and Vitaminology
Jan 1, 2008
Cancer Research
Jul 1, 2017
Journal of the American Dietetic Association
Sep 1, 1999
Nutrition Research
Mar 1, 2014
The Lancet Neurology
Aug 1, 2004
Mediterranean Journal of Nutrition and Metabolism
Feb 1, 2015
Journal of the American Dietetic Association
Journal of the American Dietetic Association
Jan 1, 2018
Journal of the American Dietetic Association
Jan 1, 2017
Journal of the American Dietetic Association
Mar 14, 2016
Journal of the American Dietetic Association
May 18, 2012
Journal of the American Dietetic Association
Dec 1, 2011
Journal of the American Dietetic Association
Dec 1, 2011
Journal of the American Dietetic Association
Dec 1, 2011
Journal of the American Dietetic Association
Dec 1, 2011
Journal of the American Dietetic Association
Dec 1, 2011
Journal of the American Dietetic Association
Dec 1, 2011