Abstract
Advanced-age adults may be at risk of iron, folate, and vitamin B12 deficiency due to low food intake and poor absorption. This study aimed to investigate the intake and adequacy of iron, folate, and vitamin B12 and their relationship with respective biomarker status. Face-to-face interviews with 216 Māori and 362 non-Māori included a detailed dietary assessment using 2 × 24-h multiple pass recalls. Serum ferritin, serum iron, total iron binding capacity, transferrin saturation, red blood cell folate, serum folate, serum vitamin B12 and hemoglobin were available at baseline. Regression techniques were used to estimate the association between dietary intake and biomarkers. The Estimated Average Requirement (EAR) was met by most participants (>88%) for dietary iron and vitamin B12 (>74%) but less than half (>42%) for folate. Increased dietary folate intake was associated with increased red blood cell (RBC) folate for Māori (p = 0.001), non-Māori (p = 0.014) and serum folate for Māori (p < 0.001). Folate intake >215 µg/day was associated with reduced risk of deficiency in RBC folate for Māori (p = 0.001). Strategies are needed to optimize the intake and bioavailability of foods rich in folate. There were no significant associations between dietary iron and vitamin B12 intake and their respective biomarkers, serum iron and serum vitamin B12.
Highlights
The population of adults aged 85+ are expected to increase six-fold by 2068 [1] and in the coming years the older Māori population will increase at a rate higher than non-Māori [2]
Folate, and vitamin B12 are largely intertwined in the production of red blood cells (RBC) and are the most common nutrient deficiencies associated with anemia [5,6]
Less than half of all participants met the Estimated Average Requirement (EAR) for folate (42% Māori; 49% non-Māori) and up to a third of participants were deficient in RBC folate (27% Māori; 31% non-Māori)
Summary
The population of adults aged 85+ are expected to increase six-fold by 2068 [1] and in the coming years the older Māori population will increase at a rate higher than non-Māori [2]. Folate, and vitamin B12 are largely intertwined in the production of red blood cells (RBC) and are the most common nutrient deficiencies associated with anemia [5,6]. Deficiency in these nutrients have been implicated in impaired cognition and depression [7,8], increased risk of falls [9], decreased quality of life and increased risk of mortality in older adults [10,11,12,13].
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