Intakes of Folate and Vitamin B12 and Biomarkers of Status in the Very Old: The Newcastle 85+ Study.

Nuno Mendonça,Tom Hill,Ashley Adamson,Carmen Martin-Ruiz,Carol Jagger,Chris Seal,John Mathers

doi:10.3390/nu8100604

Abstract

Very old adults are at increased risk of folate and vitamin B12 deficiencies due to reduced food intake and gastrointestinal absorption. The main aim was to determine the association between folate and vitamin B12 intake from total diets and food groups, and status. Folate or vitamin B12 intakes (2 × 24 h multiple pass recalls) and red blood cell (RBC) folate or plasma vitamin B12 (chemiluminescence immunoassays) concentrations were available at baseline for 731 participants aged 85 from the Newcastle 85+ Study (North-East England). Generalized additive and binary logistic models estimated the associations between folate and vitamin B12 intakes from total diets and food groups, and RBC folate and plasma B12. Folate intake from total diets and cereal and cereal products was strongly associated with RBC folate (p < 0.001). Total vitamin B12 intake was weakly associated with plasma vitamin B12 (p = 0.054) but those with higher intakes from total diets or meat and meat products were less likely to have deficient status. Women homozygous for the FUT2 G allele had higher concentrations of plasma vitamin B12. Cereals and cereal products are a very important source of folate in the very old. Higher intakes of folate and vitamin B12 lower the risk of “inadequate” status.

Highlights

B vitamins, folate and vitamin B12, are essential for one-carbon transfer reactions which include amino acid interconversions, RNA and DNA synthesis and methylation of cell macromolecules [1]
Vitamin B12 intakes were below the UK lower reference nutrient intake (LRNI) (1 μg/day) [33] in
Individuals in quartile 4 of vitamin B12 intake from meat and meat products (>2.10 μg/day) were half as likely to be deficient for plasma vitamin B12 as those in quartile 1 in the unadjusted (OR: 0.55, 95% CI: 0.31–0.98) and adjusted models (OR: 0.41, 95% CI: 0.20–0.81)

Summary

Introduction

B vitamins, folate and vitamin B12, are essential for one-carbon transfer reactions which include amino acid interconversions, RNA and DNA synthesis and methylation of cell macromolecules [1]. UK National Diet and Nutrition Survey (NDNS) rolling programme estimated that 1% of older adults (aged 65 and over) were below the UK lower reference nutrient intake (LRNI) for folate (100 μg/day). About 10%–30% of older adults have atrophic gastritis (caused by Helicobacter pylori infection, long-term use of proton pump inhibitors, H2 receptor antagonists and biguanides) which leads to hypochlorhydria [12]. This has a detrimental effect onacid–pepsin digestion and favours small bowel bacterial growth resulting in impaired vitamin B12 absorption [13]. Homozygosity of the T allele (forward orientation) (rs1801133) of the MTHFR gene (which encodes methylenetetrahydrofolate reductase) is associated with low folate status [14]

Methods

Results

Discussion

Conclusion