Low vitamin B-12 concentrations in patients without anemia: the effect of folic acid fortification of grain

Mills, James L.; Kohorn, Isabelle Von; Conley, Mary; Zeller, Jack A.; Cox, Christopher; Williamson, Robert; Dufour, D. Robert

doi:10.1093/ajcn/77.6.1474

Cited by 126 publications

(83 citation statements)

References 10 publications

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“…1 Evidence concerning relevant clinical practice could not be located in the literature, but the results of a recent United States (US) study of the prevalence of megaloblastic anaemia before and after mandatory folate fortification are reassuring. Although folate fortification may be expected to reduce the prevalence of anaemia in people with vitamin B12 deficiency, Mills and others (2003) 21 observed no significant change in anaemia prevalence among groups of older people with low serum B12 prior to and after mandatory folate fortification was introduced. Because our study suggests that a large proportion of older Australians could be at risk of B12 deficiency, this should be considered in current revisions to food regulations relating to food fortification.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of low serum folate and vitamin B12 in an older Australian population

Flood

Smith

Webb

et al. 2006

Australian and New Zealand Journal of Public Health

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Objective:To examine the prevalence of low serum folate and vitamin B12, in association with elevated serum homocysteine, in a representative sample of older Australians. Methods:During 1997‐2000, 3,508 persons aged 50+ years were examined in a population‐based cohort study conducted in two postcodes, west of Sydney, Australia. Of these, 2,901 participants (82.7%) provided fasting blood for estimates of serum folate, vitamin B12 and total homocysteine. Results:Low serum B12 (<185 pmol/L) was found in 22.9% of participants and low serum folate (<6.8 nmol/L) in 2.3% of participants. Among those people with very low serum vitamin B12 (<125 pmol/L) and low serum folate, 51% had elevated homocysteine. Conclusions:Low serum levels of vitamin B12 and elevated serum homocysteine are relatively frequent in older Australians. Implications:Appropriate public health action should be considered to reduce the prevalence of low serum vitamin B12 and elevated homocysteine in older Australians.

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Section: Discussionmentioning

confidence: 99%

Prevalence of low serum folate and vitamin B12 in an older Australian population

Flood

Smith

Webb

et al. 2006

Australian and New Zealand Journal of Public Health

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“…About 10-25 % of older adults have biochemical evidence of low vitamin B 12 status, defined by a low serum concentration (<45 pmol/l) of holotranscobalamin, which is a more sensitive test of vitamin B 12 deficiency than conventional vitamin B 12 testing (27) . There have been reports that patients with pernicious anaemia who are treated with folic acid have an accelerated decline in neurological function (32)(33)(34) . Consequently, the amount of folic acid is routinely limited to a maximum of 1000 mg/d because of concerns about the adverse effects of high-dose folic acid in individuals with vitamin B 12 deficiency.…”

Section: Possible Hazards Of Folic Acidmentioning

confidence: 99%

B-vitamins and prevention of dementia

Clarke

2008

Proc. Nutr. Soc.

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Elevated plasma homocysteine (Hcy) concentrations have been implicated with risk of cognitive impairment and dementia, but it is unclear whether low vitamin B 12 or folate status is responsible for cognitive decline. Most studies reporting associations between cognitive function and Hcy or B-vitamins have used a cross-sectional or case-control design and have been unable to exclude the possibility that such associations are a result of the disease rather than being causal. The Hcy hypothesis of dementia has attracted considerable interest, as Hcy can be easily lowered by folic acid and vitamin B 12 , raising the prospect that B-vitamin supplementation could lower the risk of dementia. While some trials assessing effects on cognitive function have used folic acid alone, vitamin B 12 alone or a combination, few trials have included a sufficient number of participants to provide reliable evidence. An individualpatient-data meta-analysis of all randomised trials of the effects on cognitive function and vascular risk of lowering Hcy with B-vitamins will maximise the power to assess the epidemiologically-predicted differences in risk. Among the twelve large randomised Hcy-lowering trials for prevention of vascular disease, data should be available on about 30 000 participants with cognitive function. The principal investigators of such trials have agreed to combine individual-participant data from their trials after their separate publication.Folate: Vitamin B 12 : Homocysteine: Dementia

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“…There are virtually no data on the Hb response or risk of developing neuropathy at such doses (77) . Notwithstanding the lack of data on folic acid dose and haematological response, optimism for the safety of fortification for the elderly in the USA has been proposed on the basis of a recent analysis (81) . This analysis tracked the incidence of anaemia among subjects with low vitamin B 12 status from the period pre-fortification until 2 years after mandatory fortification was introduced in the USA.…”

Section: Impact Of Fortification In the Usamentioning

confidence: 99%

Folate and vitamin B₁₂: friendly or enemy nutrients for the elderly

2007

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In the UK vitamin B 12 deficiency occurs in approximately 20 % of adults aged > 65 years. This incidence is significantly higher than that among the general population. The reported incidence invariably depends on the criteria of deficiency used, and in fact estimates rise to 24 % and 46 % among free-living and institutionalised elderly respectively when methylmalonic acid is used as a marker of vitamin B 12 status.

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Low vitamin B-12 concentrations in patients without anemia: the effect of folic acid fortification of grain

Cited by 126 publications

References 10 publications

Prevalence of low serum folate and vitamin B12 in an older Australian population

Prevalence of low serum folate and vitamin B12 in an older Australian population

B-vitamins and prevention of dementia

Folate and vitamin B₁₂: friendly or enemy nutrients for the elderly

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Low vitamin B-12 concentrations in patients without anemia: the effect of folic acid fortification of grain

Cited by 126 publications

References 10 publications

Prevalence of low serum folate and vitamin B12 in an older Australian population

Prevalence of low serum folate and vitamin B12 in an older Australian population

B-vitamins and prevention of dementia

Folate and vitamin B12: friendly or enemy nutrients for the elderly

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Product

Resources

About

Folate and vitamin B₁₂: friendly or enemy nutrients for the elderly