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Vincenti A, Bertuzzo L, Limitone A, D’Antona G, Cena H. Perspective: Practical Approach to Preventing Subclinical B12 Deficiency in Elderly Population. Nutrients 2021; 13:1913. [PMID: 34199569 PMCID: PMC8226782 DOI: 10.3390/nu13061913] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/25/2021] [Accepted: 05/30/2021] [Indexed: 12/11/2022] Open
Abstract
Vitamin B12 (also known as cobalamin) is an essential water-soluble vitamin that plays a pivotal role for several physiologic functions during one's lifespan. Only certain microorganisms are able to synthetize B12, thus humans obtain cobalamin exclusively from their diet, specifically from animal-derived foods. Specific sub-group populations are at risk of vitamin B12 subclinical deficiency due to different factors including poor intake of animal source foods and age-dependent decrease in the capacity of intestinal B12 uptake. Consumption of animal products produces some negative health issues and negatively impacts sustainability while a plant-based diet increases the risk of B12 deficiency. Taking a cue from the aforementioned considerations, this narrative review aims to summarize facts about B12 deficiency and the burden of inadequate dietary intake in elderly population, as well as to discuss sustainable approaches to vitamin B12 deficiency in aging population.
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Affiliation(s)
- Alessandra Vincenti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Laura Bertuzzo
- Glaxosmithkline (GSK) Consumer Healthcare, via Zambeletti s.n.c., 20021 Baranzate, Italy; (L.B.); (A.L.)
| | - Antonio Limitone
- Glaxosmithkline (GSK) Consumer Healthcare, via Zambeletti s.n.c., 20021 Baranzate, Italy; (L.B.); (A.L.)
| | - Giuseppe D’Antona
- Centro di Ricerca Interdipartimentale nelle Attività Motorie e Sportive (CRIAMS)—Sport Medicine Centre, University of Pavia, 27058 Voghera, Italy;
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy
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Aravena J, Zubarew T, Bedregal P, Zuzulich S, Urrejola P. Vegetarian diets in first year university students. Rev Chil Pediatr 2020; 91:705-710. [PMID: 33399635 DOI: 10.32641/rchped.vi91i5.2143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/25/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION There has been an increase in the popularity of vegetarian diets, especially among adolescents and young adults. These diets seem to be healthy and balanced, but the recommendations are contro versial regarding potential nutritional deficits. OBJECTIVE To identify the frequency and types of ve getarian diet used, their motivation, and sources of information. PATIENTS AND METHOD Cross-sec tional analytical study in freshmen students from the Pontifical Catholic University of Chile (PUC). Through an online survey, we collected demographic information and diet characterization of those who considered themselves as vegetarians. Variables were analyzed using IDM SPSS Statistics® soft ware and in Excel® spreadsheet in a quantitative way. RESULTS 152 students answered the survey (15.2% of the sample) and, out of these, 49.4% were vegetarian. 32.4% started this eating pattern bet ween the ages 12 and 18 and among their most frequent motivations were environmentalists (91.9%) and animalists (72.9%). 52.9% of vegetarians take vitamin B 12 supplementation but only 15.9% reported having this deficiency. 75.7% obtain information related to vegetarian diets through digital media. CONCLUSION In the surveys answered, we found a high percentage of vegetarian students, the refore, health professionals need to be trained in this area to assure adequate nutritional education, supplementation if necessary, and follow-up.
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Affiliation(s)
| | - Tamara Zubarew
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paula Bedregal
- Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Soledad Zuzulich
- Dirección de Asuntos Estudiantiles, Pontificia Universidad Católica de Chile, Chile
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Lyon P, Strippoli V, Fang B, Cimmino L. B Vitamins and One-Carbon Metabolism: Implications in Human Health and Disease. Nutrients 2020; 12:E2867. [PMID: 32961717 PMCID: PMC7551072 DOI: 10.3390/nu12092867] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/17/2020] [Accepted: 09/17/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamins B9 (folate) and B12 are essential water-soluble vitamins that play a crucial role in the maintenance of one-carbon metabolism: a set of interconnected biochemical pathways driven by folate and methionine to generate methyl groups for use in DNA synthesis, amino acid homeostasis, antioxidant generation, and epigenetic regulation. Dietary deficiencies in B9 and B12, or genetic polymorphisms that influence the activity of enzymes involved in the folate or methionine cycles, are known to cause developmental defects, impair cognitive function, or block normal blood production. Nutritional deficiencies have historically been treated with dietary supplementation or high-dose parenteral administration that can reverse symptoms in the majority of cases. Elevated levels of these vitamins have more recently been shown to correlate with immune dysfunction, cancer, and increased mortality. Therapies that specifically target one-carbon metabolism are therefore currently being explored for the treatment of immune disorders and cancer. In this review, we will highlight recent studies aimed at elucidating the role of folate, B12, and methionine in one-carbon metabolism during normal cellular processes and in the context of disease progression.
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Affiliation(s)
- Peter Lyon
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (P.L.); (V.S.); (B.F.)
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Victoria Strippoli
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (P.L.); (V.S.); (B.F.)
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Byron Fang
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (P.L.); (V.S.); (B.F.)
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Luisa Cimmino
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (P.L.); (V.S.); (B.F.)
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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Mastroianni A, Ciniselli CM, Panella R, Macciotta A, Cavalleri A, Venturelli E, Taverna F, Mazzocchi A, Bruno E, Muti P, Berrino F, Verderio P, Morelli D, Pasanisi P. Monitoring Vitamin B 12 in Women Treated with Metformin for Primary Prevention of Breast Cancer and Age-Related Chronic Diseases. Nutrients 2019; 11:nu11051020. [PMID: 31067706 PMCID: PMC6567263 DOI: 10.3390/nu11051020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 02/08/2023] Open
Abstract
Metformin (MET) is currently being used in several trials for cancer prevention or treatment in non-diabetics. However, long-term MET use in diabetics is associated with lower serum levels of total vitamin B12. In a pilot randomized controlled trial of the Mediterranean diet (MedDiet) and MET, whose participants were characterized by different components of metabolic syndrome, we tested the effect of MET on serum levels of B12, holo transcobalamin II (holo-TC-II), and methylmalonic acid (MMA). The study was conducted on 165 women receiving MET or placebo for three years. Results of the study indicate a significant overall reduction in both serum total B12 and holo-TC-II levels according with MET-treatment. In particular, in the MET group 26 of 81 patients and 10 of the 84 placebo-treated subjects had B12 below the normal threshold (<221 pmol/L) at the end of the study. Considering jointly all B12, Holo-TC-II, and MMA, 13 of the 165 subjects (10 MET and 3 placebo-treated) had at least two deficits in the biochemical parameters at the end of the study, without reporting clinical signs. Although our results do not affect whether women remain in the trial, B12 monitoring for MET-treated individuals should be implemented.
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Affiliation(s)
- Antonio Mastroianni
- Laboratory Medicine-Department of Pathology and Laboratory Medicine, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Chiara Maura Ciniselli
- Bioinformatics and Biostatistics Unit-Department of Applied Research and Technological Development, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Rossella Panella
- Laboratory Medicine-Department of Pathology and Laboratory Medicine, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Alessandra Macciotta
- Bioinformatics and Biostatistics Unit-Department of Applied Research and Technological Development, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Adalberto Cavalleri
- Epidemiology and Prevention Unit-Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Elisabetta Venturelli
- Epidemiology and Prevention Unit-Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Francesca Taverna
- Immunohematology and Transfusion Medicine Service-Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Arabella Mazzocchi
- Epidemiology and Prevention Unit-Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Eleonora Bruno
- Epidemiology and Prevention Unit-Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Paola Muti
- Chair Cancer Experimental Therapeutics, Department of Oncology Faculty of Health Science, McMaster University, Hamilton, ON L8V 1C3, Canada.
| | - Franco Berrino
- Epidemiology and Prevention Unit-Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Paolo Verderio
- Bioinformatics and Biostatistics Unit-Department of Applied Research and Technological Development, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Daniele Morelli
- Laboratory Medicine-Department of Pathology and Laboratory Medicine, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
| | - Patrizia Pasanisi
- Epidemiology and Prevention Unit-Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy.
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Ströhle A, Richter M, González‐Gross M, Neuhäuser‐Berthold M, Wagner K, Leschik‐Bonnet E, Egert S. The Revised D-A-CH-Reference Values for the Intake of Vitamin B 12 : Prevention of Deficiency and Beyond. Mol Nutr Food Res 2019; 63:e1801178. [PMID: 30657638 PMCID: PMC6590120 DOI: 10.1002/mnfr.201801178] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/07/2019] [Indexed: 12/25/2022]
Abstract
SCOPE The nutrition societies of Germany, Austria, and Switzerland are the joint editors of the "D-A-CH reference values for nutrient intake", which are revised regularly. METHODS AND RESULTS By reviewing vitamin-B12 -related biomarker studies, the reference values for vitamin B12 were revised in 2018. For adults, the estimated intake is based on the adequate serum concentrations of holotranscobalamin and methylmalonic acid. The estimated values for children and adolescents are extrapolated from the adult reference value by considering differences in body mass, an allometric exponent, and growth factors. For infants below 4 months of age, an estimated value is set based on the vitamin B12 intake via breast milk. The reference values for pregnant and lactating women consider the requirements for the fetus and for loss via breast milk. The estimated values for vitamin B12 intake for infants, children, and adolescents range from 0.5 to 4.0 µg d-1 . For adults, the estimated values are set at 4.0 µg d-1 , and for pregnant and lactating women, they are set at 4.5 and 5.5 µg d-1 , respectively. CONCLUSION Based on the data of several vitamin B12 status biomarkers studies, the reference value for vitamin B12 intake for adults is raised from 3.0 to 4.0 µg d-1 .
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Affiliation(s)
- Alexander Ströhle
- Institute of Food Science and Human NutritionLeibniz University HannoverAm Kleinen Felde 3030167HannoverGermany
| | - Margrit Richter
- German Nutrition Society (DGE)Godesberger Allee 1853175BonnGermany
| | - Marcela González‐Gross
- ImFINE Research Group, Department of Health and Human PerformanceUniversidad Politécnica de Madridc/ Martín Fierro 728040MadridSpain
| | | | - Karl‐Heinz Wagner
- Department of Nutritional SciencesUniversity of ViennaAlthanstraße 141090ViennaAustria
| | | | - Sarah Egert
- German Nutrition Society (DGE)Godesberger Allee 1853175BonnGermany
- Institute of Nutritional MedicineUniversity of HohenheimFruwirthstr. 1270599StuttgartGermany
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Anand S, Thomas S, Jayachandra M, Thomas T, Strand TA, Kurpad AV, Duggan CP, Srinivasan K. Effects of maternal B12 supplementation on neurophysiological outcomes in children: a study protocol for an extended follow-up from a placebo randomised control trial in Bangalore, India. BMJ Open 2019; 9:e024426. [PMID: 30782904 PMCID: PMC6377540 DOI: 10.1136/bmjopen-2018-024426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Vitamin B12 deficiency is highly prevalent in pregnant Indian women. Neuropsychological tests have shown an association between low maternal vitamin B12 status and poorer cognitive performances in the offspring, although findings from these studies have been inconsistent. Vitamin B12 has an important role in the formation of myelin which is important for the transmission speed of neural impulses and myelination in the central nervous system has been linked to cognition. Assessing neurophysiological measures using event-related potentials (ERPs) in children may provide additional information on the effect of maternal vitamin B12 supplementation on offspring brain function. The study examines the effects of oral vitamin B12 daily supplements (50 µg) to pregnant Indian women on child neurophysiological function at 72 months. METHODS AND ANALYSIS We previously conducted a double-blind, placebo-controlled study to examine the effects of maternal vitamin B12 supplementation on cognitive outcomes in their offspring using the Bayley scales of infant development, third edition. In this extended follow-up of the same cohort of mother-child dyad, we propose to use ERP to study the long-term impact of maternal B12 supplementation on brain function in children at 72 months of age. We intend to use P300 and mismatch negativity (MMN) as measures of neurophysiological outcomes. The primary outcome of this study will be child neurophysiological measures (as measured by amplitude and latency of P300 and MMN) assessed at 72 months of age in children whose mothers received vitamin B12 compared with neurophysiological status of children whose mothers received placebo. ETHICS AND DISSEMINATION The study was approved by the Institutional Ethical Board of St. John's Medical College and the Harvard School of Public Health Human Subjects Committee. Results obtained will be presented at national and international research meetings and published in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER NCT00641862.
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Affiliation(s)
- Shilpa Anand
- Division of Mental Health and Neurosciences, St. John's Research Institute, Bangalore, Karnataka, India
| | - Susan Thomas
- Division of Mental Health and Neurosciences, St. John's Research Institute, Bangalore, Karnataka, India
| | - Mahesh Jayachandra
- Division of Mental Health and Neurosciences, St. John's Research Institute, Bangalore, Karnataka, India
| | - Tinku Thomas
- Department of Biostatistics, St John's Medical College, Bangalore, Karnataka, India
| | - Tor Arne Strand
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Anura V Kurpad
- Division of Nutrition, St. John's Research Institute, Bangalore, Karnataka, India
| | - Christopher P Duggan
- Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Krishnamachari Srinivasan
- St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, Karnataka, India
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de Batlle J, Matejcic M, Chajes V, Moreno-Macias H, Amadou A, Slimani N, Cox DG, Clavel-Chapelon F, Fagherazzi G, Romieu I. Determinants of folate and vitamin B12 plasma levels in the French E3N-EPIC cohort. Eur J Nutr 2018; 57:751-760. [PMID: 28004270 DOI: 10.1007/s00394-016-1365-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 12/14/2016] [Indexed: 01/09/2023]
Abstract
PURPOSE Impaired B vitamin status has been identified as a risk factor for major chronic diseases. This study aims at examining the determinants of plasma folate and vitamin B12 concentrations, considering lifestyle factors and MTHFR polymorphisms. METHODS A total of 988 women aged 40-65 years from the French E3N cohort were investigated. Intakes of folate and vitamin B12 were assessed using food frequency questionnaires, and plasma concentrations were measured by microbiological assay. Dietary scores were computed to summarize folate and vitamin B12 dietary sources. MTHFR-C677T and MTHFR-A1298C were determined by Kaspar assay. Pearson's partial correlation coefficients and multivariable linear regression models were used to assess correlations between main determinants and plasma folate and vitamin B12 levels. RESULTS The partial correlation coefficient between dietary intakes and plasma folate was 0.19 (p value <0.001) and 0.08 (p value = 0.008) for vitamin B12. Dietary scores were the main determinant of B vitamin plasma concentrations with a percent change per unit increase of 12.64% (p value <0.001) for folate and 7.6% (p value <0.001) for vitamin B12. Homozygous (T/T) or heterozygous (C/T) women for MTHFR-C677T had lower plasma folate concentrations [C/T: -6.48% (p value = 0.038) and T/T: -15.89% (p value <0.001)] compared to women carrying the C/C genotype. Other determinants of B vitamin plasma concentration include: smoking status for folate, and age and hormone replacement therapy for vitamin B12. CONCLUSIONS We confirmed previous findings on the role of diet as main determinant of folate and vitamin B12 plasma concentrations. However, the impact of genetic polymorphisms and lifestyle factors on plasma B vitamin concentrations should not be neglected.
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Affiliation(s)
- Jordi de Batlle
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France.
| | - Marco Matejcic
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
| | - Veronique Chajes
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
| | | | - Amina Amadou
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
| | - Nadia Slimani
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
| | - David G Cox
- INSERM U1052, Cancer Research Center of Lyon, Centre Léon Bérard, Lyon, France
| | - Françoise Clavel-Chapelon
- Team 9: Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale (INSERM), U1018, Villejuif, France
- Université Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Guy Fagherazzi
- Team 9: Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale (INSERM), U1018, Villejuif, France
- Université Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
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Abstract
Adding folate to cereals can prevent neural tube defects and other health problems, say James Mills and Anne Molloy, but Edward Reynolds is concerned that prolonged excessive folate risks harm unless vitamin B12 is also supplemented
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Affiliation(s)
- James L Mills
- Epidemiology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
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Reynolds EH. The risks of folic acid to the nervous system in vitamin B 12 deficiency: rediscovered in the era of folic acid fortification policies. J Neurol Neurosurg Psychiatry 2017; 88:1097-1098. [PMID: 28596250 DOI: 10.1136/jnnp-2017-316296] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 04/22/2017] [Indexed: 11/03/2022]
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Pan Y, Liu Y, Guo H, Jabir MS, Liu X, Cui W, Li D. Associations between Folate and Vitamin B12 Levels and Inflammatory Bowel Disease: A Meta-Analysis. Nutrients 2017; 9:nu9040382. [PMID: 28406440 PMCID: PMC5409721 DOI: 10.3390/nu9040382] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/25/2017] [Accepted: 04/12/2017] [Indexed: 01/07/2023] Open
Abstract
Background: Inflammatory bowel disease (IBD) patients may be at risk of vitamin B12 and folate insufficiencies, as these micronutrients are absorbed in the small intestine, which is affected by IBD. However, a consensus has not been reached on the association between IBD and serum folate and vitamin B12 concentrations. Methods: In this study, a comprehensive search of multiple databases was performed to identify studies focused on the association between IBD and serum folate and vitamin B12 concentrations. Studies that compared serum folate and vitamin B12 concentrations between IBD and control patients were selected for inclusion in the meta-analysis. Results: The main outcome was the mean difference in serum folate and vitamin B12 concentrations between IBD and control patients. Our findings indicated that the average serum folate concentration in IBD patients was significantly lower than that in control patients, whereas the mean serum vitamin B12 concentration did not differ between IBD patients and controls. In addition, the average serum folate concentration in patients with ulcerative colitis (UC) but not Crohn’s disease (CD) was significantly lower than that in controls. This meta-analysis identified a significant relationship between low serum folate concentration and IBD. Conclusions: Our findings suggest IBD may be linked with folate deficiency, although the results do not indicate causation. Thus, providing supplements of folate and vitamin B12 to IBD patients may improve their nutritional status and prevent other diseases.
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Affiliation(s)
- Yun Pan
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun 130021, China.
| | - Ya Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun 130021, China.
| | - Haizhuo Guo
- Department of Radiology, The Second Part of the First Hospital, Jilin University, Changchun 130031, China.
| | - Majid Sakhi Jabir
- Department of Biotechnology, University of Technology, Baghdad 00964, Iraq.
| | - Xuanchen Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun 130021, China.
| | - Weiwei Cui
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun 130021, China.
| | - Dong Li
- Department of Immunology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Avenue, Changchun 130021, China.
- Department of Hepatology, The First Hospital, Jilin University, Changchun 130021, China.
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Mössner J. The Indications, Applications, and Risks of Proton Pump Inhibitors. Dtsch Arztebl Int 2016; 113:477-83. [PMID: 27476707 PMCID: PMC4973002 DOI: 10.3238/arztebl.2016.0477] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/17/2016] [Accepted: 03/17/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Proton pump inhibitors (PPI) are the most effective drugs for inhibiting gastric acid secretion. They have been in clinical use for more than 25 years, In 2014, 3.475 billion daily defined doses (DDD) of PPI were prescribed in Germany. This high number alone calls for a critical analysis of the spectrum of indications for PPI and their potential adverse effects. METHODS This review is based on pertinent publications retrieved by a selective search in the PubMed and Cochrane Library databases, with particular emphasis on randomized, prospective multicenter trials, cohort studies, case-control studies, and meta-analyses. RESULTS The inhibition of gastric acid secretion with PPI is successfully used for the treatment of gastroesophageal reflux disease and of gastric and duodenal ulcers, for the secondary prevention of gastroduodenal lesions that have arisen under treatment with nonsteroidal anti-inflammatory drugs and acetylsalicylic acid, and for the prevention of recurrent hemorrhage from ulcers after successful endoscopic hemostasis. PPI are given along with practically all antibiotic regimens for the eradication of Helicobacter pylori infection. The number of prescriptions for PPI has risen linearly over the past 25 years. As there has been no broadening of indications, one may well ask whether the current, extensive use of PPI is justified. There is evidence that patients taking PPI are at greater risk for fractures. Moreover, the vitamin B12 level should be checked occasionally in all patients taking PPI. CONCLUSION PPI are among the more effective drugs for the treatment of diseases associated with gastric acid. In view of their cost and potential adverse effects, they should only be prescribed for scientifically validated indications.
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Affiliation(s)
- Joachim Mössner
- Division of Gastroenterology and Rheumatology, Department of Internal Medicine, Neurology and Dermatology, University Hospital of Leipzig, Germany: Mössner
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Takagi Y, Hosomi Y, Nagamata M, Watanabe K, Takahashi S, Nakahara Y, Yomota M, Sunami K, Okuma Y, Shimokawa T, Okamura T. Phase II study of oral vitamin B12 supplementation as an alternative to intramuscular injection for patients with non-small cell lung cancer undergoing pemetrexed therapy. Cancer Chemother Pharmacol 2016; 77:559-64. [PMID: 26821156 DOI: 10.1007/s00280-015-2954-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 12/26/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE A vitamin B12 supplement is required in pemetrexed single agent therapy. Intramuscular administration is the method of choice; however, oral administration is simpler and easier and may be sufficiently effective. We conducted a Phase II study to evaluate the safety of oral administration of vitamin B12 in patients with advanced non-small cell lung cancer who received pemetrexed single agent therapy. METHODS Folic acid and vitamin B12 were given orally for ˃ 1 week before pemetrexed administration. The primary end-point was onset of a grade ≥ 3 neutropenia ratio (50% of threshold expression ratios; an expectation expression ratio of 21%; α, 0.05; β, 0.1). Blood concentration of folic acid and homocysteine which are markers of vitamin B12 deficiency were also examined (UMIN000003180). RESULTS A total of 25 cases were registered from February 2010 to July 2014. The ratio of grade ≥ 3 neutropenia was 36% (95% CI 22-52 %). Grade ≥ 3 non-hematologic toxicity and hematologic toxicity were seen in 20% (5 cases) and 44% (11 cases) of patients, respectively. In addition, the homocysteine blood concentration just before the first cycle dosage of pemetrexed was significantly elevated relative to the 2-3 cycle. CONCLUSION This study failed to meet its primary endpoint. We could not demonstrate the safety and efficacy of the 1-week vitamin B12 oral administration protocol as compared with intramuscular administration.
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Affiliation(s)
- Yusuke Takagi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
- MSD K.K., Tokyo, 1028667, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan.
| | - Makoto Nagamata
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
| | - Kageaki Watanabe
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
| | - Satoshi Takahashi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
| | - Yoshiro Nakahara
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, 2520375, Japan
| | - Makiko Yomota
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
| | - Kuniko Sunami
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
- National Cancer Center Hospital, Tokyo, 1040045, Japan
| | - Yusuke Okuma
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
| | - Tsuneo Shimokawa
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, 2408555, Japan
| | - Tatsuru Okamura
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyoku, Tokyo, 1138677, Japan
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Javid P, Christensen E. [Vegetarians are at high risk of vitamin B12 deficiency]. Ugeskr Laeger 2016; 178:V06150484. [PMID: 26750191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Since vegetarians have a lower intake of vitamin B12 (B12) than non-vegetarians, they are at increased risk of developing B12 deficiency. The less animal products the food contains the worse the B12 status. However, even lacto-ovo-vegetarians run the risk of becoming deficient in B12. Vegetarians are recommended regularly to take supplements of B12, and they should be informed of the lacking content of B12 of plant products and the hazards of B12 deficiency. Furthermore, vegetarians should routinely be checked for possible B12 deficiency.
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Kuriyan R, Thankachan P, Selvam S, Pauline M, Srinivasan K, Kamath-Jha S, Vinoy S, Misra S, Finnegan Y, Kurpad AV. The effects of regular consumption of a multiple micronutrient fortified milk beverage on the micronutrient status of school children and on their mental and physical performance. Clin Nutr 2015; 35:190-198. [PMID: 25746819 DOI: 10.1016/j.clnu.2015.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 11/22/2014] [Accepted: 02/03/2015] [Indexed: 11/18/2022]
Abstract
Multiple micronutrient deficiencies exist in school going children in India and bridging the gap between nutrient intake and requirements is an effective way to combat the deficiencies. This study aimed to test the effect of a multi-micronutrient fortified malt and cocoa based milk beverage on the micronutrient status, cognition, physical performance and nutritional deficiencies of 7-10 years old south Indian children. A randomized, double blind placebo controlled study design was used with normal healthy children from low to middle income families, aged 7-10 years randomly assigned to receive either a multi-micronutrient fortified or an unfortified milk based control drink. The drinks were provided 6 days/week for 5 months. Assessments included anthropometry, blood biochemistry, physical performance and cognition at baseline and endline. The baseline characteristics of the study groups were similar. The changes in body weight and height were similar between the groups at the end of the study. Levels of vitamin B12, red cell folate and vitamin B2 significantly improved in the intervention group, while vitamin D, selenium and body iron showed no difference. The Hemoglobin (Hb) and serum ferritin levels of the control group decreased at endline, while those in the intervention group maintained their levels. The serum transferrin receptor levels increased in both the groups. The prevalence of iron deficiency and Vitamin B2 deficiency were significantly lower in the intervention group at endline. Overall improvement in cognitive and physical performance was seen in both the groups at endline, with no significant differences between the groups. The micronutrient fortified milk based drink was efficacious in improving the micronutrient status of Vitamin B2, Vitamin B12 and red cell folate and in preventing a decline in Hb level compared to an unfortified milk based drink. It also reduced anemia and the risk of deficiencies of iron, and B12, in apparently healthy children. ClinicalTrials.gov IdentifierNCT01415557. Clinical Trial RegistryIndia - REF/2012/12/004332.
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Affiliation(s)
- Rebecca Kuriyan
- Division of Nutrition, St. John's Research Institute, India.
| | | | | | - Maria Pauline
- Division of Nutrition, St. John's Research Institute, India
| | - K Srinivasan
- Division of Nutrition, St. John's Research Institute, India
| | | | - Sophie Vinoy
- Mondelez International R&D, Nutrition Research, Saclay, France
| | - Situn Misra
- Mondelez International R&D, Product Development Beverages, Thane, Maharashtra, India
| | | | - Anura V Kurpad
- Division of Nutrition, St. John's Research Institute, India
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Dogan K, Aarts EO, Koehestanie P, Betzel B, Ploeger N, de Boer H, Aufenacker TJ, van Laarhoven KJHM, Janssen IMC, Berends FJ. Optimization of vitamin suppletion after Roux-en-Y gastric bypass surgery can lower postoperative deficiencies: a randomized controlled trial. Medicine (Baltimore) 2014; 93:e169. [PMID: 25437032 PMCID: PMC4616370 DOI: 10.1097/md.0000000000000169] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Iron, vitamin B12, and folic acid deficiencies are among the most common deficiencies occurring after laparoscopic Roux-en-Y gastric bypass (LRYGB). The present study evaluates the effectiveness of a specially designed multivitamin supplement (WLS Forte, FitForMe, Rotterdam, the Netherlands) specifically developed for LRYGB patients.A triple-blind, randomized, 12-month study was conducted comparing WLS forte with a standard multivitamin supplement (sMVS) containing approximately 100% of the recommended daily allowance (RDA) for iron, vitamin B12, and folic acid. WLS Forte contains vitamin B12 14000% RDA, iron 500% RDA, and folic acid 300% RDA.In total, 148 patients (74 in each group) underwent a LRYGB procedure. Baseline characteristics were similar for both groups. Per protocol analysis demonstrated that sMVS treatment was associated with a decline in ferritin (-24.4 ± 70.1 μg/L) and vitamin B12 (-45.9 ± 150.3 pmol/L) over 12 months, whereas in WLS Forte patients, ferritin remained stable (+3.2 ± 93.2 μg/L) and vitamin B12 increased significantly (+55.1 ± 144.2 pmol/L). The number of patients developing ferritin or vitamin B12 deficiency was significantly lower with WLS Forte compared with sMVS (P < 0.05). Iron deficiency (ID) was reduced by 88% after WLS Forte compared with sMVS. Adverse events related to supplement use did not occur.An optimized multivitamin supplement is safe and reduces the development of iron and vitamin B12 deficiencies after LRYGB.
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Affiliation(s)
- Kemal Dogan
- From the Department of Surgery (KD, EOA, PK, BB, NP, TJA, IMCJ, FJB); Department of Internal Medicine, Rijnstate Hospital, Arnhem (HDB); and Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands (KJHMVL)
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I take vitamin B₁₂supplements daily, but blood tests show that I have a deficiency. How is this possible? Johns Hopkins Med Lett Health After 50 2014; 26:7. [PMID: 25300076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Another PPI precaution. Johns Hopkins Med Lett Health After 50 2014; 26:8. [PMID: 24873000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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18
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Füessl HS. [Long-term proton pump inhibitor therapy: beware of vitamin B 12 deficiency]. MMW Fortschr Med 2014; 156:34. [PMID: 24912265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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19
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Heartburn medicine users: watch vitamin B12 levels. Harv Health Lett 2014; 39:8. [PMID: 24834538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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20
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Mirchuk KK, Sedletskiĭ II. [Prevention of side effects and complications after operation for partial ileal bypass]. Vestn Khir Im I I Grek 2014; 173:34-38. [PMID: 25055507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Side effects and complications of the application of partial ileal bypass used for dislipidemia were analyzed in 162 patients with atherosclerosis. It was shown, that the partial ileal bypass operation could lead to the development of series of undesirable side effects such as diarrhea, hypovitaminosis B12, off-state intestine enteritis. The application of modification of partial ileal bypass such as formation of ileo-ileoanastomosis 5-6 cm long near ileocecal valve with the maintenance of its functions disposed the diarrhea and minimized the risk of the development of hypovitaminosis B12 after operation. It is possible to prevent the development of enteritis of off-state loop of the small intestine by using microanastomosis between off-state and functioning iliac intestine. The partial ileal bypass operation didn't influence on body weight, wouldn't increase the risk of stone formation in the gallbladder and kidneys. The risk of the development of hypovitaminosis B12 is minimal after operation.
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Sanchez H, Albala C, Lera L, Dangour AD, Uauy R. Effectiveness of the National Program of Complementary Feeding for older adults in Chile on vitamin B12 status in older adults; secondary outcome analysis from the CENEX Study (ISRCTN48153354). Nutr J 2013; 12:124. [PMID: 24016218 PMCID: PMC3848755 DOI: 10.1186/1475-2891-12-124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 07/31/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Older people are at increased risk of vitamin B12 deficiency and the provision of fortified foods may be an effective way to ensure good vitamin B12 status in later life. AIM To evaluate the effectiveness of a vitamin B12 fortified food provided by a national program of complementary food for older people on plasma vitamin B12 levels. SUBJECTS AND METHODS A random sub-sample of 351 subjects aged 65-67 y from a large cluster randomised controlled trial provided blood samples at baseline and after 24 months of intervention. The intervention arm (10 clusters 186 participants) received a vitamin B12 fortified food designed to deliver 1.4 μg/day, while the control arm did not receive complementary food (10 clusters, 165 participants). Serum vitamin B12 and folate levels determined by radioimmunoassay were used to estimate the effect of intervention on vitamin B12 levels, adjusting for baseline levels and sex. RESULTS Attrition at 24 months was 16.7% and 23.6% in the intervention and control arms respectively (p = 0.07). Over 24 months of intervention, mean (95% CI) serum vitamin B12 decreased from 392 (359-425) pmol/dL to 357 (300-414) pmol/dL (p < 0.07) in the intervention arm and from 395 (350-440) pmol/dL to 351 (308-395) pmol/dL in the control arm. There was no significant effect of the intervention on folate status. DISCUSSION Our findings suggest that foods fortified with 1.4 μg/daily vitamin B12 as provided by Chile's national programme for older people are insufficient to ensure adequate vitamin B12 levels in this population. Chile has a long and successful experience with nutrition intervention programs; however, the country's changing demographic and nutritional profiles require a constant adjustment of the programs.
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Affiliation(s)
- Hugo Sanchez
- Nutrition and Public Health, Aging, and Genetic Epidemiology Unit, Institute of Nutrition and Food Technology, University of Chile, Avda. El Libano 5524, Casilla 138–11, Santiago, Chile
| | - Cecilia Albala
- Nutrition and Public Health, Aging, and Genetic Epidemiology Unit, Institute of Nutrition and Food Technology, University of Chile, Avda. El Libano 5524, Casilla 138–11, Santiago, Chile
| | - Lydia Lera
- Nutrition and Public Health, Aging, and Genetic Epidemiology Unit, Institute of Nutrition and Food Technology, University of Chile, Avda. El Libano 5524, Casilla 138–11, Santiago, Chile
| | - Alan D Dangour
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ricardo Uauy
- Nutrition and Public Health, Aging, and Genetic Epidemiology Unit, Institute of Nutrition and Food Technology, University of Chile, Avda. El Libano 5524, Casilla 138–11, Santiago, Chile
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Ströhle A, Wolters M, Hahn A. [Food supplements--potential and limits: part 3]. Med Monatsschr Pharm 2013; 36:324-342. [PMID: 24069646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Ageing processes are associated with physiological changes, e.g. a reduction of metabolically active body mass and an impaired hunger-satiety regulation, which--combined with chronic diseases and psychosocial problems--significantly increase the risk for malnutrition. However, considering their nutrition and health status elderly people are a very heterogeneous group. The nutrition situation of "young" seniors does generally not differ from the situation of working-age adults while institutionalized elderly people and those in need of care often show signs of a global malnutrition. The critical nutrients in the nutrition of the elderly particularly include vitamin B12 and D. Six percent of all elderly have a manifest and 10 to 30% a functional vitamin B12 deficiency. The main cause is vitamin B12 malabsorption resulting from a type B atrophic gastritis. The functional vitamin B12 deficiency and the associated hyperhomocysteinemia are risk factors for neurodegenerative diseases and accelerate bone loss. With increasing age the vitamin D status is deteriorating. About 50% of the elderly living in private households is deficient in vitamin D; in geriatrics vitamin D deficiency is more the rule than an exception. This is caused by a reduced endogenous biosynthesis, low UVB exposure and a diet low in vitamin D. A vitamin D deficiency increases the risk for falls and fractures as well as the risk for neurodegenerative diseases. Also the overall mortality is increased.
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Affiliation(s)
- Alexander Ströhle
- Leibniz Universität Hannover, Institut für Lebensmittelwissenschaft und Humanernährung, Am Kleinen Felde 30, 30167 Hannover.
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Vitamin B-12 deficiency. Common, with troubling symptoms. Mayo Clin Health Lett 2013; 31:7. [PMID: 24719965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Watanabe F, Yabuta Y, Tanioka Y, Bito T. Biologically active vitamin B12 compounds in foods for preventing deficiency among vegetarians and elderly subjects. J Agric Food Chem 2013; 61:6769-6775. [PMID: 23782218 DOI: 10.1021/jf401545z] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The usual dietary sources of vitamin B12 are animal-source based foods, including meat, milk, eggs, fish, and shellfish, although a few plant-based foods such as certain types of dried lavers (nori) and mushrooms contain substantial and considerable amounts of vitamin B12, respectively. Unexpectedly, detailed characterization of vitamin B12 compounds in foods reveals the presence of various corrinoids that are inactive in humans. The majority of edible blue-green algae (cyanobacteria) and certain edible shellfish predominately contain an inactive corrinoid known as pseudovitamin B12. Various factors affect the bioactivity of vitamin B12 in foods. For example, vitamin B12 is partially degraded and loses its biological activity during cooking and storage of foods. The intrinsic factor-mediated gastrointestinal absorption system in humans has evolved to selectively absorb active vitamin B12 from naturally occurring vitamin B12 compounds, including its degradation products and inactive corrinoids that are present in daily meal foods. The objective of this review is to present up-to-date information on various factors that can affect the bioactivity of vitamin B12 in foods. To prevent vitamin B12 deficiency in high-risk populations such as vegetarians and elderly subjects, it is necessary to identify plant-source foods that contain high levels of bioactive vitamin B12 and, in conjunction, to prepare the use of crystalline vitamin B12-fortified foods.
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Affiliation(s)
- Fumio Watanabe
- Division of Applied Bioresources Chemistry, The United Graduate School of Agricultural Sciences, Tottori University, Tottori 680-8553, Japan.
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Cardinia-Casey Community Health Service's refugee health clinic. Aust Nurs J 2013; 20:46-7. [PMID: 23700629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Ouédraogo S, Koura GK, Accrombessi MMK, Bodeau-Livinec F, Massougbodji A, Cot M. Maternal anemia at first antenatal visit: prevalence and risk factors in a malaria-endemic area in Benin. Am J Trop Med Hyg 2012; 87:418-24. [PMID: 22826498 PMCID: PMC3435342 DOI: 10.4269/ajtmh.2012.11-0706] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Accepted: 03/03/2012] [Indexed: 11/07/2022] Open
Abstract
The risk factors for maternal anemia (hemoglobin level less than 110 g/L) were studied in human immunodeficiency virus-negative pregnant women in Benin at the time of first antenatal visit and prior to any prevention. Data for the first 1,005 pregnant women included in a multicentre randomized controlled trial were analyzed. Anemia was common (68.3%), and malaria and helminth infestations were prevalent in 15.2% and 11.1% of the women. A total of 33.3%, 31.3% and 3.6% of the women were iron, folic acid and vitamin B12 deficient, respectively. These parasitic infections and nutrient deficiencies were associated with a high risk of anemia. Twenty-one percent, 15%, 12%, 11% and 7% of anemia were attributable to malnutrition, malaria, iron, folic acid deficiencies, and helminth infestations, respectively. Most anemia was caused by factors that could be prevented by available tools, stressing the need to reinforce their implementation and to evaluate their effectiveness throughout the course of the pregnancy.
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Affiliation(s)
- Smaïla Ouédraogo
- Institut de Recherche pour le Développement, Mère et Enfant Face aux Infections Tropicales, Faculté des Sciences de la Santé, Paris, France.
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[Vitamins in toothpaste to control malnutrition symptoms? Scientists study the effectiveness of vitamin B 12 fortified toothpaste]. Kinderkrankenschwester 2012; 31:296. [PMID: 22876471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Abstract
OBJECTIVE To determine the prevalence of undiagnosed vitamin B12 deficiency among residential aged care facility residents in southern Tasmania, Australia, and to identify associated risk factors. DESIGN AND SETTING Cross-sectional study of residents from five southern Tasmanian residential aged care facilities. PARTICIPANTS Two hundred and fifty-nine residents without a prior diagnosis of vitamin B12 deficiency or recorded serum B12 level within the past 6 months were approached to have their serum B12 level tested. One hundred and sixty (61%) residents consented and their doctors were contacted for further consent. A total of 130 (50%) residents completed the study. MEASUREMENTS Clinical and demographic characteristics, and serum B12 level. RESULTS Of the 130 residents tested, 18 residents (14%) were considered vitamin B12 deficient (serum level <150 pmol/L), 47 (36%) were equivocal (150 pmol/L to 250 pmol/L) and 65 (50%) had normal serum B12 levels (>250 pmol/L). There was a weak negative correlation between age and serum B12 level in those residents not taking a multivitamin (n=120, r=-0.19, p<0.05). The use of a multivitamin or antipsychotic drug were associated with altered mean serum B12 levels (+137 pmol/L, p<0.001 and -70 pmol/L, p<0.001 respectively). CONCLUSION As vitamin B12 deficiency can manifest in a range of symptoms that are frequently misdiagnosed, the finding of undetected deficiency in 14% of residents is a cause for concern. Oral multivitamin supplementation may help prevent deficiency, and potentially treat existing deficiencies in older institutionalised people.
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Affiliation(s)
- C Mirkazemi
- Unit for Medication Outcomes Research and Education, School of Pharmacy, University of Tasmania, Hobart, Tasmania 7001, Australia
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Sicińska E, Cholewa M. [Evaluation of the needs and possibilities of increasing the vitamin B12 content in diet]. Rocz Panstw Zakl Hig 2012; 63:67-71. [PMID: 22642072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Vitamin B12 belongs to the biologically active compounds related to cyanocobalamin group. The bioavailability of B12 from different food products varies considerably, for example from the chicken meat it ranges from 61 to 66%, from fish meat is 42%, and from eggs below 9% only. The deficiency of vitamin B12 could easily be overcame by the appropriate diet or food supplements. OBJECTIVE The aim of this study was to characterize the fortified with vitamin B12 food products available on the market and to assess the possibilities of increasing the intake of this vitamin by including such products into the daily diet. MATERIAL AND METHOD The study was carried out in winter 2011, at eleven Warsaw supermarkets. Information about food products was based on label declarations. There were 220 products fortified with vitamin B12 from various food categories, like breakfast cereals, fruit juice, non-alcoholic beverages, cereals bars, candies, instant cocoa and tea, margarine, as well as soya products. Breakfast cereals (40%) and juice, non-alcoholic beverages (30%) were the largest groups. RESULTS. The highest amount of vitamin B12 was found in some candies (max. 4,5 microg/100 g) and instant tea (max. 3,75 microg/100g). The lowest amount was found in some fruit beverages (min. 0,12 microg/100 g). There is possibility of increasing the vitamin B12 intake by consuming various fortified products: for instance a glass of soya drink (20,8% RDA), a cup of soya pudding (15%), a glass of instant tea (14%), apple juice (12,5%), a cereal bar (10%), a bowl of corn flakes (9,8%) or a slice of bread with margarine (7,5%). The intake of one average portion of chosen food products fortified with vitamin B12 provides about 0,18-0,5 microg (7,5-20,8% Polish RDA for adults). CONCLUSIONS The wide public education is essential for increasing the role of these products in nutrition, it is especially recommendable to vegetarian and elderly people.
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Affiliation(s)
- Ewa Sicińska
- Wydział Nauk o Zywieniu Człowieka i Konsumpcji Szkoła Główna Gospodarstwa Wiejskiego w Warszawie.
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Ozsoylu S. Vitamin B12 (vit B12) deficiency treatment in infants and its prevention. Turk J Pediatr 2011; 53:718. [PMID: 22390003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Langan RC, Zawistoski KJ. Update on vitamin B12 deficiency. Am Fam Physician 2011; 83:1425-1430. [PMID: 21671542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Vitamin B(12) (cobalamin) deficiency is a common cause of megaloblastic anemia, a variety of neuropsychiatric symptoms, and elevated serum homocysteine levels, especially in older persons. There are a number of risk factors for vitamin B(12) deficiency, including prolonged use of metformin and proton pump inhibitors. No major medical organizations, including the U.S. Preventive Services Task Force, have published guidelines on screening asymptomatic or low-risk adults for vitamin B(12) deficiency, but high-risk patients, such as those with malabsorptive disorders, may warrant screening. The initial laboratory assessment of a patient with suspected vitamin B(12) deficiency should include a complete blood count and a serum vitamin B(12) level. Measurements of serum vitamin B(12) may not reliably detect deficiency, and measurement of serum homocysteine and/or methylmalonic acid should be used to confirm deficiency in asymptomatic high-risk patients with low normal levels of vitamin B(12). Oral administration of high-dose vitamin B(12) (1 to 2 mg daily) is as effective as intramuscular administration in correcting the deficiency, regardless of etiology. Because crystalline formulations are better absorbed than naturally occurring vitamin B(12), patients older than 50 years and strict vegetarians should consume foods fortified with vitamin B(12) and vitamin B(12) supplements, rather than attempting to get vitamin B(12) strictly from dietary sources. Administration of vitamin B(12) to patients with elevated serum homocysteine levels has not been shown to reduce cardiovascular outcomes in high-risk patients or alter the cognitive decline of patients with mild to moderate Alzheimer disease.
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Abstract
The literature regarding the vitamin B(12) status of patients with phenylketonuria was reviewed. Adequate amounts of B(12) are provided in products used in dietary treatment; however, a number of case reports and cohort studies document deficiency in those who have discontinued taking amino acid, mineral and vitamin supplements but who continue to eat only very limited amounts of natural protein. Symptoms and signs of B(12) deficiency are variable but severe deficiency may cause serious neurological disease. Nitrous oxide anaesthesia is a particular risk. It is recommended that plasma total homocysteine and plasma or urinary methylmalonate should be routinely measured, as they are more sensitive markers of deficiency than serum B(12) concentrations. Functional B(12) deficiency can occur in the presence of a normal B(12) concentration.
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Affiliation(s)
- John H Walter
- Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
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Diabetes drug interferes with vitamin B12. Harv Heart Lett 2010; 20:7. [PMID: 20597154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Sturtzel B, Dietrich A, Wagner KH, Gisinger C, Elmadfa I. The status of vitamins B6, B12, folate, and of homocysteine in geriatric home residents receiving laxatives or dietary fiber. J Nutr Health Aging 2010; 14:219-23. [PMID: 20191257 DOI: 10.1007/s12603-010-0053-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Vitamin B12 deficiency as a digestive disorder and constipation as a gastro motility disorder are common in the elderly. Laxative treatment is often chosen without regard for gut health. OBJECTIVE To investigate whether the addition of oat-bran to the common oral diet for 12 weeks is able to reduce constipation and laxative use and improve gut health. It is assumed that this will lead to improved plasma levels of vitamins B6, B12, folate, and of homocysteine in nursing home residents. METHODS A controlled, parallel intervention trial. 30 frail patients with multiple chronic diseases, aged 57-98 years, receiving laxative therapy were included. Patients were randomized into a fiber (n=15) and a control group (n=15). The intervention group received 5.2g/d oat-bran for 84 days mixed into the daily common meals. The control group received the ward's habitual diet. Food intake and laxative use were documented and blood samples (on day 01, day 42 and day 84) were collected. Vitamin B12 and folate were analyzed by radioimmunoassay, B6 and homocysteine by RP-HPLC with fluorescence detection, in addition to the routine lab test of albumin and CRP. RESULTS In the fiber group, the intervention was well tolerated and laxative use decreased significantly (p < 0.001). In the control group, plasma B12 decreased faster (p < 0.05). In both groups, B6 and folate status remained unchanged. Plasma homocysteine decreased in both groups (p < 0.05). General mean energy intake was low (4861.4 kJ/d). CONCLUSION Oat-bran helps to improve constipation management and B12 bioavailability in elderly, with multiple chronic diseases who live in nursing homes.
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Affiliation(s)
- B Sturtzel
- Department of Nutritional Sciences, University of Vienna, Althanstrasse 14, A-1090 Vienna, Austsria.
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Barghouti FF, Younes NA, Halaseh LJ, Said TT, Ghraiz SM. High frequency of low serum levels of vitamin 12 among patients attending Jordan University Hospital. East Mediterr Health J 2009; 15:853-860. [PMID: 20187536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study aimed to estimate the status of serum vitamin B12 level in patients attending Jordan University Hospital in Amman, and to examine the relationship with demographic data, chronic illness, dietary habits, haematological parameters and symptoms related to vitamin B12 levels. A total of 838 patients completed a questionnaire and gave blood samples; 44.6% were vitamin B12 deficient (< 180 pg/mL) and 34.2% had hypovitaminosis (180-300 pg/mL). Vitamin B12 deficiency was associated with memory impairment, low meat intake and strict vegetarian (vegan) diets. The high frequency of low vitamin B12 warrants the development of a strategy to correct this problem in Jordan.
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Affiliation(s)
- F F Barghouti
- Department of Family Medicine, Jordan University Hospital, Amman, Jordan.
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Folate and vitamin B12 deficiencies. Proceedings of a WHO technical consultation held 18-21 October, 2005, in Geneva, Switzerland. Food Nutr Bull 2008; 29:S1-246. [PMID: 18990791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Ryan-Harshman M, Aldoori W. Vitamin B12 and health. Can Fam Physician 2008; 54:536-41. [PMID: 18411381 PMCID: PMC2294088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To review recent evidence that suggests vitamin B12 is associated with risk reduction for some chronic diseases and birth defects. QUALITY OF EVIDENCE A MEDLINE search from 1999 to 2007 was performed using the key word vitamin B12. The most relevant articles (129) dealt with cardiovascular disease, cancer, mental health, and birth outcomes;most studies presented level II evidence. MAIN MESSAGE Vitamin B12 might confer health benefits; however, such benefits are difficult to ascertain because of the complementary functions of vitamin B12 and folic acid. Vitamin B12 might lower high homocysteine levels below a threshold level achieved by folic acid alone. Furthermore, the interactions between the nutritional environment and genotype might have an important influence on vitamin B12, chronic disease risk, and risk of neural tube defects. CONCLUSION Vitamin B12 might help protect against chronic disease and neural tube defects, but more research, particularly in the area of nutritional genomics, is needed to determine how vitamin B12 might augment the benefits of folic acid. Some consideration should be given to the potential value of fortifying foods with vitamin B12 in addition to the current mandatory folic acid fortification of grains.
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Folic acid. Good for brain health. Mayo Clin Health Lett 2007; 25:6. [PMID: 17684820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Toteja GS, Singh P, Dhillon BS, Saxena BN, Ahmed FU, Singh RP, Prakash B, Vijayaraghavan K, Singh Y, Rauf A, Sarma UC, Gandhi S, Behl L, Mukherjee K, Swami SS, Meru V, Chandra P, Mohan U. Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India. Food Nutr Bull 2007; 27:311-5. [PMID: 17209473 DOI: 10.1177/156482650602700405] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Nutritional anemia is one of India's major public health problems. The prevalence of anemia ranges from 33% to 89% among pregnant women and is more than 60% among adolescent girls. Under the anemia prevention and control program of the Government of India, iron and folic acid tablets are distributed to pregnant women, but no such program exists for adolescent girls. OBJECTIVE To assess the status of anemia among pregnant women and adolescent girls from 16 districts of 11 states of India. METHODS A two-stage random sampling method was used to select 30 clusters on the basis of probability proportional to size. Anemia was diagnosed by estimating the hemoglobin concentration in the blood with the use of the indirect cyanmethemoglobin method. RESULTS The survey data showed that 84.9% of pregnant women (n = 6,923) were anemic (hemoglobin < 110 g/L); 13.1% had severe anemia (hemoglobin < 70 g/L), and 60.1% had moderate anemia (hemoglobin > or = 70 to 100 g/L). Among adolescent girls (n = 4,337)from 16 districts, the overall prevalence of anemia (defined as hemoglobin < 120 g/L) was 90.1%, with 7.1% having severe anemia (hemoglobin < 70 g/L). CONCLUSIONS Any intervention strategy for this population must address not only the problem of iron deficiency, but also deficiencies of other micronutrients, such as B12 and folic acid and other possible causal factors.
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Affiliation(s)
- G S Toteja
- Indian Council of Medical Research, Ansari Nagar, New Delhi.
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Abstract
Since the last century, fortified and enriched foods are products whose original composition has been modified-through addition of essential nutrients-to satisfy specific population needs. For the fortification of foods to have a positive impact on nutritional status, the micronutrients added must be well absorbed and utilized by the organism (bioavailability). Diverse factors affect bioavailability, such as the nutritional status of individuals, the presence in the diet of substances which facilitate or inhibit its absorption, interactions among micronutrients, illnesses, and chemical characteristics of the compound used for fortification. In countries such as Chile, Venezuela and Mexico, important effects have been demonstrated in reducing iron deficiency anaemia in children under 5 years of age. In less than a decade, the salt iodization programme has also proven its effectiveness. Other programmes have fortified foods with Zn, vitamin A and folic acid, which are deficient in infants and children of many populations. In summary, food fortification is a low-cost, relatively simple strategy that may reach a wide range of people, and contribute to reducing the high prevalence of micronutrient deficiencies affecting children, especially in poor countries. The costs due to losses of human capital and their repercussions on health and future development are very high. Building links among academic researchers, politicians, food manufacturers and consumers is essential in order for food fortification to be efficacious and effective, and therefore should be considered as part of an integral strategy to combat micronutrient deficiencies.
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Affiliation(s)
- Teresa Shamah
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Sta. María Ahuacatitlán, CP 62508 Cuernavaca, Morelos, México.
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Bentley TGK, Willett WC, Weinstein MC, Kuntz KM. Population-level changes in folate intake by age, gender, and race/ethnicity after folic acid fortification. Am J Public Health 2006; 96:2040-7. [PMID: 17018833 PMCID: PMC1751812 DOI: 10.2105/ajph.2005.067371] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to quantify the impact of the 1998 US Food and Drug Administration (FDA) folic acid fortification policy by estimating folate intake at the population level. METHODS We analyzed total folate intake levels (from food and supplements) according to gender, age, and race/ethnicity, using data from 2 National Health and Nutrition Examination Surveys. We measured pre- and postfortification folate intake distributions, adjusted for measurement error, and examined proportions of the population who reached certain thresholds of daily total folate intake. RESULTS Mean daily food and total folate intake increased by approximately 100 microg/day after fortification. The proportion of women aged 15-44 years who consume more than 400 microg/day of folate has increased since fortification, but has not yet reached the FDA's 50% target and varies by race/ethnicity from 23% to 33%. Among persons aged 65 years and older who may be at risk for masking a vita-microg/day (the min B12 deficiency, the percentage who consume more than 1000 "tolerable upper intake level") has at least doubled among Whites and Black men, but has remained less than 5% for all groups. CONCLUSIONS Since fortification, folic acid intake among the US population has increased, and there are substantial variations by age, gender, and race/ethnicity.
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Affiliation(s)
- Tanya G K Bentley
- Faculty of Arts and Sciences, Harvard University, Cambridge, Mass, USA
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Abstract
Bariatric surgery is currently the most effective method of sustainable weight loss among morbidly obese patients. The types of bariatric surgeries can be divided into three categories: restrictive procedures, malabsorptive procedures, and combination (restrictive and malabsorption) procedures. In general, patients undergoing restrictive procedures have the least risk for long-term diet-related complications, whereas patients undergoing malabsorptive procedures have the highest risk. For many patients, the benefits of weight loss, such as decreased blood glucose, lipids, and blood pressure and increased mobility, will outweigh the risks of surgical complications. Most diet-related surgical complications can be prevented by adhering to strict eating behavior guidelines and supplement prescriptions. Eating behavior guidelines include restricting portion sizes, chewing foods slowly and completely, eating and drinking separately, and avoiding foods that are poorly tolerated. Supplement prescriptions vary among practitioners and usually involve at least a multivitamin with minerals. Some practitioners may add other supplements only as needed for diagnosed deficiencies; others may prescribe additional prophylactic supplements. The most common nutrient deficiencies are of iron, folate, and vitamin B12. However, deficiencies of fat-soluble vitamins have been reported in patients with malabsorption procedures, and thiamin deficiency has been reported among patients with very poor intake and/or nausea and vomiting. Frequent monitoring of nutrition status for all patients can aid in preventing severe clinical deficiencies.
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Affiliation(s)
- Emmy Parkes
- University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
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Norberg B. [Vitamins B in primary health care--requirement, deficiency, adverse effects]. Lakartidningen 2006; 103:1047. [PMID: 16646230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Kollée LAA. [Vitamin deficiencies in breastfed children due to maternal dietary deficiency]. Ned Tijdschr Geneeskd 2006; 150:473-5. [PMID: 16553044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Dietary deficiencies of vitamin B12 and vitamin D during pregnancy and lactation may result in health problems in exclusively breastfed infants. Vitamin-B12 deficiency in these infants results in irritability, anorexia and failure to thrive during the first 4-8 months of life. Severe and permanent neurodevelopmental disturbances may occur. The most at risk for vitamin-B12 deficiency are breast-fed infants ofveganist and vegetarian mothers. Mothers who cover their skin prevent exposure to the sun and may consequently be at risk for vitamin-D deficiency, as well as putting their offspring at risk. In prenatal and perinatal care, it is important to take the maternal dietary history in order to be able to prevent or treat these disorders. Guidelines for obstetrical and neonatal care should include the topic of vitamin deficiency.
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Affiliation(s)
- L A A Kollée
- Universitair Medisch Centrum St Radboud, 833, Universitair Kinderziekenhuis, Postbus 9101, 6500 HB Nijmegen.
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Bor MV, Lydeking-Olsen E, Møller J, Nexø E. A daily intake of approximately 6 microg vitamin B-12 appears to saturate all the vitamin B-12-related variables in Danish postmenopausal women. Am J Clin Nutr 2006; 83:52-8. [PMID: 16400049 DOI: 10.1093/ajcn/83.1.52] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recommended daily intakes of vitamin B-12 vary between 2 and 6 microg. OBJECTIVE The objective was to examine the associations between vitamin B-12 intake and markers of vitamin B-12 deficiency. DESIGN We studied 98 Danish postmenopausal women aged 41-75 y. Serum cobalamin, transcobalamin (TC) saturated with vitamin B-12 (holo-TC), TC saturation (holo-TC/total TC), methylmalonic acid (MMA), and total homocysteine (tHcy) were measured to assess vitamin B-12 status. Dietary intakes of vitamin B-12 were determined from 7-d weighed food records. Gastric pH measurement and the alkali-challenge test were performed with the use of Heidelberg radiotelemetric capsules. RESULTS The total intake of vitamin B-12 ranged from 1.2 to 23.9 microg/d. All vitamin B-12-related variables, except gastric pH, correlated significantly with total vitamin B-12 intake. Those taking supplements (54%) had higher circulating concentrations of cobalamin and TC saturation and lower concentrations of MMA and tHcy than did those not taking supplements. All subjects were divided into quintiles according to their total vitamin B-12 intake. For all the variables analyzed, the curves appeared to level off at a daily vitamin B-12 intake of approximately 6 microg; the median (and 25th-75th percentiles) for cobalamin was 380 (270-480) pmol/L, for holo-TC was 119 (92-162) pmol/L, for MMA was 0.12 (0.14-0.17) micromol/L, and for tHcy was 9.75 (8.3-11.40) micromol/L (n = 58). CONCLUSION A daily vitamin B-12 intake of 6 microg appeared to be sufficient to correct all the vitamin B-12-related variables measured in the postmenopausal Danish women in this study.
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Affiliation(s)
- Mustafa Vakur Bor
- Department of Clinical Biochemistry, Nørrebrogade Section, Aarhus Hospital, Aarhus, Denmark.
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