Folate, Vitamin B12 and Vitamin D Status in Healthy and Active Home-dwelling People over 70 Years

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2023 Oct 18

PMID 37853337

Authors

Felix Kerlikowsky

Jan Philipp Schuchardt

Andreas Hahn

Affiliations

Soon will be listed here.

Abstract

Background: Ageing is characterised by physiological changes that can affect the nutrient availability and requirements. In particular, the status of vitamin D, cobalamin and folate has often been found to be critical in older people living in residential care. However, there is a lack of studies investigating the status of these nutrients in healthy and active home-dwelling elderly people.

Methods: The aim of this cross-sectional study was to assess the status of vitamin D based on serum concentrations of 25-hydroxycholecalciferol [25-(OH)D], cobalamin based on serum concentrations of holotranscobalamin (holoTC) and folate based on red blood cell (RBC) folate in unsupplemented, healthy and active German home-dwelling subjects ≥ 70 years of age (n = 134, mean ± SD: 75.8 ± 4.5 years). Dietary intake was assessed by 3-day food recalls. The study was conducted between March and November of 2021 (during the COVID-19 pandemic).

Results: The mean 25-(OH)D concentration was high at 85.1 ± 26.0 nmol/L, while the majority of women (92%) and men (94%) had 25-(OH)D concentrations ≥ 50 nmol/L. Less than 10% of men and women had 25-(OH)D concentrations < 50 nmol/L. The mean holoTC concentration was 88.9 ± 33.7 pmol/L (94.8 ± 34.6 pmol/L in women and 73.6 ± 25.6 in men). Only 8% of the women were cobalamin deficient (< 50 pmol/L holoTC) compared to 22% of the men. The mean RBC folate concentration was 831 ± 244 nmol/L, while the prevalence of folate deficiency was 10%. Linear regression analysis showed that only folate equivalent intake was associated with the relevant nutrient status marker.

Conclusion: Our findings suggest that healthy, independently living older people with high levels of education, physical activity, and health awareness are not necessarily at higher risk of vitamin D, folate and cobalamin deficiency. Further studies are needed to verify these findings and to identify lifestyle and dietary patterns that can predict adequate nutrient status for healthy ageing.

Trial Registration: This study is officially recorded in the German Clinical Trials Register (DRKS00021302).

References

Herrmann W, Obeid R, Schorr H, Geisel J . The usefulness of holotranscobalamin in predicting vitamin B12 status in different clinical settings. Curr Drug Metab. 2005; 6(1):47-53. DOI: 10.2174/1389200052997384. View

Hinds H, Johnson A, Webb M, Graham A . Iron, folate, and vitamin B12 status in the elderly by gender and ethnicity. J Natl Med Assoc. 2012; 103(9-10):870-7. DOI: 10.1016/s0027-9684(15)30442-9. View

Fedosov S, Brito A, Miller J, Green R, Allen L . Combined indicator of vitamin B12 status: modification for missing biomarkers and folate status and recommendations for revised cut-points. Clin Chem Lab Med. 2015; 53(8):1215-25. DOI: 10.1515/cclm-2014-0818. View

Marchi G, Busti F, Lira Zidanes A, Vianello A, Girelli D . Cobalamin Deficiency in the Elderly. Mediterr J Hematol Infect Dis. 2020; 12(1):e2020043. PMC: 7340236. DOI: 10.4084/MJHID.2020.043. View

Wanner M, Richard A, Martin B, Linseisen J, Rohrmann S . Associations between objective and self-reported physical activity and vitamin D serum levels in the US population. Cancer Causes Control. 2015; 26(6):881-91. DOI: 10.1007/s10552-015-0563-y. View

Cox N, Morrison L, Ibrahim K, Robinson S, Sayer A, Roberts H . New horizons in appetite and the anorexia of ageing. Age Ageing. 2020; 49(4):526-534. DOI: 10.1093/ageing/afaa014. View

Klenk J, Rapp K, Denkinger M, Nagel G, Nikolaus T, Peter R . Seasonality of vitamin D status in older people in Southern Germany: implications for assessment. Age Ageing. 2013; 42(3):404-8. DOI: 10.1093/ageing/aft042. View

Harrington D . Laboratory assessment of vitamin B12 status. J Clin Pathol. 2016; 70(2):168-173. DOI: 10.1136/jclinpath-2015-203502. View

Pfeiffer C, Hughes J, Lacher D, Bailey R, Berry R, Zhang M . Estimation of trends in serum and RBC folate in the U.S. population from pre- to postfortification using assay-adjusted data from the NHANES 1988-2010. J Nutr. 2012; 142(5):886-93. PMC: 3327747. DOI: 10.3945/jn.111.156919. View

10.

Boucher B . Vitamin D status and its management for achieving optimal health benefits in the elderly. Expert Rev Endocrinol Metab. 2018; 13(6):279-293. DOI: 10.1080/17446651.2018.1533401. View

11.

Rabenberg M, Scheidt-Nave C, Busch M, Rieckmann N, Hintzpeter B, Mensink G . Vitamin D status among adults in Germany--results from the German Health Interview and Examination Survey for Adults (DEGS1). BMC Public Health. 2015; 15:641. PMC: 4499202. DOI: 10.1186/s12889-015-2016-7. View

12.

Turck D, Bresson J, Burlingame B, Dean T, Fairweather-Tait S, Heinonen M . Dietary reference values for vitamin K. EFSA J. 2020; 15(5):e04780. PMC: 7010012. DOI: 10.2903/j.efsa.2017.4780. View

13.

Lehmann U, Gjessing H, Hirche F, Mueller-Belecke A, Gudbrandsen O, Ueland P . Efficacy of fish intake on vitamin D status: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2015; 102(4):837-47. DOI: 10.3945/ajcn.114.105395. View

14.

Maretzke F, Bechthold A, Egert S, Ernst J, van Lent D, Pilz S . Role of Vitamin D in Preventing and Treating Selected Extraskeletal Diseases-An Umbrella Review. Nutrients. 2020; 12(4). PMC: 7231149. DOI: 10.3390/nu12040969. View

15.

Weck M, Brenner H . Prevalence of chronic atrophic gastritis in different parts of the world. Cancer Epidemiol Biomarkers Prev. 2006; 15(6):1083-94. DOI: 10.1158/1055-9965.EPI-05-0931. View

16.

Brouwer-Brolsma E, Vaes A, van der Zwaluw N, van Wijngaarden J, Swart K, Ham A . Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: The B-PROOF study. J Steroid Biochem Mol Biol. 2015; 164:168-176. DOI: 10.1016/j.jsbmb.2015.08.008. View

17.

Yetley E . Monitoring folate status in population-based surveys. Biofactors. 2011; 37(4):285-9. DOI: 10.1002/biof.176. View

18.

Kumar A, Palfrey H, Pathak R, Kadowitz P, Gettys T, Murthy S . The metabolism and significance of homocysteine in nutrition and health. Nutr Metab (Lond). 2018; 14:78. PMC: 5741875. DOI: 10.1186/s12986-017-0233-z. View

19.

Porter K, Hoey L, Hughes C, Ward M, Clements M, Strain J . Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults. Am J Clin Nutr. 2021; 114(4):1286-1294. PMC: 8488868. DOI: 10.1093/ajcn/nqab193. View

20.

Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Kostenberger M, Tmava Berisha A . Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020; 74(11):1498-1513. PMC: 7091696. DOI: 10.1038/s41430-020-0558-y. View