Study finds significant proportion of older adults are deficient in vitamin B12 and folate

June 26, 2018, Trinity College Dublin

A new study by researchers from The Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin, Ireland, has shown for the first time that a substantial number of adults over 50 are at risk of deficiency in vitamin B12 and folate (the natural vitamin linked to the dietary supplement, folic acid).

The researchers found that one in eight adults in Ireland are deficient in B12; one in seven are deficient in ; and there are variations in deficiency across different provinces in Ireland, in addition to variations dependent on health, lifestyle and the time of year measured. The findings form part of the largest representative study of its kind conducted among older persons in Ireland and have just been published in the prestigious journal, British Journal of Nutrition.

Both vitamin B12 and folate are essential for nerve function, brain health and the production of red blood cells and DNA. Numerous studies have shown that low nutritional status of folate and B12 are linked to poor long-term health, especially among older people.

In Ireland, fortification of food products is voluntary and some foods (such as ready-to-eat cereals) are enriched with micronutrients such as , though this is inconsistent between products fortified and over time, resulting in haphazard exposure. There have been repeated calls for an official policy of mandatory fortification of staple foods such as bread, with folic acid, to reduce the occurrence of neural tube defects in babies. Such a policy would also reduce the prevalence of folate deficiency in older adults who are most at risk. Before this can occur, however, comprehensive information is needed on the prevalence and determinates of deficiency.

Our study suggests that the current custom of voluntary food fortification is ineffective in preventing deficiency or low status of these vitamins among older people. The results are of relevance not just for Ireland but for all countries that do not have mandatory fortification.

Key findings:

  • One in eight adults over 50 were low to deficient in vitamin B12 while one in seven were low to deficient in folate
  • The prevalence of low or deficient folate increased with age, from 14% among those aged 50-60 years to 23% among people over 80 years old. Low folate status was also more common in smokers, the obese, and those who lived alone
  • Low or deficient vitamin B12 was more common in smokers (14%), people who lived alone (14.3%) and those from lower socio-economic backgrounds (13%)
  • Use of both vitamin B12 and folic acid supplementation was low, with higher rates among women than men but less than 4% overall taking supplements of either vitamin

Commenting on the significance of the research, lead author of the study and Research Fellow at TILDA, Dr. Eamon Laird, said:

"This is the largest representative and most comprehensive study of vitamin B12 and folate status in older adults ever conducted in Ireland. There are striking differences in the prevalence of deficiency across different lifestyle factors such as obesity and smoking—both of which are modifiable risk factors. Our findings will provide useful data to help inform public health policy -particularly regarding the proposition of mandatory folic acid and/or vitamin B12 fortification. To place our findings in context, in a country such as the United States where mandatory folic acid fortification occurs, rates of low folate status are around 1.2% in compared with 15% in Ireland."

Professor Anne Molloy, senior author of the study noted:

"This study shows a surprising level of inadequate folate among older persons, despite many years of voluntary folic acid fortification of certain foods on the Irish market. Concerns relating to excessive folic acid intake, particularly in , have been at the heart of current debates regarding the risks of population-wide . However, in countries such as the US, mandatory folic food fortification for the past 20 years has prevented millions of cases of folate deficiency without any proven adverse effects. Irish public health authorities need to act on the facts from studies such as ours."

Professor Rose Anne Kenny, Principal Investigator of TILDA, said:

"The high rates of B-vitamin deficiency seen in the older adult population are of concern and, given that this can be easily treated with , this has significant policy and practice implications for Government and health services. TILDA has consistently assisted policy makers by providing strong evidence based data on which to make recommendations but also by assisting with information of most vulnerable people and therefore those who should be targeted."

Explore further: Upper limit for intake of folate is invalid—government urged to fortify flour with folic acid

More information: Eamon J. Laird et al, Voluntary fortification is ineffective to maintain the vitamin B12 and folate status of older Irish adults: evidence from the Irish Longitudinal Study on Ageing (TILDA), British Journal of Nutrition (2018). DOI: 10.1017/S0007114518001356

Related Stories

Upper limit for intake of folate is invalid—government urged to fortify flour with folic acid

January 30, 2018
There is no need for an upper limit of folate intake, according to a study by Queen Mary University of London and the School of Advanced Study, University of London.

Folic acid in pregnancy: MTHFR gene explains why benefits may differ

May 2, 2018
It's generally recommended that all women should take folic acid, both while they're trying to get pregnant and during the first 12 weeks of pregnancy. This is because folic acid is considered to be very important for the ...

Fortifying flour with folic acid could immediately prevent 57,000 annual birth defects, study suggests

April 2, 2018
According to researchers from the Rollins School of Public Health, approximately 57,000 birth defects of the brain and spine could be immediately prevented every year in 71 countries by adding folic acid to wheat flour.

Britain to add folate to bread

May 18, 2007
British food regulators say folic acid should be added to all packaged white bread.

Vitamin B-12 function may be diminished by excessive folate

December 18, 2007
In a study of adults aged 20 and over, researchers at Tufts University showed that homocysteine and methylmalonic acid are at much higher levels in individuals who have a combination of vitamin B12 deficiency and high blood ...

Increased consumption of folic acid can reduce birth defects but blood levels in Canadians are now high

December 13, 2010
Folic acid can reduce birth defects including neural tube defects, congenital heart disease and oral clefts but some speculate high intakes of folic acid may be associated with adverse events such as colorectal cancer, states ...

Recommended for you

Patient-centered visual aid helps physicians discuss risks, treatments with parents

September 21, 2018
A series of illustrations and charts designed as decision aids for parents of children with minor head injuries helped them communicate with emergency medicine physicians and make informed decisions about their child's care, ...

It's not just for kids—even adults appear to benefit from a regular bedtime

September 21, 2018
Sufficient sleep has been proven to help keep the body healthy and the mind sharp. But it's not just an issue of logging at least seven hours of Z's.

Most nations falling short of UN targets to cut premature deaths from chronic diseases

September 21, 2018
People in the UK, US and China have a higher risk of dying early from conditions like cancer, heart disease and stroke than people in Italy, France, South Korea and Australia.

Alcohol responsible for one in 20 deaths worldwide: WHO

September 21, 2018
Alcohol kills three million people worldwide each year—more than AIDS, violence and road accidents combined, the World Health Organization said Friday, adding that men are particularly at risk.

Smart pills dumb down medical care, experts warn

September 21, 2018
Enthusiasm for an emerging digital health tool, the smart pill, is on the rise but researchers at the University of Illinois at Chicago have published a paper in the American Journal of Bioethics that cautions health care ...

China's doctor shortage prompts rush for AI health care

September 20, 2018
Qu Jianguo, 64, had a futuristic medical visit in Shanghai as he put his wrist through an automated pulse-taking machine and received the result within two minutes on a mobile phone—without a doctor present.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.