Bread cofortified with folic acid and vitamin B-12 improves the folate and vitamin B-12 status of healthy older people: a randomized controlled trial

R.M. Winkels, I.A. Brouwer, R. Clarke, M.B. Katan, P. Verhoef

Research output: Contribution to journalArticleAcademicpeer-review

36 Citations (Scopus)

Abstract

Background: Mandatory fortification of flour with folic acid has reduced the number of neural tube defects in North America. Concerns that high intakes of folic acid might mask vitamin B-12 deficiency in older persons have delayed the introduction of fortification in many European countries. Cofortification of flour with folic acid and vitamin B-12 could simultaneously improve folate and vitamin B-12 status. Objective: The objective was to estimate the effect of the consumption of bread fortified with modest amounts of folic acid and vitamin B-12 on folate and vitamin B-12 status in healthy older persons living in the Netherlands, where folic acid fortification is not taking place. Design: Men and women aged 50-75 y were randomly assigned in this 12-wk double-blind, placebo-controlled trial to consume bread fortified with 138 mu g folic acid and 9.6 mu g vitamin B-12 daily (n = 72) or unfortified bread (n = 70). Results: The consumption of fortified bread increased serum folate concentrations by 45% (mean: 6.3 nmol/L; 95% CI: 4.5, 8.1 nmol/L) and serum vitamin B-12 concentrations by 49% (mean: 102 pmol/L; 95% CI: 82, 122 pmol/L) relative to the placebo group. Fortified bread increased erythrocyte folate concentrations by 22% and holo-transcobalamin concentrations by 35%; it decreased homocysteine concentrations by 13% and methylmalonic acid concentrations by 10%. Consumption of fortified bread decreased the proportion of individuals with marginal serum vitamin B-12 concentrations (
Original languageEnglish
Pages (from-to)348-355
JournalAmerican Journal of Clinical Nutrition
Volume88
Issue number2
DOIs
Publication statusPublished - 2008

Keywords

  • neural-tube defects
  • double-blind
  • homocysteine concentrations
  • food fortification
  • serum vitamin-b-12
  • cognitive function
  • oral vitamin-b-12
  • united-states
  • deficiency
  • supplementation

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