Dietary intake of cobalamin in elderly people who have abnormal serum cobalamin, methylmalonic acid and homocysteine levels

J. M. Howard, C. Azen, D. W. Jacobsen, Ralph Green, R. Carmel

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Objective: To determine if poor dietary intake can explain the cobalamin-related abnormalities often seen in the elderly. Design: Prospective laboratory survey with a follow-up dietary assessment. Setting: Social centers for the elderly and an outpatient clinic. Subjects: Ninety-five free-living subjects > 60 y old with abnormal or suspicious findings in cobalamin-related tests and 78 subjects > 60 y old with normal results. Interventions: Serum cobalamin, methylmalonic acid and homocysteine determinations to assess cobalamin status and a one year food-frequency questionnaire to assess cobalamin intake. Results: Only three of the 173 subjects (1.7%), one of whom had normal cobalamin status, ingested < 2 μg cobalamin/d, the Recommended Daily Allowance. Sixty-nine subjects (39.9%) ingested < 6 μg/d, but they did not have more abnormal serum cobalamin or metabolite values than those ingesting > 6 μg. Ordering all subjects by quintiles according to cobalamin intake revealed no significant trends or differences in any of the serum values either. Moreover, arranging subjects by results of tests of cobalamin status showed that the subjects with abnormal cobalamin status did not differ in cobalamin intake from those with normal cobalamin status, although they did differ in use of supplements. Finally, cobalamin intake, with or without supplements, did not correlate with serum cobalamin or metabolite levels. The absence of any association between cobalamin status and intake contrasts sharply with the significant correlation between folate intake and folate status (P = 0.0001). Conclusions: The high frequency of mildly abnormal cobalamin status in the elderly cannot be attributed to poor intake of cobalamin. Nondietary explanations, such as malabsorption and other phenomena, must always be sought to explain mild cobalamin deficiency in the elderly.

Original languageEnglish (US)
Pages (from-to)582-587
Number of pages6
JournalEuropean Journal of Clinical Nutrition
Volume52
Issue number8
StatePublished - 1998
Externally publishedYes

Fingerprint

Methylmalonic Acid
methylmalonic acid
homocysteine
Homocysteine
vitamin B12
Vitamin B 12
food intake
Serum
Folic Acid
folic acid

Keywords

  • Cobalamin (vitamin B)
  • Dietary intake
  • Elderly
  • Folate
  • Homocysteine
  • Methylmalonic acid
  • Pyridoxine

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Dietary intake of cobalamin in elderly people who have abnormal serum cobalamin, methylmalonic acid and homocysteine levels. / Howard, J. M.; Azen, C.; Jacobsen, D. W.; Green, Ralph; Carmel, R.

In: European Journal of Clinical Nutrition, Vol. 52, No. 8, 1998, p. 582-587.

Research output: Contribution to journalArticle

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abstract = "Objective: To determine if poor dietary intake can explain the cobalamin-related abnormalities often seen in the elderly. Design: Prospective laboratory survey with a follow-up dietary assessment. Setting: Social centers for the elderly and an outpatient clinic. Subjects: Ninety-five free-living subjects > 60 y old with abnormal or suspicious findings in cobalamin-related tests and 78 subjects > 60 y old with normal results. Interventions: Serum cobalamin, methylmalonic acid and homocysteine determinations to assess cobalamin status and a one year food-frequency questionnaire to assess cobalamin intake. Results: Only three of the 173 subjects (1.7{\%}), one of whom had normal cobalamin status, ingested < 2 μg cobalamin/d, the Recommended Daily Allowance. Sixty-nine subjects (39.9{\%}) ingested < 6 μg/d, but they did not have more abnormal serum cobalamin or metabolite values than those ingesting > 6 μg. Ordering all subjects by quintiles according to cobalamin intake revealed no significant trends or differences in any of the serum values either. Moreover, arranging subjects by results of tests of cobalamin status showed that the subjects with abnormal cobalamin status did not differ in cobalamin intake from those with normal cobalamin status, although they did differ in use of supplements. Finally, cobalamin intake, with or without supplements, did not correlate with serum cobalamin or metabolite levels. The absence of any association between cobalamin status and intake contrasts sharply with the significant correlation between folate intake and folate status (P = 0.0001). Conclusions: The high frequency of mildly abnormal cobalamin status in the elderly cannot be attributed to poor intake of cobalamin. Nondietary explanations, such as malabsorption and other phenomena, must always be sought to explain mild cobalamin deficiency in the elderly.",
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