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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.
Am J Clin Nutr. 2008 Aug; 88(2):348-55.AJ

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 mug folic acid and 9.6 mug 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 holotranscobalamin 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 (<133 pmol/L) from 8% at enrollment to 0% after 12 wk.

CONCLUSION

Bread fortified with modest amounts of folic acid and vitamin B-12 will improve folate and vitamin B-12 status and a considerable proportion of vitamin B-12 deficiency in older people. This trial was registered at clinicaltrials.gov as NCT00353353.

Authors+Show Affiliations

Top Institute of Food & Nutrition, Wageningen, Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18689370

Citation

Winkels, Renate M., et al. "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." The American Journal of Clinical Nutrition, vol. 88, no. 2, 2008, pp. 348-55.
Winkels RM, Brouwer IA, Clarke R, et al. 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. Am J Clin Nutr. 2008;88(2):348-55.
Winkels, R. M., Brouwer, I. A., Clarke, R., Katan, M. B., & Verhoef, P. (2008). 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. The American Journal of Clinical Nutrition, 88(2), 348-55.
Winkels RM, et al. 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. Am J Clin Nutr. 2008;88(2):348-55. PubMed PMID: 18689370.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Winkels,Renate M, AU - Brouwer,Ingeborg A, AU - Clarke,Robert, AU - Katan,Martijn B, AU - Verhoef,Petra, PY - 2008/8/12/pubmed PY - 2008/9/16/medline PY - 2008/8/12/entrez SP - 348 EP - 55 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 88 IS - 2 N2 - 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 mug folic acid and 9.6 mug 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 holotranscobalamin 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 (<133 pmol/L) from 8% at enrollment to 0% after 12 wk. CONCLUSION: Bread fortified with modest amounts of folic acid and vitamin B-12 will improve folate and vitamin B-12 status and a considerable proportion of vitamin B-12 deficiency in older people. This trial was registered at clinicaltrials.gov as NCT00353353. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/18689370/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_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/88.2.348 DB - PRIME DP - Unbound Medicine ER -