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How common is vitamin B-12 deficiency?

Abstract

In considering the vitamin B-12 fortification of flour, it is important to know who is at risk of vitamin B-12 deficiency and whether those individuals would benefit from flour fortification. This article reviews current knowledge of the prevalence and causes of vitamin B-12 deficiency and considers whether fortification would improve the status of deficient subgroups of the population. In large surveys in the United States and the United Kingdom, approximately 6% of those aged > or =60 y are vitamin B-12 deficient (plasma vitamin B-12 < 148 pmol/L), with the prevalence of deficiency increasing with age. Closer to 20% have marginal status (plasma vitamin B-12: 148-221 pmol/L) in later life. In developing countries, deficiency is much more common, starting in early life and persisting across the life span. Inadequate intake, due to low consumption of animal-source foods, is the main cause of low serum vitamin B-12 in younger adults and likely the main cause in poor populations worldwide; in most studies, serum vitamin B-12 concentration is correlated with intake of this vitamin. In older persons, food-bound cobalamin malabsorption becomes the predominant cause of deficiency, at least in part due to gastric atrophy, but it is likely that most elderly can absorb the vitamin from fortified food. Fortification of flour with vitamin B-12 is likely to improve the status of most persons with low stores of this vitamin. However, intervention studies are still needed to assess efficacy and functional benefits of increasing intake of the amounts likely to be consumed in flour, including in elderly persons with varying degrees of gastric atrophy.

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  • Publisher Full Text
  • Authors+Show Affiliations

    US Department of Agriculture, ARS Western Human Nutrition Research Center, University of California, Davis, Davis, CA 95616, USA. lindsay.allen@ars.usda.gov

    Source

    MeSH

    Adult
    Age Factors
    Aged
    Aged, 80 and over
    Aging
    Biological Availability
    Female
    Flour
    Food, Fortified
    Humans
    Intestinal Absorption
    Male
    Middle Aged
    Nutritional Requirements
    Nutritional Status
    Prevalence
    Vitamin B 12
    Vitamin B 12 Deficiency
    Young Adult

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    19116323

    Citation

    Allen, Lindsay H.. "How Common Is Vitamin B-12 Deficiency?" The American Journal of Clinical Nutrition, vol. 89, no. 2, 2009, 693S-6S.
    Allen LH. How common is vitamin B-12 deficiency? Am J Clin Nutr. 2009;89(2):693S-6S.
    Allen, L. H. (2009). How common is vitamin B-12 deficiency? The American Journal of Clinical Nutrition, 89(2), 693S-6S. doi:10.3945/ajcn.2008.26947A.
    Allen LH. How Common Is Vitamin B-12 Deficiency. Am J Clin Nutr. 2009;89(2):693S-6S. PubMed PMID: 19116323.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - How common is vitamin B-12 deficiency? A1 - Allen,Lindsay H, Y1 - 2008/12/30/ PY - 2009/1/1/entrez PY - 2009/1/1/pubmed PY - 2009/2/12/medline SP - 693S EP - 6S JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 89 IS - 2 N2 - In considering the vitamin B-12 fortification of flour, it is important to know who is at risk of vitamin B-12 deficiency and whether those individuals would benefit from flour fortification. This article reviews current knowledge of the prevalence and causes of vitamin B-12 deficiency and considers whether fortification would improve the status of deficient subgroups of the population. In large surveys in the United States and the United Kingdom, approximately 6% of those aged > or =60 y are vitamin B-12 deficient (plasma vitamin B-12 < 148 pmol/L), with the prevalence of deficiency increasing with age. Closer to 20% have marginal status (plasma vitamin B-12: 148-221 pmol/L) in later life. In developing countries, deficiency is much more common, starting in early life and persisting across the life span. Inadequate intake, due to low consumption of animal-source foods, is the main cause of low serum vitamin B-12 in younger adults and likely the main cause in poor populations worldwide; in most studies, serum vitamin B-12 concentration is correlated with intake of this vitamin. In older persons, food-bound cobalamin malabsorption becomes the predominant cause of deficiency, at least in part due to gastric atrophy, but it is likely that most elderly can absorb the vitamin from fortified food. Fortification of flour with vitamin B-12 is likely to improve the status of most persons with low stores of this vitamin. However, intervention studies are still needed to assess efficacy and functional benefits of increasing intake of the amounts likely to be consumed in flour, including in elderly persons with varying degrees of gastric atrophy. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/19116323/full_citation L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2008.26947A DB - PRIME DP - Unbound Medicine ER -