Intakes, Adequacy, and Biomarker Status of Iron, Folate, and Vitamin B12 in Māori and Non-Māori Octogenarians: Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ)

Advanced-age adults may be at risk of iron, folate, and vitamin B12 deficiency due to low food intake and poor absorption. This study aimed to investigate the intake and adequacy of iron, folate, and vitamin B12 and their relationship with respective biomarker status. Face-to-face interviews with 216 Māori and 362 non-Māori included a detailed dietary assessment using 2 × 24-h multiple pass recalls. Serum ferritin, serum iron, total iron binding capacity, transferrin saturation, red blood cell folate, serum folate, serum vitamin B12 and hemoglobin were available at baseline. Regression techniques were used to estimate the association between dietary intake and biomarkers. The Estimated Average Requirement (EAR) was met by most participants (>88%) for dietary iron and vitamin B12 (>74%) but less than half (>42%) for folate. Increased dietary folate intake was associated with increased red blood cell (RBC) folate for Māori (p = 0.001), non-Māori (p = 0.014) and serum folate for Māori (p < 0.001). Folate intake >215 µg/day was associated with reduced risk of deficiency in RBC folate for Māori (p = 0.001). Strategies are needed to optimize the intake and bioavailability of foods rich in folate. There were no significant associations between dietary iron and vitamin B12 intake and their respective biomarkers, serum iron and serum vitamin B12.

[1]  Ali Bijani,et al.  Ability of serum ferritin to diagnose iron deficiency anemia in an elderly cohort , 2017, Revista brasileira de hematologia e hemoterapia.

[2]  C. Jagger,et al.  Intakes of Folate and Vitamin B12 and Biomarkers of Status in the Very Old: The Newcastle 85+ Study , 2016, Nutrients.

[3]  A. Rolleston,et al.  Macronutrient intake in advanced age: Te Puāwaitanga o Ngā Tapuwae Kia ora Tonu, Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ) , 2016, British Journal of Nutrition.

[4]  J. Spence,et al.  Metabolic vitamin B12 deficiency: a missed opportunity to prevent dementia and stroke. , 2016, Nutrition research.

[5]  Amanda J. Patterson,et al.  Is Higher Consumption of Animal Flesh Foods Associated with Better Iron Status among Adults in Developed Countries? A Systematic Review , 2016, Nutrients.

[6]  Kaylen J. Pfisterer,et al.  Vitamin B12 status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor. , 2016, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[7]  N. Kerse,et al.  Factors associated with nutrition risk in older Māori: a cross sectional study. , 2015, The New Zealand medical journal.

[8]  A. MacFarlane,et al.  Genetic modifiers of folate, vitamin B-12, and homocysteine status in a cross-sectional study of the Canadian population. , 2015, The American journal of clinical nutrition.

[9]  M. P. Vaquero,et al.  Chronic Iron Deficiency as an Emerging Risk Factor for Osteoporosis: A Hypothesis , 2015, Nutrients.

[10]  C. W. Wong,et al.  Vitamin B12 deficiency in the elderly: is it worth screening? , 2015, Hong Kong medical journal = Xianggang yi xue za zhi.

[11]  A. Yalçın,et al.  The prevalence of anemia, iron, vitamin B12, and folic acid deficiencies in community dwelling elderly in Ankara, Turkey. , 2015, Archives of gerontology and geriatrics.

[12]  A. Schmid,et al.  Vitamin B12 in meat and dairy products. , 2015, Nutrition reviews.

[13]  Efsa Panel on Dietetic Products Scientific Opinion on Dietary Reference Values for folate. , 2014 .

[14]  A. Molloy,et al.  Guidelines for the diagnosis and treatment of cobalamin and folate disorders , 2014, British journal of haematology.

[15]  P. Myint,et al.  Iron status in the elderly , 2014, Mechanisms of Ageing and Development.

[16]  E. Rahimi,et al.  Heme Iron Content in Lamb Meat Is Differentially Altered upon Boiling, Grilling, or Frying as Assessed by Four Distinct Analytical Methods , 2013, TheScientificWorldJournal.

[17]  N. Kerse,et al.  Engagement and recruitment of Māori and non‐Māori people of advanced age to LiLACS NZ , 2013, Australian and New Zealand journal of public health.

[18]  D. Swinkels,et al.  Plasma hepcidin levels and anemia in old age. The Leiden 85-Plus Study , 2013, Haematologica.

[19]  L. Jones,et al.  Nutritional risk amongst community-living Maori and non-Maori older people in Hawke's Bay. , 2012, Journal of primary health care.

[20]  N. Kerse,et al.  Korero te kai o te Rangatira: Nutritional wellbeing of Māori at the pinnacle of life , 2012 .

[21]  N. Kerse,et al.  Life and Living in Advanced Age: A Cohort Study in New Zealand -Te Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ: Study protocol , 2012, BMC Geriatrics.

[22]  B. Altun,et al.  Iron deficiency can cause cognitive impairment in geriatric patients , 2012, The journal of nutrition, health & aging.

[23]  R. Green Indicators for assessing folate and vitamin B-12 status and for monitoring the efficacy of intervention strategies. , 2011, The American journal of clinical nutrition.

[24]  E. Nexo,et al.  Holotranscobalamin, a marker of vitamin B-12 status: analytical aspects and clinical utility12345 , 2011, American Journal of Clinical Nutrition.

[25]  I. Egli,et al.  Iron bioavailability and dietary reference values. , 2010, The American journal of clinical nutrition.

[26]  M. Caudill Folate bioavailability: implications for establishing dietary recommendations and optimizing status. , 2010, The American journal of clinical nutrition.

[27]  S. Samman,et al.  Vitamin B12 in Health and Disease , 2010, Nutrients.

[28]  P. Stover,et al.  Vitamin B12 and older adults , 2010, Current opinion in clinical nutrition and metabolic care.

[29]  S. Vollset,et al.  Determinants of plasma methylmalonic acid in a large population: implications for assessment of vitamin B12 status. , 2009, Clinical chemistry.

[30]  G. Sacks,et al.  Micronutrients and older adults. , 2009, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[31]  B. Davis,et al.  Iron, B12 and folate , 2009 .

[32]  T. Kirkwood,et al.  Nutrition in advanced age: dietary assessment in the Newcastle 85+ study , 2009, European Journal of Clinical Nutrition.

[33]  L. Allen How common is vitamin B-12 deficiency? , 2009, The American journal of clinical nutrition.

[34]  B. Benoist Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. , 2008 .

[35]  L. Allen,et al.  Causes of Vitamin B12 and Folate Deficiency , 2008, Food and nutrition bulletin.

[36]  B. de Benoist Conclusions of a WHO Technical Consultation on Folate and Vitamin B12 Deficiencies , 2008, Food and nutrition bulletin.

[37]  J. Jolles,et al.  Homocysteine, vitamin B-12, and folic acid and the risk of cognitive decline in old age: the Leiden 85-Plus study. , 2005, The American journal of clinical nutrition.

[38]  Jun Suk Kim,et al.  The cutoff value of serum ferritin for the diagnosis of iron deficiency in community-residing older persons , 2005, Annals of Hematology.

[39]  B. Venn,et al.  Serum vitamin B12 concentrations and atrophic gastritis in older New Zealanders , 2005, European Journal of Clinical Nutrition.

[40]  Luigi Ferrucci,et al.  Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. , 2004, Blood.

[41]  M. Schroll,et al.  Iron status in 358 apparently healthy 80-year-old Danish men and women: relation to food composition and dietary and supplemental iron intake , 2004, Annals of Hematology.

[42]  M. A. López,et al.  Iron availability: An updated review , 2004, International journal of food sciences and nutrition.

[43]  S. Fairweather-Tait,et al.  Iron and calcium bioavailability of fortified foods and dietary supplements. , 2002, Nutrition reviews.

[44]  A. Aguzzi,et al.  Total heme and non-heme iron in raw and cooked meats , 2002 .

[45]  K. Mohanaruban,et al.  Iron deficiency anaemia in older people: investigation, management and treatment. , 2002, Age and ageing.

[46]  C. West,et al.  Bioavailability and bioefficacy of folate and folic acid in man , 2001, Nutrition Research Reviews.

[47]  R. Russell,et al.  Factors in aging that effect the bioavailability of nutrients. , 2001, The Journal of nutrition.

[48]  R. Baumgartner,et al.  Effects of Iron Intake on Iron Stores in Elderly Men and Women: Longitudinal and Cross-Sectional Results , 2000, Journal of the American College of Nutrition.

[49]  C. Bates,et al.  Iron deficiency in older people: Interactions between food and nutrient intakes with biochemical measures of iron; further analysis of the National Diet and Nutrition Survey of people aged 65 years and over , 1999, European Journal of Clinical Nutrition.

[50]  M. Carroll,et al.  Prevalence of iron deficiency in the United States. , 1997, JAMA.

[51]  E. Doets,et al.  Vitamin B12 Requirements in Older Adults , 2016 .

[52]  R. Rizzoli,et al.  Malnutrition in very old hospitalized patients: A new etiologic factor of anemia? , 2015, The journal of nutrition, health & aging.

[53]  B. Holmes,et al.  The influence of social and physical factors and out-of-home eating on food consumption and nutrient intake in the materially deprived older UK population , 2009 .

[54]  Sandra Capra,et al.  Nutrient reference values for Australia and New Zealand: Including recommended dietary intakes , 2006 .

[55]  W. Pan,et al.  Association between dietary folate-rich food intake and folate status of elderly Taiwanese. , 2005, Asia Pacific journal of clinical nutrition.

[56]  N. Milman,et al.  Serum ferritin and iron status in a population of 'healthy' 85-year-old individuals. , 1990, Scandinavian journal of clinical and laboratory investigation.

[57]  R. Russell,et al.  Hypochlorhydria: a factor in nutrition. , 1989, Annual review of nutrition.

[58]  R W Markham,et al.  Geriatric nutrition. , 1989, The Veterinary clinics of North America. Small animal practice.

[59]  L. Mahan,et al.  Krause's Food, Nutrition, & Diet Therapy , 1984 .

[60]  E. Russell Dr. Cyril G. Hopkins , 1920, Nature.

[61]  A Research Institute for New Zealand , 2022, Nature.