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 Aug;88(2):348-355.
http://www.ajcn.org/cgi/content/abstract/88/2/348
http://www.ajcn.org/cgi/content/full/88/2/348
http://www.ajcn.org/cgi/reprint/88/2/348
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American Journal of Clinical Nutrition, Vol. 88, No. 2, 348-355, August 2008
© 2008 American Society for Nutrition
ORIGINAL RESEARCH COMMUNICATION
Bread cofortified with folic acid and vitamin B-12 improves the folate and vitamin B-12 status of healthy older people: a randomized controlled trial1,2,3
Renate M Winkels, Ingeborg A Brouwer, Robert Clarke, Martijn B Katan and Petra Verhoef
1 From the Top Institute of Food & Nutrition (formerly the Wageningen Centre for Food Sciences), Wageningen, Netherlands (RMW and IAB); the Division of Human Nutrition, Wageningen University, Wageningen, Netherlands (RMW and IAB); the Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, Netherlands (IAB and MBK); the Clinical Trial Service Unit, Richard Doll Building, University of Oxford, Oxford, United Kingdom (RC); Unilever Food and Health Research Institute, Vlaardingen, Netherlands (PV)
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 µg folic acid and 9.6 µg 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 (
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.
Copyright © 2008 by The American Society for Nutrition