Addressing optimal folate and related B-vitamin status through the lifecycle: health impacts and challenges

Abstract

The functional effects of folate within C1 metabolism involve interrelationships with vitamin B12, vitamin B6 and riboflavin, and related gene–nutrient interactions. These B vitamins have important roles throughout life, from pregnancy, through childhood, to middle and older age. Achieving optimal nutritional status for preventing folate-related disease is challenging, however, primarily as a result of the poor stability and incomplete bioavailability of folate from natural food sources when compared with the synthetic vitamin form, folic acid. Thus, in European countries, measures to prevent neural tube defects (NTD) have been largely ineffective because of the generally poor compliance of women with folic acid supplementation as recommended before and in early pregnancy. In contrast, countries worldwide with mandatory folic acid fortification policies have experienced marked reductions in NTD. Low vitamin B12 status is associated with increased risk of cognitive dysfunction, CVD and osteoporosis. Achieving optimal B12 status can be problematic for older people, however, primarily owing to food-bound B12 malabsorption which leads to sub-clinical deficiency even with high dietary B12 intakes. Optimising B-vitamin intake may be particularly important for sub-populations with impaired folate metabolism owing to genetic characteristics, most notably the 677C→T variant in the gene encoding the enzyme methylenetetrahydrofolate reductase (MTHFR). This common folate polymorphism is linked with several adverse health outcomes, including stroke, however, recent evidence has identified its novel interaction with riboflavin (the MTHFR cofactor) in relation to blood pressure and risk of developing hypertension. This review addresses why and how the optimal status of folate-related B vitamins should be achieved through the lifecycle.

Edible Insects versus Meat—Nutritional Comparison: Knowledge of Their Composition Is the Key to Good Health

“…Optimization of B vitamins' intake is particularly important in people with disorders of folate metabolism due to genetic characteristics, particularly in people with mutations in the gene encoding the enzyme methylenetetrahydrofolate reductase (MTHFR) [42,81], and also in the elderly. This is because, with age, you can notice the deterioration in absorption and a reduced intake of vitamins with the diet.…”

Diet Quality and Micronutrient Intake among Long-Term Weight Loss Maintainers

“…Adequate intake of antioxidants such as vitamins A, C, and E has been associated with lower risk of atherosclerosis and improved glucose metabolism and insulin resistance [35]. Dietary intake of adequate B-vitamins has been shown to be important in cognitive function and is associated with a decreased risk of dementia and depression [36]. Higher magnesium has been associated with decreased risk of cardiovascular disease, ischemic heart disease mortality [35,37], incidence of diabetes, and lower bone density [35].…”

Impact of the common MTHFR 677C→T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension: evidence from the JINGO project

“…Unlike other B vitamins (e.g. folate and vitamin B12), riboflavin biomarkers are rarely measured in human studies and no previous cohort study to have investigated this polymorphism has considered riboflavin [ 25 ]. We estimated a 3-fold increased risk of hypertension when the variant TT genotype occurred in combination with deficient riboflavin status (relative to the CC genotype and normal riboflavin status), whereas better riboflavin status was associated with reducing the excess hypertension risk, and normal riboflavin status with no genetic risk.…”

“…Our results indicate that the most effective timeframe to target adults with this genetic variant will be up to 70 years, via supplementation with riboflavin to potentially offer an effective low-cost strategy to lower BP. Of note, sub-optimal riboflavin status may be more widespread than is generally recognised, but is largely undocumented as riboflavin biomarkers are rarely measured in human studies [ 25 ]. The UK is one of the very few countries worldwide to include a riboflavin biomarker in its population-wide diet and nutrition survey, and recent data shows that over 50% of healthy British adults have low or deficient riboflavin status [ 33 ], in close agreement with the current results in Irish adults.…”