Riboflavin and vitamin B-6 intakes and status and biochemical response to riboflavin supplementation in free-living elderly people

Madigan, Sharon M.; Tracey, Fergal; McNulty, Helene; Eaton-Evans, J; Coulter, James; McCartney, Heather; Strain, JJ

doi:10.1093/ajcn/68.2.389

Cited by 72 publications

(58 citation statements)

References 18 publications

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“…For riboflavin, less than 10% of men and women had intakes below the LRNI, whereas 38% were judged deficient on the status measurement (EGRAC). This paradox has been noted before in this same population 15 and in other surveys of older people 16,17 . It was also a finding in the recent survey of school children 18 , where the status results were attributed to the sensitive assay used.…”

Section: Discussionsupporting

confidence: 75%

Dietary sugars and micronutrient dilution in normal adults aged 65 years and over

Gibson¹

2001

Public Health Nutr.

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Objective: To examine the relationship between non-milk extrinsic sugars (NMES) concentration and micronutrient intakes and status in free-living older people. Design: The National Diet and Nutrition Survey of people aged 65 years and over; a cross-sectional study in Britain in 1994/5. Subjects and methods: Eight hundred and six men and women living in private households who were not on medication for nutritional disorders. Subjects were classified into four groups (Q1 to Q4), using cut-off points corresponding to quartiles of energy from NMES. Relationships were examined between dietary NMES concentration and intakes of calcium, iron, riboflavin, folate, vitamin C and vitamin D. Status indices were also assessed in each group. Results: Overall, a small proportion of men and women had intakes below the Lower Reference Nutrient Intake (LRNI) for calcium, iron, folate, riboflavin or vitamin C, while vitamin D intakes were universally low. Intakes of micronutrients tended to be highest at moderate levels of NMES in the diet (Q2 and Q3, equivalent to 8±15% of energy from NMES). Micronutrient status was low for riboflavin in 38% of the sample, while 15% had low vitamin C status and more than 10% were anaemic. There was little evidence that poorer nutrient status was associated with higher levels of dietary NMES. Although some indices of folate status were lower in Q4, this is most likely to reflect confounding by smoking. Energy intake accounted for 20±40% of the variance in micronutrient intakes, compared with less than 5% for NMES concentration. Conclusions: A diet moderately high in NMES (up to around 15% of energy) is unlikely to have a detrimental impact on micronutrient intake or status in this age group. Energy intake is the major determinant of micronutrient adequacy. KeywordsDiet Sugars Nutrient Intake Status ElderlyPeople over the age of 65 in Britain today can look forward to more years of healthy retirement than previous generations. This has come about chiefly as a result of improved public health and nutrition over the last century and better medical treatment in the past 40 years. Nonetheless, there is a still a minority for whom nutrient intakes may be inadequate and nutritional status suboptimal.Older people are potentially`at risk' of low micronutrient intakes and status because energy requirements decline with age, while most micronutrient requirements do not 1 . The latter may even increase if absorption is less efficient or adversely affected by disease or medication. Dietary quality becomes more important at lower energy intakes.The UK Department of Health's report 2 , The Nutrition of Elderly People, recommended that elderly people should consume``a diet containing nutrient-dense foods''. It also asserts that``a reduction in sugar intakes is especially important, given the probability of higher than average consumption by elderly people''. The report also warns,``if large amounts of foods rich in simple sugars are consumed, appetite for a more varied and nutrient rich diet may be blunte...

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Section: Discussionsupporting

confidence: 75%

Dietary sugars and micronutrient dilution in normal adults aged 65 years and over

Gibson¹

2001

Public Health Nutr.

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“…This paradox has also been noted in other recent studies of older people in the UK (Bailey et al 1997;Madigan et al 1998). Table 3 lists mean values for the biochemical status indices where there were significant differences between free-living participants and those in institutions, and examines the percentage differences between these two population groups, adjusted for age (since there was a highly significant difference in age profile between the two groups) and for sex.…”

Section: Biochemical Status Indicessupporting

confidence: 58%

Micronutrients: highlights and research challenges from the 1994–5 National Diet and Nutrition Survey of people aged 65 years and over

et al. 1999

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The aims of the National Diet and Nutrition Survey series are summarized, and the new National Diet and Nutrition Survey of people aged 65 years and over is explored, with particular emphasis on micronutrient intakes and status indices. Mean nutrient intakes were generally satisfactory for most micronutrients, but intakes of vitamin D, Mg, K and Cu were low. Intakes of vitamin D were far below the reference nutrient intake for people aged 65 years and over, and there was also biochemical evidence of vitamin D deficiency, for 8 % of free-living and 37 % of institution participants, attributed partly to limited exposure to sunlight. A substantial proportion of people living in institutions had inadequate biochemical status indices, notably for vitamin C, Fe and folate. Relationships between intake and status were close for vitamins. Mineral intakes did not correlate well with currently used status indices. Some intakes and indices, especially those of vitamin C, carotenoids, Na and K, were strongly correlated with socio-economic status and with north-south gradients in Britain. Future research challenges should address the functional and health significance of low intakes and sub-optimal biochemical indices for certain micronutrients, especially for people living in institutions; the shortcomings of mineral status indices especially as indicators of mineral intake; the social and geographical inequalities of micronutrient intakes and status, and why micronutrient status deteriorates with increasing age. The answers to these questions will help to define the characteristics of nutritional risk for older people in Britain, and to clarify future needs for education and intervention. Micronutrients: National Diet and Nutrition Survey: ElderlyThe purpose of the present paper is to draw attention to the British Government's National Diet and Nutrition Survey of people aged 65 years and over, and the reports derived from it Steele et al. 1998). It also considers some of the problems of interpretation and research challenges of this large dataset in order to encourage other researchers to continue this investigation. The primary data from the survey will be lodged with the

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“…The adequacy of sample size was established from power calculations using typical variances from other similar investigations (Madigan et al, 1998). All potential subjects were initially screened for riboflavin status.…”

Section: Methodsmentioning

confidence: 99%

“…A supplementation level of 1.6 mg=day riboflavin for 12 weeks was chosen based on data from a previous riboflavin intervention ( Madigan et al, 1998) carried out at this centre (but not concerned with tHcy), which demonstrated that this amount significantly improved riboflavin status in elderly people. We therefore chose the same regimen in order to observe what effect, if any, a change in riboflavin status would have on plasma tHcy.…”

Section: Methodsmentioning

confidence: 99%

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Effect of riboflavin supplementation on plasma homocysteine in elderly people with low riboflavin status

et al. 2002

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Objective: To investigate the effect of riboflavin supplementation on plasma homocysteine (tHcy) concentrations in healthy elderly people with sub-optimal riboflavin status. Design: A double-blind, randomized, placebo-controlled riboflavin supplementation trial. Setting: Community based study in Northern Ireland. Subjects: From a screening sample of 101 healthy elderly people, 52 had sub-optimal riboflavin status (erythrocyte glutathione reductase activation coefficient, EGRAC ! 1.20) and were invited to participate in the study. Intervention: The intervention had two parts. Part 1 was a 12 week randomized double blind, placebo-controlled intervention with riboflavin (1.6 mg=day). Following completion of part 1, the placebo group went on to part 2 of the study which involved supplementation with folic acid (400 mg=day) for 6 weeks followed by folic acid and riboflavin (1.6 mg=day) for a further 12 weeks, with a 16 week washout period post-supplementation. The purpose of part 2 was: (a) to address the possibility that homocysteine-lowering in response to riboflavin may be obscured by a much greater effect of folate, and that, once folate status was optimized, a dependence of homocysteine on riboflavin might emerge; and (b) to demonstrate that these subjects had homocysteine concentrations which could be lowered by nutritional intervention. Results: Although riboflavin supplementation significantly improved riboflavin status in both parts 1 and 2 of the study (P < 0.001 for each), tHcy concentrations were unaffected (P ¼ 0.719). In contrast, folic acid supplementation (study part 2) resulted in a homocysteine lowering of 19.6% (P ¼ 0.001). Conclusion: Despite the metabolic dependency of tHcy on riboflavin, it did not prove to be an effective homocysteine-lowering agent, even in the face of sub-optimal riboflavin status.

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Riboflavin and vitamin B-6 intakes and status and biochemical response to riboflavin supplementation in free-living elderly people

Cited by 72 publications

References 18 publications

Dietary sugars and micronutrient dilution in normal adults aged 65 years and over

Dietary sugars and micronutrient dilution in normal adults aged 65 years and over

Micronutrients: highlights and research challenges from the 1994–5 National Diet and Nutrition Survey of people aged 65 years and over

Effect of riboflavin supplementation on plasma homocysteine in elderly people with low riboflavin status

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