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Paul L, Selhub J. Interaction between excess folate and low vitamin B12 status. Mol Aspects Med 2016; 53:43-47. [PMID: 27876554 DOI: 10.1016/j.mam.2016.11.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/18/2016] [Indexed: 01/05/2023]
Abstract
Current epidemiological evidence suggests that an imbalance of high folate status and low vitamin B12 status is associated with negative health outcomes in older adults and children. Such an imbalance during pregnancy also predisposes women to diabetes and their offspring to insulin resistance and adiposity and low birthweight. In older adults, vitamin B12 status can remain low despite adequate intake due to age-related decline in vitamin B12 absorption. Pregnant women are exposed to folic acid at varying doses depending on the prenatal care prescribed in different countries. This review summarizes the current knowledge on the interaction between folate and vitamin B12 and the associated health outcomes.
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Affiliation(s)
- Ligi Paul
- Jean Mayer USDA Human Nutrition Research Center for Aging at Tufts University, Boston, MA, 02111, USA.
| | - Jacob Selhub
- Jean Mayer USDA Human Nutrition Research Center for Aging at Tufts University, Boston, MA, 02111, USA
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Crott JW. Effects of altered parental folate and one-carbon nutrient status on offspring growth and metabolism. Mol Aspects Med 2016; 53:28-35. [PMID: 27865887 DOI: 10.1016/j.mam.2016.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 11/15/2016] [Indexed: 01/23/2023]
Affiliation(s)
- Jimmy W Crott
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St., Boston, MA, United States.
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53
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Porter K, Hoey L, Hughes CF, Ward M, McNulty H. Causes, Consequences and Public Health Implications of Low B-Vitamin Status in Ageing. Nutrients 2016; 8:E725. [PMID: 27854316 PMCID: PMC5133110 DOI: 10.3390/nu8110725] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 10/26/2016] [Accepted: 11/09/2016] [Indexed: 12/11/2022] Open
Abstract
The potential protective roles of folate and the metabolically related B-vitamins (vitamins B12, B6 and riboflavin) in diseases of ageing are of increasing research interest. The most common cause of folate and riboflavin deficiencies in older people is low dietary intake, whereas low B12 status is primarily associated with food-bound malabsorption, while sub-optimal vitamin B6 status is attributed to increased requirements in ageing. Observational evidence links low status of folate and the related B-vitamins (and/or elevated concentrations of homocysteine) with a higher risk of degenerative diseases including cardiovascular disease (CVD), cognitive dysfunction and osteoporosis. Deficient or low status of these B-vitamins alone or in combination with genetic polymorphisms, including the common MTHFR 677 C → T polymorphism, could contribute to greater disease risk in ageing by causing perturbations in one carbon metabolism. Moreover, interventions with the relevant B-vitamins to optimise status may have beneficial effects in preventing degenerative diseases. The precise mechanisms are unknown but many have been proposed involving the role of folate and the related B-vitamins as co-factors for one-carbon transfer reactions, which are fundamental for DNA and RNA biosynthesis and the maintenance of methylation reactions. This review will examine the evidence linking folate and related B-vitamins with health and disease in ageing, associated mechanisms and public health implications.
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Affiliation(s)
- Kirsty Porter
- Northern Ireland Centre for Food and Health, Ulster University, Cromore Road, Coleraine BT52 1SA, UK.
| | - Leane Hoey
- Northern Ireland Centre for Food and Health, Ulster University, Cromore Road, Coleraine BT52 1SA, UK.
| | - Catherine F Hughes
- Northern Ireland Centre for Food and Health, Ulster University, Cromore Road, Coleraine BT52 1SA, UK.
| | - Mary Ward
- Northern Ireland Centre for Food and Health, Ulster University, Cromore Road, Coleraine BT52 1SA, UK.
| | - Helene McNulty
- Northern Ireland Centre for Food and Health, Ulster University, Cromore Road, Coleraine BT52 1SA, UK.
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Hartman B, Donnelly-VanderLoo M, Watson T, O'Connor C, Madill J. Proton-pump inhibitor therapy and vitamin B 12 status in an inpatient hospital setting. Appl Physiol Nutr Metab 2016; 41:1071-1076. [PMID: 27690565 DOI: 10.1139/apnm-2016-0020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The risk for impaired vitamin B12 status increases with age, as does the use of proton pump inhibitors (PPI). Long-term use of PPIs is associated with several nutritional deficiencies including B12. Currently, there are no recommendations for B12 screening among patients taking PPIs. Data were abstracted on B12 concentrations, B12-containing supplement use, medications, and select hematological values from a retrospective chart review of 658 adults, 391 with serum B12 concentrations, admitted to 6 different medical units at 2 regional hospitals in Southwestern Ontario between 2010 and 2012. We found no difference between PPI users and nonusers and serum B12 concentrations (404 ± 224 vs 369 ± 213 pmol/L; P = 0.0690). This may be due to use of B12 containing multivitamins in 41% of PPI users. Regression modelling found that aging increases the odds of having an impaired B12 status (<220 pmol/L) by 1.4 times and those using B12 supplements are almost 4 times more likely to have an impaired status. Mean corpuscular volume was not related to B12 status. In this population, older PPI users are more likely to be using multivitamins, which may delay nutritional deficiencies. However, the lower B12 concentrations of PPI users taking only B12 supplements is a concern and requires further research. Finally, physicians need to be aware that mean corpuscular volume is no longer recommended as an effective biomarker for B12 screening and updated screening protocols need to be used to reduce the possibility of adverse neurological effects from impaired B12 status.
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Affiliation(s)
- Brenda Hartman
- a Department of Nutritional Sciences, FitzGerald Building, University of Toronto, 150 College St, Toronto, ON M5S 3E2.,b The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8
| | - Mary Donnelly-VanderLoo
- c Brescia University College, 1285 Western Rd, London, ON N6G 1H2.,d London Health Sciences Centre, 800 Commissioners Rd E, London, ON N6A 5W9
| | - Tiffany Watson
- c Brescia University College, 1285 Western Rd, London, ON N6G 1H2
| | - Colleen O'Connor
- c Brescia University College, 1285 Western Rd, London, ON N6G 1H2
| | - Janet Madill
- c Brescia University College, 1285 Western Rd, London, ON N6G 1H2
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Selhub J, Rosenberg IH. Excessive folic acid intake and relation to adverse health outcome. Biochimie 2016; 126:71-8. [DOI: 10.1016/j.biochi.2016.04.010] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 04/07/2016] [Indexed: 11/27/2022]
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Sechi G, Sechi E, Fois C, Kumar N. Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults. Nutr Rev 2016; 74:281-300. [PMID: 27034475 DOI: 10.1093/nutrit/nuv107] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
B vitamin deficiency is a leading cause of neurological impairment and disability throughout the world. Multiple B vitamin deficiencies often coexist, and thus an understanding of the complex relationships between the different biochemical pathways regulated in the brain by these vitamins may facilitate prompter diagnosis and improved treatment. Particular populations at risk for multiple B vitamin deficiencies include the elderly, people with alcoholism, patients with heart failure, patients with recent obesity surgery, and vegetarians/vegans. Recently, new clinical settings that predispose individuals to B vitamin deficiency have been highlighted. Moreover, other data indicate a possible pathogenetic role of subclinical chronic B vitamin deficiency in neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. In light of these findings, this review examines the clinical manifestations of B vitamin deficiency and the effect of B vitamin deficiency on the adult nervous system. The interrelationships of multiple B vitamin deficiencies are emphasized, along with the clinical phenotypes related to B vitamin deficiencies. Recent advances in the clinical determinants and diagnostic clues of B vitamin deficiency, as well as the suggested therapies for B vitamin disorders, are described.
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Affiliation(s)
- GianPietro Sechi
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA.
| | - Elia Sechi
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
| | - Chiara Fois
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
| | - Neeraj Kumar
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
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What is the safe upper intake level of folic acid for the nervous system? Implications for folic acid fortification policies. Eur J Clin Nutr 2016; 70:537-40. [PMID: 26862004 DOI: 10.1038/ejcn.2015.231] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 11/19/2015] [Accepted: 12/09/2015] [Indexed: 12/31/2022]
Abstract
Between 1945 and 1959 it was convincingly documented that folic acid can precipitate or aggravate the neurological and haematological consequences of vitamin B12 deficiency by increasing the demand for vitamin B12. Since then there has been much misunderstanding of the issues, mainly by advocates of folic acid fortification who have been inclined to minimise or even dismiss the risks by misinterpreting the evidence as only a 'masking' of the anaemia of pernicious anaemia. Recent studies in the era of fortification are rediscovering the risks to the nervous system, especially cognitive function, of excess folate in the presence of vitamin B12 deficiency. I have reviewed the Reports of four Expert Advisory Committees in Europe and the USA, which suggest that the safe upper tolerable limit (UL) for folic acid is 1 mg in adults. These reports are unsound and there is already evidence of neurological harm from long-term exposure to doses of folic acid between 0.5 and 1 mg in the presence of vitamin B12 deficiency. There is an urgent need to review the safe UL for folic acid and to consider the addition of vitamin B12 to folic acid fortification policies.
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59
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Metabolic vitamin B12 deficiency: a missed opportunity to prevent dementia and stroke. Nutr Res 2016; 36:109-16. [DOI: 10.1016/j.nutres.2015.10.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/16/2015] [Accepted: 10/19/2015] [Indexed: 12/17/2022]
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Kennedy DO. B Vitamins and the Brain: Mechanisms, Dose and Efficacy--A Review. Nutrients 2016; 8:68. [PMID: 26828517 PMCID: PMC4772032 DOI: 10.3390/nu8020068] [Citation(s) in RCA: 428] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 01/11/2016] [Accepted: 01/21/2016] [Indexed: 12/12/2022] Open
Abstract
The B-vitamins comprise a group of eight water soluble vitamins that perform essential, closely inter-related roles in cellular functioning, acting as co-enzymes in a vast array of catabolic and anabolic enzymatic reactions. Their collective effects are particularly prevalent to numerous aspects of brain function, including energy production, DNA/RNA synthesis/repair, genomic and non-genomic methylation, and the synthesis of numerous neurochemicals and signaling molecules. However, human epidemiological and controlled trial investigations, and the resultant scientific commentary, have focused almost exclusively on the small sub-set of vitamins (B9/B12/B6) that are the most prominent (but not the exclusive) B-vitamins involved in homocysteine metabolism. Scant regard has been paid to the other B vitamins. This review describes the closely inter-related functions of the eight B-vitamins and marshals evidence suggesting that adequate levels of all members of this group of micronutrients are essential for optimal physiological and neurological functioning. Furthermore, evidence from human research clearly shows both that a significant proportion of the populations of developed countries suffer from deficiencies or insufficiencies in one or more of this group of vitamins, and that, in the absence of an optimal diet, administration of the entire B-vitamin group, rather than a small sub-set, at doses greatly in excess of the current governmental recommendations, would be a rational approach for preserving brain health.
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Affiliation(s)
- David O Kennedy
- Brain, Performance and Nutrition Research Centre, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK.
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61
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Horvat P, Gardiner J, Kubinova R, Pajak A, Tamosiunas A, Schöttker B, Pikhart H, Peasey A, Jansen E, Bobak M. Serum folate, vitamin B-12 and cognitive function in middle and older age: The HAPIEE study. Exp Gerontol 2016; 76:33-8. [PMID: 26808046 PMCID: PMC4839985 DOI: 10.1016/j.exger.2016.01.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 01/20/2016] [Accepted: 01/21/2016] [Indexed: 12/22/2022]
Abstract
Background Nutrient status of B vitamins, particularly folate and vitamin B-12, may be related to cognitive ageing but epidemiological evidence remains inconclusive. Objective The aim of this study was to estimate the association of serum folate and vitamin B-12 concentrations with cognitive function in middle-aged and older adults from three Central and Eastern European populations. Methods Men and women aged 45–69 at baseline participating in the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study were recruited in Krakow (Poland), Kaunas (Lithuania) and six urban centres in the Czech Republic. Tests of immediate and delayed recall, verbal fluency and letter search were administered at baseline and repeated in 2006–2008. Serum concentrations of biomarkers at baseline were measured in a sub-sample of participants. Associations of vitamin quartiles with baseline (n = 4166) and follow-up (n = 2739) cognitive domain-specific z-scores were estimated using multiple linear regression. Results After adjusting for confounders, folate was positively associated with letter search and vitamin B-12 with word recall in cross-sectional analyses. In prospective analyses, participants in the highest quartile of folate had higher verbal fluency (p < 0.01) and immediate recall (p < 0.05) scores compared to those in the bottom quartile. In addition, participants in the highest quartile of vitamin B-12 had significantly higher verbal fluency scores (β = 0.12; 95% CI = 0.02, 0.21). Conclusions Folate and vitamin B-12 were positively associated with performance in some but not all cognitive domains in older Central and Eastern Europeans. These findings do not lend unequivocal support to potential importance of folate and vitamin B-12 status for cognitive function in older age. Long-term longitudinal studies and randomised trials are required before drawing conclusions on the role of these vitamins in cognitive decline. Epidemiological evidence linking B vitamins to cognitive ageing is inconclusive. Serum folate, vitamin B-12 and cognition were studied in older Eastern Europeans. Both vitamins were positively associated with 3-year verbal fluency. Folate and vitamin B-12 may be related to performance in some cognitive domains. More research is needed to clarify the causal relevance of B vitamins to cognition.
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Affiliation(s)
- Pia Horvat
- Department of Epidemiology & Public Health, UCL, 1-19 Torrington Place, London WC1E 7HB, UK.
| | - Julian Gardiner
- Department of Education, University of Oxford, 15 Norham Gardens, Oxford OX2 6PY, UK
| | - Ruzena Kubinova
- National Institute of Public Health, Srobarova 48, 10042 Prague, Czech Republic
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Jagellonian University Collegium Medicum, Grzegorzecka 20, 31-531 Krakow, Poland
| | - Abdonas Tamosiunas
- Department of Population Studies, Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas LT-50161, Lithuania
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
| | - Hynek Pikhart
- Department of Epidemiology & Public Health, UCL, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Anne Peasey
- Department of Epidemiology & Public Health, UCL, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Eugene Jansen
- Center for Health Protection, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Martin Bobak
- Department of Epidemiology & Public Health, UCL, 1-19 Torrington Place, London WC1E 7HB, UK
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Philip D, Buch A, Moorthy D, Scott TM, Parnell LD, Lai CQ, Ordovás JM, Selhub J, Rosenberg IH, Tucker KL, Troen AM. Dihydrofolate reductase 19-bp deletion polymorphism modifies the association of folate status with memory in a cross-sectional multi-ethnic study of adults. Am J Clin Nutr 2015; 102:1279-88. [PMID: 26354538 PMCID: PMC4625589 DOI: 10.3945/ajcn.115.111054] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 08/13/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Folate status has been positively associated with cognitive function in many studies; however, some studies have observed associations of poor cognitive outcomes with high folate. In search of an explanation, we hypothesized that the association of folate with cognition would be modified by the interaction of high-folate status with a common 19-bp deletion polymorphism in the dihydrofolate reductase (DHFR) gene. To our knowledge, the cognitive effects of this gene have not been studied previously. OBJECTIVE We examined the association between cognitive outcomes with the 19-bp deletion DHFR polymorphism, folate status, and their interaction with high or normal plasma folate. DESIGN This was a pooled cross-sectional study of the following 2 Boston-based cohorts of community living adults: the Boston Puerto Rican Health Study and the Nutrition, Aging, and Memory in Elders study. Individuals were genotyped for the DHFR 19-bp deletion genotype, and plasma folate status was determined. Cognitive outcomes included the Mini-Mental State Examination, Center for Epidemiologic Studies Depression Scale, and factor scores for the domains of memory, executive function, and attention from a set of cognitive tests. RESULTS The prevalence of the homozygous deletion (del/del) genotype was 23%. In a multivariable analysis, high folate status (>17.8 ng/mL) was associated with better memory scores than was normal-folate status (fourth-fifth quintiles compared with first-third quintiles: β ± SE = -0.22 ± 0.06, P < 0.01). Carriers of the DHFR del/del genotype had worse memory scores (β ± SE = -0.24 ± 0.10, P < 0.05) and worse executive scores (β = -0.19, P < 0.05) than did those with the del/ins and ins/ins genotypes. Finally, we observed an interaction such that carriers of the del/del genotype with high folate had significantly worse memory scores than those of both noncarriers with high-folate and del/del carriers with normal-folate (β-interaction = 0.26 ± 0.13, P < 0.05). CONCLUSIONS This study identifies a putative gene-nutrient interaction that, if confirmed, would predict that a sizable minority carrying the del/del genotype might not benefit from high-folate status and could see a worsening of memory. An understanding of how genetic variation affects responses to high-folate exposure will help weigh risks and benefits of folate supplementation for individuals and public health.
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Affiliation(s)
- Dana Philip
- Nutrition and Brain Health Laboratory, Institute of Biochemistry, Food Science and Nutrition, Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Assaf Buch
- Nutrition and Brain Health Laboratory, Institute of Biochemistry, Food Science and Nutrition, Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | | | | | | | | | | | | | | | - Katherine L Tucker
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA; and Department of Clinical Laboratory and Nutritional Sciences at University of Massachusetts, Lowell, MA
| | - Aron M Troen
- Nutrition and Brain Health Laboratory, Institute of Biochemistry, Food Science and Nutrition, Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel; Neuroscience and Aging Laboratory,
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Araújo JR, Martel F, Borges N, Araújo JM, Keating E. Folates and aging: Role in mild cognitive impairment, dementia and depression. Ageing Res Rev 2015; 22:9-19. [PMID: 25939915 DOI: 10.1016/j.arr.2015.04.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 04/18/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Abstract
In almost all tissues, including the brain, folates are required for one-carbon transfer reactions, which are essential for the synthesis of DNA and RNA nucleotides, the metabolism of amino acids and the occurrence of methylation reactions. The aim of this paper is to review the impact of folate status on the risk of development of neuropsychiatric disorders in older individuals. The prevalence of folate deficiency is high among individuals aged ≥ 65 years mainly due to reduced dietary intake and intestinal malabsorption. Population-based studies have demonstrated that a low folate status is associated with mild cognitive impairment, dementia (particularly Alzheimer's disease) and depression in healthy and neuropsychiatric diseased older individuals. The proposed mechanisms underlying that association include hyperhomocysteinemia, lower methylation reactions and tetrahydrobiopterin levels, and excessive misincorporation of uracil into DNA. However, currently, there is no consistent evidence demonstrating that folic acid supplementation improves cognitive function or slows cognitive decline in healthy or cognitively impaired older individuals. In conclusion, folate deficiency seems to be an important contributor for the onset and progression of neuropsychiatric diseases in the geriatric population but additional studies are needed in order to increase the knowledge of this promising, but still largely unexplored, area of research.
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Dong M, Lu Y, Zou Z, Yang H. Monoacylglycerol lipase inhibitor protects primary cultured neurons against homocysteine-induced impairments in rat caudate nucleus through COX-2 signaling. Life Sci 2015; 138:64-71. [PMID: 25818189 DOI: 10.1016/j.lfs.2015.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/01/2015] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
AIMS URB602 is a selective inhibitor of monoacylglycerol lipase (MAGL), a serine hydrolase involved in the biological deactivation of the endocannabinoid 2-arachidonoyl glycerol (2-AG). It has been described that URB602 significantly enhances depolarization-induced increases in 2-AG. A high level of homocysteine (Hcy) is a modifiable risk factor for developing Alzheimer's disease (AD). The aim of this study was to investigate the protective effects of URB602 on Hcy-induced impairments underlying its cellular and molecular mechanism in primary cultured caudate nucleus (CN) neurons. MAIN METHODS The expressions of cyclooxygenase-2 (COX-2), ERK1/2, NF-κB and IκB-α as well as cleaved caspase-3 and p-Bcl-2 in Hcy-, URB602 or SR1 (a selective inhibitor of CB1 receptor)-treated primary cultured neurons in CN were measured by immunoblotting technique and neurotoxicity assays were performed by using Hoechst staining. KEY FINDINGS The MAGL inhibitor URB602 exerted a neuroprotective effect on Hcy-induced impairment through suppression of cyclooxygenase-2 (COX-2) elevation and ERK1/2 and NF-κB phosphorylation as well as suppressions of IκB-α degradation in a CB1 receptor-dependent way. Moreover, anti-neuronal impairments of URB602 were mediated by modulating down-regulation of cleaved caspase-3 expression and up-regulation of p-Bcl-2 expression in a CB1 receptor-dependent manner in primary cultured CN neurons. SIGNIFICANCE These data suggest that the MAGL inhibitor is a promising therapeutic target for some neurodegenerative disorders, such as AD, via the COX-2 signaling pathway.
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Affiliation(s)
- Manman Dong
- Department of Physiology and Pathophysiology, College of Medical Sciences, China Three Gorges University, 443002 Yichang, Hubei, PR China
| | - Yongli Lu
- Department of Physiology and Pathophysiology, College of Medical Sciences, China Three Gorges University, 443002 Yichang, Hubei, PR China
| | - Ziliang Zou
- Department of Physiology and Pathophysiology, College of Medical Sciences, China Three Gorges University, 443002 Yichang, Hubei, PR China
| | - Hongwei Yang
- Department of Physiology and Pathophysiology, College of Medical Sciences, China Three Gorges University, 443002 Yichang, Hubei, PR China.
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Kuczmarski AV, Cotugna N, Mason MA, Evans MK, Zonderman AB. Depression and Cognitive Impairment Are Associated with Low Education and Literacy Status and Smoking but Not Caffeine Consumption in Urban African Americans and White Adults. JOURNAL OF CAFFEINE RESEARCH 2015; 5:31-41. [PMID: 25785235 DOI: 10.1089/jcr.2014.0019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Recent research has linked caffeine consumption with a lower risk for depression and cognitive decline. However, no studies have examined the relationship in an African American compared to a white, socioeconomically diverse representative urban sample. Methods: Data from a cross-sectional study were used to determine the associations of caffeine use with depressive symptomatology and cognition in a sample of 1,724 participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. The United States Department of Agriculture's Automated Multiple Pass Method was used by trained interviewers to collect two, in-person 24-hour dietary recalls. Depressive symptoms and global cognition were assessed using two well-validated measures: the Center for Epidemiologic Studies Depressive Scale (CES-D) and Mini Mental State Examination (MMSE), respectively. Usual caffeine intake was based on both recalls. Data were analyzed with t- and chi-square tests, correlation analysis, and ordinal logistic regression. Results: African Americans consumed significantly less caffeine than did whites (89.0±3.2 and 244.0±8.7 mg respectively). Caffeine consumption was not associated with depressive symptomatology or global cognition. Age, less than 5th grade literacy, and less than high school education were significantly associated with both depressive symptoms and cognitive function. Smokers had a 43% greater risk for depression but only a 3% higher risk for cognitive impairment. Conclusion: The low level of dietary caffeine intake in combination with smoking among HANDLS study participants may have influenced the lack of association with depressive symptomatology or global cognition. For this sample, low literacy and education appear more highly associated with depressive symptoms and cognitive function than caffeine intake.
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Affiliation(s)
- Andrew V Kuczmarski
- Department of Kinesiology and Applied Physiology, University of Delaware , Newark, Delaware
| | - Nancy Cotugna
- Department of Behavioral Health and Nutrition, University of Delaware , Newark, Delaware
| | - Marc A Mason
- Laboratory of Epidemiology and Population Sciences , National Institute on Aging , National Institutes of Health, Baltimore, Maryland
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences , National Institute on Aging , National Institutes of Health, Baltimore, Maryland
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences , National Institute on Aging , National Institutes of Health, Baltimore, Maryland
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The association between vitamin B12, albuminuria and reduced kidney function: an observational cohort study. BMC Nephrol 2015; 16:7. [PMID: 25644490 PMCID: PMC4361211 DOI: 10.1186/1471-2369-16-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 01/14/2015] [Indexed: 12/30/2022] Open
Abstract
Background Variants in CUBN, the gene encoding cubilin, a proximal tubular transport protein, have been associated with albuminuria and vitamin B12 (B12) deficiency. We hypothesized that low levels of B12 would be associated with albuminuria in a population-based cohort. Methods We analyzed participants from the Framingham Heart Study (n = 2965, mean age 58 years, 53% female) who provided samples for plasma B12. Logistic regression models adjusted for covariates including homocysteine were constructed to test the association between B12 and prevalent albuminuria (UACR ≥17 mg/g [men] and ≥25 mg/g [women]) and reduced kidney function (defined as an eGFR < 60 ml/min/1.73 m2, RKF). Because of a significant interaction between B12 and homocysteine in the prevalent RKF model (p = 0.005), the model was stratified by the median homocysteine levels. Logistic regression models were constructed to test the association between B12 and incident albuminuria and RKF. The results were replicated in 4445 participants from NHANES 2003–2004. Results Baseline B12 levels ranged from 50-1690 pg/ml. Elevated B12 was associated with prevalent albuminuria (OR 1.44 per 1 SD increase, 95% CI 1.10-1.87) and RKF (OR 1.83, 95% CI 1.30-2.60). However after stratifying by median homocysteine levels, this relationship remained only in the higher homocysteine stratum. There was no association between B12 and incident albuminuria (OR 1.17, 95% CI 0.79 – 1.73) or RKF (OR 1.45, 95% CI 0.97 – 1.88). In the NHANES cohort, elevated B12 was associated with RKF after full covariate adjustment (OR 3.06, 95% CI 2.30-4.08). There was no association with albuminuria. Conclusion In participants with high baseline homocysteine levels, increased plasma B12 was associated with RKF.
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Agnew-Blais JC, Wassertheil-Smoller S, Kang JH, Hogan PE, Coker LH, Snetselaar LG, Smoller JW. Folate, vitamin B-6, and vitamin B-12 intake and mild cognitive impairment and probable dementia in the Women's Health Initiative Memory Study. J Acad Nutr Diet 2015; 115:231-241. [PMID: 25201007 PMCID: PMC4312724 DOI: 10.1016/j.jand.2014.07.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 06/23/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Whether higher B vitamin intake (ie, B-6, B-12, and folate) is protective against cognitive decline in later life remains uncertain. Several prospective, observational studies find higher B vitamin intake to be associated with lower risk of dementia; other studies, including most trials of B vitamin supplementation, have observed no effect on cognition. We examined this question in a large population of older women carefully monitored for development of mild cognitive impairment (MCI) and probable dementia. OBJECTIVE To determine whether baseline folate, vitamin B-6, and/or vitamin B-12 intake, alone or in combination, are associated with incident MCI/probable dementia among older women. DESIGN Prospective, longitudinal cohort study. Participants were enrolled between 1993 and 1998, and B vitamin intake was self-reported using a food frequency questionnaire administered at baseline. PARTICIPANTS/SETTING Postmenopausal women (N=7,030) free of MCI/probable dementia at baseline in the Women's Health Initiative Memory Study. MAIN OUTCOME MEASURES Over a mean follow-up of 5.0 years, 238 cases of incident MCI and 69 cases of probable dementia were identified through rigorous screening and expert adjudication. STATISTICAL ANALYSES Cox proportional hazard models adjusting for sociodemographic and lifestyle factors examined the association of B vitamin intake above and below the Recommended Daily Allowance and incident MCI/probable dementia. RESULTS Folate intake below the Recommended Daily Allowance at study baseline was associated with increased risk of incident MCI/probable dementia (hazard ratio 2.0, 95% CI 1.3 to 2.9), after controlling for multiple confounders. There were no significant associations between vitamins B-6 or B-12 and MCI/probable dementia, nor any evidence of an interaction between these vitamins and folate intake. CONCLUSIONS Folate intake below the Recommended Daily Allowance may increase risk for MCI/probable dementia in later life. Future research should include long-term trials of folic acid supplementation to examine whether folate may impart a protective effect on cognition in later life.
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Affiliation(s)
- Jessica C. Agnew-Blais
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. Tel: 617.432.1050, Fax: 617.566.7805,
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA. Tel: 718.430.2358, Fax: 718.430.3076,
| | - Jae H. Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. Tel: 617.525.2022, Fax : 617.525.2008,
| | - Patricia E. Hogan
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA. Tel: 336.716.2835,
| | - Laura H. Coker
- Division of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, NC, USA. Tel: 336.716.3324,
| | - Linda G. Snetselaar
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA. Tel: 319.384.1553,
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. Tel: 617.724.0835, Fax: 617-643-3080,
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68
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Abstract
OBJECTIVE To analyse the relationship between serum folate (SF), vitamin B12 and impaired cognitive function in the Chilean elderly. DESIGN We analysed the relationships between impaired cognitive function and age, SF (µg/l) and vitamin B12 (pg/ml) with Student's t test, as well as between impaired cognitive function and gender, educational level, residence area, diabetes and hypertension with the χ 2 test. Multiple logistic regressions with interactions were estimated to assess the impact of SF on impaired cognitive function according to these methods. SETTING Chile. SUBJECTS Older adults (>65 years, n 1051), drawn from representative households of a national prevalence study, assessed using the Modified Mini Mental Status Examination (MMMSE). Individuals with altered MMMSE scores (≤13 points) were sequentially assessed using the Pfeffer Functional Activities Questionnaire (PFAQ). RESULTS Multivariate models using the MMMSE demonstrated an increased risk of impaired cognitive function for seniors who had hypertension, diabetes and higher vitamin B12 levels. SF and its square (SF2) were statistically significant, indicating that this predictor of impaired cognitive function displays a U-shaped distribution. The interaction between SF and vitamin B12 was not statistically significant. Models using the MMMSE plus PFAQ suggested that urban residence decreased the risk of impaired cognitive function, whereas male gender, older age, vitamin B12 levels and hypertension increased this risk. The variables SF and SF2 and the SF × vitamin B12 interaction were statistically significant (P<0.05). The risk of impaired cognitive function depended on different combinations of SF and vitamin B12 levels. When SF was low, a one-unit increase in SF (1 µg/l) diminished the risk. When SF was elevated, a further increase in SF raised the risk, especially at low vitamin B12 levels. CONCLUSIONS The relationship between folate, vitamin B12 and impaired cognitive function warrants further study.
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Chen LY, Liu LK, Peng LN, Lin MH, Chen LK, Lan CF, Chang PL. Identifying residents at greater risk for cognitive decline by Minimum Data Set in long-term care settings. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.jcgg.2014.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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70
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Barnes JL, Tian M, Edens NK, Morris MC. Consideration of nutrient levels in studies of cognitive decline. Nutr Rev 2014; 72:707-19. [PMID: 25323849 DOI: 10.1111/nure.12144] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Epidemiological studies suggest that certain micronutrients may improve or maintain cognitive function. Consistent demonstration of benefits in intervention trials has been elusive, possibly because most intervention trials do not select subjects on the basis of nutrient status and/or intake. The objective of this review was to identify levels of intake or markers of nutrient insufficiency that define at-risk older adult populations to determine whether these populations will benefit from nutritional intervention. This review examines evidence from interventional and prospective observational studies that evaluated the effects of folate, vitamin B12 , and vitamin E on cognitive decline in older populations. The studies suggest that supplementation may protect against cognitive decline when serum folate is <12 nmol/L or vitamin E intake is <6.1 mg/day. The literature is inadequate to define a level for vitamin B12 . Epidemiological studies investigating the relations of nutrients to cognitive decline should consider nutrient status in the reporting and interpretation of results. Randomized trials should design inclusion and exclusion criteria to select individuals with low intake and to disallow multivitamin intake. These recommendations may be useful for the design of valid trials and to advance the current understanding of nutrition and neurological diseases.
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Affiliation(s)
- Jennifer L Barnes
- Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana-Champaign, Illinois, USA; Abbott Nutrition, Columbus, Ohio, USA
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71
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Mecocci P, Tinarelli C, Schulz RJ, Polidori MC. Nutraceuticals in cognitive impairment and Alzheimer's disease. Front Pharmacol 2014; 5:147. [PMID: 25002849 PMCID: PMC4066843 DOI: 10.3389/fphar.2014.00147] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 06/03/2014] [Indexed: 12/31/2022] Open
Abstract
Several chemical substances belonging to classes of natural dietary origin display protective properties against some age-related diseases including neurodegenerative ones, particularly Alzheimer's disease (AD). These compounds, known as nutraceuticals, differ structurally, act therefore at different biochemical and metabolic levels and have shown different types of neuroprotective properties. The aim of this review is to summarize data from observational studies, clinical trials, and randomized clinical trials (RCTs) in humans on the effects of selected nutraceuticals against age-related cognitive impairment and dementia. We report results from studies on flavonoids, some vitamins and other natural substances that have been studied in AD and that might be beneficial for the maintenance of a good cognitive performance. Due to the substantial lack of high-level evidence studies there is no possibility for recommendation of nutraceuticals in dementia-related therapeutic guidelines. Nevertheless, the strong potential for their neuroprotective action warrants further studies in the field.
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Affiliation(s)
- P. Mecocci
- Section of Gerontology and Geriatrics, Department of Medicine, University of PerugiaPerugia, Italy
| | - C. Tinarelli
- Section of Gerontology and Geriatrics, Department of Medicine, University of PerugiaPerugia, Italy
| | - R. J. Schulz
- Geriatrics Department, Medical Faculty, University of CologneCologne, Germany
| | - M. C. Polidori
- Geriatrics Department, Medical Faculty, University of CologneCologne, Germany
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Franke K, Ristow M, Gaser C. Gender-specific impact of personal health parameters on individual brain aging in cognitively unimpaired elderly subjects. Front Aging Neurosci 2014; 6:94. [PMID: 24904408 PMCID: PMC4033192 DOI: 10.3389/fnagi.2014.00094] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 04/28/2014] [Indexed: 12/24/2022] Open
Abstract
Aging alters brain structure and function. Personal health markers and modifiable lifestyle factors are related to individual brain aging as well as to the risk of developing Alzheimer's disease (AD). This study used a novel magnetic resonance imaging (MRI)-based biomarker to assess the effects of 17 health markers on individual brain aging in cognitively unimpaired elderly subjects. By employing kernel regression methods, the expression of normal brain-aging patterns forms the basis to estimate the brain age of a given new subject. If the estimated age is higher than the chronological age, a positive brain age gap estimation (BrainAGE) score indicates accelerated atrophy and is considered a risk factor for developing AD. Within this cross-sectional, multi-center study 228 cognitively unimpaired elderly subjects (118 males) completed an MRI at 1.5Tesla, physiological and blood parameter assessments. The multivariate regression model combining all measured parameters was capable of explaining 39% of BrainAGE variance in males (p < 0.001) and 32% in females (p < 0.01). Furthermore, markers of the metabolic syndrome as well as markers of liver and kidney functions were profoundly related to BrainAGE scores in males (p < 0.05). In females, markers of liver and kidney functions as well as supply of vitamin B12 were significantly related to BrainAGE (p < 0.05). In conclusion, in cognitively unimpaired elderly subjects several clinical markers of poor health were associated with subtle structural changes in the brain that reflect accelerated aging, whereas protective effects on brain aging were observed for markers of good health. Additionally, the relations between individual brain aging and miscellaneous health markers show gender-specific patterns. The BrainAGE approach may thus serve as a clinically relevant biomarker for the detection of subtly abnormal patterns of brain aging probably preceding cognitive decline and development of AD.
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Affiliation(s)
- Katja Franke
- Structural Brain Mapping Group, Department of Psychiatry, Jena University Hospital Jena, Germany ; Department of Neurology, Jena University Hospital Jena, Germany
| | - Michael Ristow
- Department of Human Nutrition, Friedrich Schiller-University Jena Jena, Germany ; Energy Metabolism Laboratory, ETH Zurich (Swiss Federal Institute of Technology) Schwerzenbach, Zürich, Switzerland
| | - Christian Gaser
- Structural Brain Mapping Group, Department of Psychiatry, Jena University Hospital Jena, Germany ; Department of Neurology, Jena University Hospital Jena, Germany
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73
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de Jager CA. Critical levels of brain atrophy associated with homocysteine and cognitive decline. Neurobiol Aging 2014; 35 Suppl 2:S35-9. [PMID: 24927906 DOI: 10.1016/j.neurobiolaging.2014.03.040] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 03/17/2014] [Accepted: 03/20/2014] [Indexed: 11/27/2022]
Abstract
Few B-vitamin trials to lower homocysteine (Hcy) have reported evidence of beneficial effects on cognition in older adults with cognitive impairment or Alzheimer's disease. This article reviews the role of Hcy in cognitive decline. It also considers some reasons why meta-analyses have failed to find effects of B-vitamin treatment. Findings from the successful VITACOG trial are examined from a new perspective of critical levels of Hcy and brain atrophy that may impact on the efficacy of B-vitamin treatment. It appears that there is a critical level of brain shrinkage, possibly mediated by elevated Hcy, which when reached, results in cognitive decline, especially in episodic memory performance. Supplements, food sources, and effects of folic acid fortification are discussed in relation to B12 deficiency.
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Affiliation(s)
- Celeste A de Jager
- Oxford Project to Investigate Memory and Ageing, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
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74
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Matte JJ, Britten M, Girard CL. The importance of milk as a source of vitamin B12 for human nutrition. Anim Front 2014. [DOI: 10.2527/af.2014-0012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- J. J. Matte
- Agriculture and Agri-Food Canada, Dairy and Swine Research and Development Centre, Sherbrooke, QC, Canada
| | - M. Britten
- Agriculture and Agri-Food Canada, Food Research and Development Centre, St-Hyacinthe, QC, Canada
| | - C. L. Girard
- Agriculture and Agri-Food Canada, Dairy and Swine Research and Development Centre, Sherbrooke, QC, Canada
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Abstract
PURPOSE OF REVIEW Aging is associated with a decline in cognition. This review examines the available data on the effects of nutrition on cognitive impairment. It also explores the mechanism(s) by which food may enhance memory. RECENT FINDINGS An increasing body of evidence has supported the role of the Mediterranean diet and extra-virgin olive oil in protecting cognition. A number of nutritional formulations to improve deteriorating memory are being studied. Undernutrition is associated with cognitive decline. Hyperglycemia and hypertriglyceridemia cause cognitive impairment. SUMMARY There are increasing data to support the role of nutrition in maintaining cognition.
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Affiliation(s)
- John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
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77
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Engelborghs S, Gilles C, Ivanoiu A, Vandewoude M. Rationale and clinical data supporting nutritional intervention in Alzheimer's disease. Acta Clin Belg 2014; 69:17-24. [PMID: 24635394 DOI: 10.1179/0001551213z.0000000006] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Adequate nutrition plays an important role in the maintenance of cognitive function, particularly during aging. Malnutrition is amongst the risk factors for developing mild cognitive impairment (MCI) and Alzheimer's disease (AD). Epidemiological studies have associated deficiencies in some nutrients with a higher risk of cognitive dysfunction and/or AD. Cognitive decline in AD is correlated with synaptic loss and many of the components required to maintain optimal synaptic function are derived from dietary sources. As synapses are part of the neuronal membrane and are continuously being remodelled, the availability of sufficient levels of nutritional precursors (mainly uridine monophosphate, choline and omega-3 fatty acids) to make the phospholipids required to build neuronal membranes may have beneficial effects on synaptic degeneration in AD. In addition, B-vitamins, phospholipids and other micronutrients act as cofactors to enhance the supply of precursors required to make neuronal membranes and synapses. Despite this, no randomized controlled trial has hitherto provided evidence that any single nutrient has a beneficial effect on cognition or lowers the risk for AD. However, a multi-target approach using combinations of (micro)nutrients might have beneficial effects on cognitive function in neurodegenerative brain disorders like AD leading to synaptic degeneration. Here we review the clinical evidence for supplementation, based on a multi-target approach with a focus on key nutrients with a proposed role in synaptic dysfunction. Based on preclinical evidence, a nutrient mixture, Souvenaid(®) (Nutricia N.V., Zoetermeer, The Netherlands) was developed. Clinical trials with Souvenaid(®) have shown improved memory performance in patients with mild AD. Further clinical trials to evaluate the effects of nutritional intervention in MCI and early dementia due to AD are on-going.
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Abstract
John Scott (1940-2013) was born in Dublin where he was to spend the rest of his career, both as an undergraduate and subsequently Professor of Biochemistry and Nutrition at Trinity College. His research with the talented group of scientists and clinicians that he led has had a substantial impact on our understanding of folate metabolism, mechanisms of its catabolism and deficiency. His research established the leading theory of folate involvement with vitamin B12 in the pathogenesis of vitamin B12 neuropathy. He helped to establish the normal daily intake of folate and the increased requirements needed either in food or as a supplement before and during pregnancy to prevent neural tube defects. He also suggested a dietary supplement of vitamin B12 before and during pregnancy to reduce the risk of neural tube defects. It would be an appropriate epitaph if fortification of food with folic acid became mandatory in the UK and Ireland, as it is in over 70 other countries.
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Affiliation(s)
- A Victor Hoffbrand
- Emeritus Professor of Haematology, University College London, London, UK; Honorary Consultant Haematologist, Royal Free Hospital, London, UK
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79
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Interactions between plasma concentrations of folate and markers of vitamin B(12) status with cognitive performance in elderly people not exposed to folic acid fortification: the Hordaland Health Study. Br J Nutr 2013; 111:1085-95. [PMID: 24229560 DOI: 10.1017/s000711451300336x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
A combination of high folate with low vitamin B12 plasma status has been associated with cognitive impairment in a population exposed to mandatory folic acid fortification. The objective of the present study was to examine the interactions between plasma concentrations of folate and vitamin B12 markers in relation to cognitive performance in Norwegian elderly who were unexposed to mandatory or voluntary folic acid fortification. Cognitive performance was assessed by six cognitive tests in 2203 individuals aged 72-74 years. A combined score was calculated using principal component analysis. The associations of folate concentrations, vitamin B12 markers (total vitamin B12, holotranscobalamin (holoTC) and methylmalonic acid (MMA)) and their interactions in relation to cognitive performance were evaluated by quantile regression and least-squares regression, adjusted for sex, education, apo-ɛ4 genotype, history of CVD/hypertension and creatinine. Cross-sectional analyses revealed an interaction (P= 0·009) between plasma concentrations of folate and vitamin B12 in relation to cognitive performance. Plasma vitamin B12 concentrations in the lowest quartile ( < 274 pmol/l) combined with plasma folate concentrations in the highest quartile (>18·5 nmol/l) were associated with a reduced risk of cognitive impairment compared with plasma concentrations in the middle quartiles of both vitamins (OR 0·22, 95 % CI 0·05, 0·92). The interaction between folate and holoTC or MMA in relation to cognitive performance was not significant. In conclusion, this large study population unexposed to mandatory folic acid fortification showed that plasma folate, but not plasma vitamin B12, was associated with cognitive performance. Among the elderly participants with vitamin B12 concentrations in the lower range, the association between plasma folate and cognitive performance was strongest.
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80
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Ferry M, Coley N, Andrieu S, Bonhomme C, Caubère JP, Cesari M, Gautry J, Garcia Sanchez I, Hugonot L, Mansuy L, Pahor M, Pariente J, Ritz P, Salva A, Sijben J, Wieggers R, Ythier-Moury P, Zaïm M, Zetlaoui J, Vellas B. How to design nutritional intervention trials to slow cognitive decline in apparently healthy populations and apply for efficacy claims: a statement from the International Academy on Nutrition and Aging Task Force. J Nutr Health Aging 2013; 17:619-23. [PMID: 23933873 PMCID: PMC4312656 DOI: 10.1007/s12603-013-0350-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Interventions are crucial as they offer simple and inexpensive public health solutions that will be useful over the long term use. A Task Force on designing trials of nutritional interventions to slow cognitive decline in older adults was held in Toulouse in September 2012. The aim of the Task Force was to bring together leading experts from academia, the food industry and regulatory agencies to determine the best trial designs that would enable us to reach our goal of maintaining or improving cognitive function in apparently healthy aging people. An associated challenge for this Task Force was to determine the type of trials required by the Public Food Agencies for assessing the impact of nutritional compounds in comparison to well established requirements for drug trials. Although the required quality of the study design, rationale and statistical analysis remains the same, the studies designed to show reduction of cognitive decline require a long duration and the objectives of this task force was to determine best design for these trials. Two specific needs were identified to support trials of nutritional interventions: 1- Risk- reduction strategies are needed to tackle the growing burden of cognitive decline that may lead to dementia, 2- Innovative study designs are needed to improve the quality of these studies.
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Affiliation(s)
- M Ferry
- Nutritional Epidemiology Unit, Human Nutrition Research Center of Ile de France, UFR SMBH Paris 13, 75 rue Marcel Cachin, F-93017 Bobigny cedex, France.
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81
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Shah R. The Role of Nutrition and Diet in Alzheimer Disease: A Systematic Review. J Am Med Dir Assoc 2013; 14:398-402. [DOI: 10.1016/j.jamda.2013.01.014] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 01/22/2013] [Indexed: 01/16/2023]
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82
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Morris MS. The role of B vitamins in preventing and treating cognitive impairment and decline. Adv Nutr 2012; 3:801-12. [PMID: 23153734 PMCID: PMC3648704 DOI: 10.3945/an.112.002535] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Many epidemiologic studies have considered whether markers of B-vitamin status are associated with cognitive function and cognitive decline. This avenue of research was sparked by the homocysteine (Hcy) theory of cardiovascular disease, which was extended to Alzheimer's disease when a link between vascular dementia and Alzheimer's disease was discovered. Hcy could cause cognitive impairment via direct neurotoxicity. However, decreased remethylation of Hcy to methionine might also compromise cognitive function by means other than mere Hcy lowering. Folate and vitamin B-12 participate in Hcy remethylation and largely determine Hcy status. Consequently, much of the relevant research has focused on these 2 B vitamins. The many subtly different hypotheses that investigators have addressed by attempting to link several B-vitamin status indicators to diverse cognition-related outcomes have created a confusing body of conflicting studies that seems to defy summarization. Nevertheless, themes are discernible that aid interpretation, foster hypothesis generation, and inform future study design. For example, despite a shared metabolic pathway, Hcy, vitamin B-12, and folate are differently related to specific cognitive outcomes. Although consistency of findings across studies is often touted as essential to distinguishing causal from coincidental relationships, discrepancies among study findings can be even more informative.
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Affiliation(s)
- Martha Savaria Morris
- Nutritional Epidemiology Program, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
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