Breakfast cereal fortified with folic acid, vitamin B-6, and vitamin B-12 increases vitamin concentrations and reduces homocysteine concentrations: A randomized trial

Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA 02111, USA.
American Journal of Clinical Nutrition (Impact Factor: 6.92). 06/2004; 79(5):805-11.
Source: PubMed

ABSTRACT High homocysteine and low B vitamin concentrations have been linked to the risk of vascular disease, stroke, and dementia and are relatively common in older adults.
We assessed the effect of breakfast cereal fortified with folic acid, vitamin B-6, and vitamin B-12 on vitamin and homocysteine status.
A randomized, double-blind trial was conducted in 189 volunteers aged 50-85 y. The subjects had no history of hypertension, anemia, asthma, cancer, or cardiovascular or digestive disease and did not regularly consume multiple or B vitamin supplements or highly fortified breakfast cereal. Subjects were randomly assigned to consume 1 cup (0.24 L) breakfast cereal fortified with 440 microg folic acid, 1.8 mg vitamin B-6, and 4.8 microg vitamin B-12 or placebo cereal for 12 wk. Blood was drawn at 0, 2, 12, and 14 wk. Methionine-loading tests were conducted at baseline and week 14.
Final baseline-adjusted plasma homocysteine concentrations were significantly lower and B vitamin concentrations were significantly higher in the treatment group than in the placebo group (P < 0.001). The percentage of subjects with plasma folate concentrations < 11 nmol/L decreased from 2% to 0%, with vitamin B-12 concentrations < 185 pmol/L from 9% to 3%, with vitamin B-6 concentrations < 20 nmol/L from 6% to 2%, and with homocysteine concentrations > 10.4 micromol/L (women) or > 11.4 micromol/L (men) from 6.4% to 1.6%. The percentage of control subjects with values beyond these cutoff points remained nearly constant or increased.
In this relatively healthy group of volunteers, consumption of 1 cup fortified breakfast cereal daily significantly increased B vitamin and decreased homocysteine concentrations, including post-methionine-load homocysteine concentrations.

Download full-text


Available from: Katherine L Tucker, Oct 07, 2014
  • Source
    • "Ready-to-eat cereal products fortified with vitamin B12 are known to constitute a great proportion of dietary vitamin B12 intake (Watanabe 2007). Several groups of investigators suggested that eating a breakfast cereal fortified with folic acid, vitamin B12 and vitamin B6 increases blood concentrations of these vitamins and decreases plasma total homocysteine concentrations in elderly populations (Tucker et al. 2004). Therefore, fortified breakfast cereals have therefore become a particularly valuable source of vitamin B12 for elderly people and for vegetarians and/or vegans (Watanabe 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Wheat contains various essential nutrients including the B group of vitamins. However, B group vitamins, normally present in cereals-derived products, are easily removed or destroyed during milling, food processing or cooking. Lactic acid bacteria (LAB) are widely used as starter cultures for the fermentation of a large variety of foods and can improve the safety, shelf life, nutritional value, flavor and overall quality of the fermented products. In this regard, the identification and application of strains delivering health-promoting compounds is a fascinating field. Besides their key role in food fermentations, several LAB found in the gastrointestinal tract of humans and animals are commercially used as probiotics and possess generally recognized as safe status. LAB are usually auxotrophic for several vitamins although certain strains of LAB have the capability to synthesize water-soluble vitamins such as those included in the B group. In recent years, a number of biotechnological processes have been explored to perform a more economical and sustainable vitamin production than that obtained via chemical synthesis. This review article will briefly report the current knowledge on lactic acid bacteria synthesis of vitamins B2, B11 and B12 and the potential strategies to increase B-group vitamin content in cereals-based products, where vitamins-producing LAB have been leading to the elaboration of novel fermented functional foods. In addition, the use of genetic strategies to increase vitamin production or to create novel vitamin-producing strains will be also discussed.
    Applied Microbiology and Biotechnology 10/2012; 96(6). DOI:10.1007/s00253-012-4440-2 · 3.81 Impact Factor
  • Source
    • "Some of these deficiencies are associated with an increase in serum cholesterol levels and blood pressure [11] [12] [13]. Other deficiencies such as vitamin B 6 , B 12 , or folic acid deficiency are associated with increased homocysteine levels [6] [7] [8]. For this reason, it is important to plan diets that, besides producing a loss of weight, contribute the necessary nutrients in order that deficiencies do not take place and that the next result is to improve CRF. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study was conducted to determine how the follow-up of 2 different energy-restricted (hypocaloric) diets, based on approximating the diet to its theoretical ideal, influences cardiovascular risk factors such as obesity, blood pressure, serum cholesterol, serum low-density lipoprotein and very low density lipoprotein, serum triacylglycerol and homocysteine, and serum high-density lipoprotein. Fifty-seven young overweight or obese women were randomly assigned to one of 2 different weight-control programs designed to approximate the diet to the theoretical ideal. Twenty-eight women were assigned to the vegetable (V) group; this group was characterized by a relatively increased consumption of vegetables. Twenty-nine women were assigned to the cereal (C) group, which was characterized by a relatively increased consumption of cereals. Dietetic, anthropometric, and biochemical data were collected at the outset of the study and again 2 and 6 weeks into the program in both groups. Both interventions resulted in a significant improvement in warning parameters of obesity (weight, body mass index, and waist/hip ratio), total serum cholesterol, and homocysteine at the end of the study. Plasma homocysteine levels fell by 14.9 ± 13.6% in the group C subjects and by 8.8 ± 14.0% in the group V subjects after 6 weeks. This may have been due to an increase in the intake and serum levels of vitamin B6 and folate in both groups. At the end of the intervention, the V group exhibited a significant reduction in low-density lipoprotein cholesterol and in non–high-density lipoprotein cholesterol. Group C subjects showed a reduction in diastolic blood pressure at this time. The results suggest that both hypocaloric diets with a relative increase in the consumption of vegetables or cereals were effective in improving cardiovascular risk factors in overweight and obese women.
    Nutrition Research 06/2007; 27(6):313-320. DOI:10.1016/j.nutres.2007.04.014 · 2.59 Impact Factor
  • Source
    • "A number of intervention studies indicate that changes in intakes of fortified foods are reflected in changed status and functional effects for some micronutrients. A recent example is a randomised intervention trial by Tucker et al. (2004) "
    [Show abstract] [Hide abstract]
    ABSTRACT: Micronutrient malnutrition is widespread throughout the world, with important health and economic consequences. Tools to address this situation include food fortification, supplementation and dietary diversification, each having different and complementary roles. Fortification (mandatory and voluntary) has been practised over several decades in Western countries as well as in developing countries. Iodised salt was introduced in the USA in 1924 to reduce severe I deficiency. In 1938 voluntary enrichment of flours and breads with niacin and Fe was initiated to reduce the incidence of pellagra and Fe-deficiency anaemia respectively. Micronutrient intakes in European countries appear to be generally adequate for most nutrients. However, a number of population subgroups are at higher risk of suboptimal intakes (below the lower reference nutrient intake) for some micronutrients, e.g. folate, Fe, Zn and Ca in children, adolescents and young women. Dietary surveys indicate that fortified foods play a role in mitigating such risks for several important nutrients. The number of foods suited to fortification are considerably limited by several factors, including technological properties (notably moisture, pH and O2 permeability), leading to unacceptable taste and appearance, as well as cost and consumer expectations. In countries in which voluntary fortification is widely practised micronutrient intakes are considerably below tolerable upper intake levels. Concerns about safety are addressed in relation to the potentially increased level or proportion of fortified foods (e.g. following potential EU legislation), for nutrients with relatively low tolerable upper intake levels and where the potential benefit and risks are in different subpopulations (e.g. folic acid). Recent models for assessing these issues are discussed.
    Proceedings of The Nutrition Society 12/2004; 63(4):605-14. DOI:10.1079/PNS2004391 · 4.94 Impact Factor
Show more