The status of vitamins B6, B12, folate, and of homocysteine in geriatric home residents receiving laxatives or dietary fiber
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Vitamin B12 deficiency as a digestive disorder and constipation as a gastro motility disorder are common in the elderly. Laxative treatment is often chosen without regard for gut health.
To investigate whether the addition of oat-bran to the common oral diet for 12 weeks is able to reduce constipation and laxative use and improve gut health. It is assumed that this will lead to improved plasma levels of vitamins B6, B12, folate, and of homocysteine in nursing home residents.
A controlled, parallel intervention trial. 30 frail patients with multiple chronic diseases, aged 57–98 years, receiving laxative therapy were included. Patients were randomized into a fiber (n=15) and a control group (n=15). The intervention group received 5.2g/d oat-bran for 84 days mixed into the daily common meals. The control group received the ward’s habitual diet. Food intake and laxative use were documented and blood samples (on day 01, day 42 and day 84) were collected. Vitamin B12 and folate were analyzed by radioimmunoassay, B6 and homocysteine by RP-HPLC with fluorescence detection, in addition to the routine lab test of albumin and CRP.
In the fiber group, the intervention was well tolerated and laxative use decreased significantly (p<0.001). In the control group, plasma B12 decreased faster (p<0.05). In both groups, B6 and folate status remained unchanged. Plasma homocysteine decreased in both groups (p< 0.05). General mean energy intake was low (4861.4 kJ/d).
Oat-bran helps to improve constipation management and B12 bioavailability in elderly, with multiple chronic diseases who live in nursing homes.
- Andres E, Affenberger S, Vinzio S, et al. Food-cobalamin malabsorption in elderly patients: clinical manifestations and treatment. Am J Med 2005;118:1154–1159. CrossRef
- Morris MC, Schneider JA, Tangney CC. Thoughts on B-vitamins and dementia. J Alzheimers Dis 2006;9:429–433.
- Spence JD. Homocysteine: call off the funeral. Stroke 2006;37:282–283. CrossRef
- Reynolds E. Vitamin B12, folic acid, and the nervous system. Lancet Neurol 2006;5:949–960. CrossRef
- Mercier S, Breuille D, Buffiere C, et al. Methionine kinetics are altered in the elderly both in the basal state and after vaccination. Am J Clin Nutr 2006;83:291–298.
- Seshadri S, Beiser A, Selhub J, et al. Plasma homocysteine as a risk factor for dementia and Alzheimer’s disease. N Engl J Med 2002;346:476–483. CrossRef
- Riggs KM, Spiro A, 3rd, Tucker K, Rush D. Relations of vitamin B-12, vitamin B-6, folate, and homocysteine to cognitive performance in the Normative Aging Study. Am J Clin Nutr 1996;63:306–314.
- Luchsinger JA, Tang MX, Miller J, Green R, Mayeux R. Relation of higher folate intake to lower risk of Alzheimer disease in the elderly. Arch Neurol 2007;64:86–92. CrossRef
- Bosshard W, Dreher R, Schnegg JF, Bula CJ. The treatment of chronic constipation in elderly people: an update. Drugs Aging 2004;21:911–930. CrossRef
- Annells M, Koch T. Older people seeking solutions to constipation: the laxative mire. J Clin Nurs 2002;11:603–612. CrossRef
- Howard LV, West D, Ossip-Klein DJ. Chronic constipation management for institutionalized older adults. Geriatr Nurs 2000;21:78–82; quiz 82–3. CrossRef
- Roberfroid MB. Introducing inulin-type fructans. Br J Nutr 2005;93Suppl 1:S13–S25. CrossRef
- Kleessen B, Blaut M. Modulation of gut mucosal biofilms. Br J Nutr 2005;93Suppl 1:S35–S40. CrossRef
- Bengmark S. Colonic food: pre- and probiotics. Am J Gastroenterol 2000;95:S5–S7. CrossRef
- Blaut M, Collins MD, Welling GW, Dore J, van Loo J, de Vos W. Molecular biological methods for studying the gut microbiota: the EU human gut flora project. Br J Nutr 2002;87Suppl 2:S203–S211. CrossRef
- Van Loo JA. Prebiotics promote good health: the basis, the potential, and the emerging evidence. J Clin Gastroenterol 2004;38:S70–S75. CrossRef
- Sturtzel B, Mikulits C, Gisinger C, Elmadfa I. Use of Fiber instead of Laxative Treatment in a Geriatric Hospital to Improve the Wellbeing of Seniors. J Nutr Health Aging 2009;13:136–139. CrossRef
- D-A-CH Reference Values. Reference Values, 2000. Frankfurt am Main, 2000: Umschau Braus GmbH.
- Andrieu S, Coley N, Aisen P, et al. Methodological issues in primary prevention trials for neurodegenerative dementia. J Alzheimers Dis 2009;16:235–270.
- Vellas B, Sinclair AJ, Sieber C, Bernabei R, Guimaraes RM, Olde-Rikkert M. Editorial: Geronto-Net: a network of exellence for clinical trials in geriatrics. J Nutr Health Aging 2007;11:250.
- Wouters-Wesseling W, Vos AP, Van Hal M, De Groot LC, Van Staveren WA, Bindels JG. The effect of supplementation with an enriched drink on indices of immune function in frail elderly. J Nutr Health Aging 2005;9:281–286.
- Wendland BE, Greenwood CE, Weinberg I, Young KW. Malnutrition in institutionalized seniors: the iatrogenic component. J Am Geriatr Soc 2003;51:85–90. CrossRef
- Hickson M. Malnutrition and ageing. Postgrad Med J 2006;82:2–8. CrossRef
- Roberfroid MB, Bornet F, Bouley C, Cummings JH. Colonic microflora: nutrition and health. Summary and conclusions of an International Life Sciences Institute (ILSI) [Europe] workshop held in Barcelona, Spain. Nutr Rev 1995;53:127–130. CrossRef
- Schneeman BO. Building scientific consensus: the importance of dietary fiber. Am J Clin Nutr 1999;69:1.
- Friso S, Jacques PF, Wilson PW, Rosenberg IH, Selhub J. Low circulating vitamin B(6) is associated with elevation of the inflammation marker C-reactive protein independently of plasma homocysteine levels. Circulation 2001;103:2788–2791.
- Chiang EP, Bagley PJ, Selhub J, Nadeau M, Roubenoff R. Abnormal vitamin B(6) status is associated with severity of symptoms in patients with rheumatoid arthritis. Am J Med 2003;114:283–287. CrossRef
- Chiang EP, Selhub J, Bagley PJ, Dallal G, Roubenoff R. Pyridoxine supplementation corrects vitamin B6 deficiency but does not improve inflammation in patients with rheumatoid arthritis. Arthritis Res Ther 2005;7:R1404–411. CrossRef
- Chiang EP, Smith DE, Selhub J, Dallal G, Wang YC, Roubenoff R. Inflammation causes tissue-specific depletion of vitamin B6. Arthritis Res Ther 2005;7:R1254–R1262. CrossRef
- Kagansky N, Berner Y, Koren-Morag N, Perelman L, Knobler H, Levy S. Poor nutritional habits are predictors of poor outcome in very old hospitalized patients. Am J Clin Nutr 2005;82:784–91; quiz 913–914.
- Saibeni S, Cattaneo M, Vecchi M, et al. Low vitamin B(6) plasma levels, a risk factor for thrombosis, in inflammatory bowel disease: role of inflammation and correlation with acute phase reactants. Am J Gastroenterol 2003;98:112–117. CrossRef
- Paulos CM, Varghese B, Widmer WR, Breur GJ, Vlashi E, Low PS. Folate-targeted immunotherapy effectively treats established adjuvant and collagen-induced arthritis. Arthritis Res Ther 2006;8:R77. CrossRef
- Zhang R, Ma J, Xia M, Zhu H, Ling W. Mild hyperhomocysteinemia induced by feeding rats diets rich in methionine or deficient in folate promotes early atherosclerotic inflammatory processes. J Nutr 2004;134:825–830.
- Schroecksnadel K, Frick B, Fiegl M, Winkler C, Denz HA, Fuchs D. Hyperhomocysteinaemia and immune activation in patients with cancer. Clin Chem Lab Med 2007;45:47–53. CrossRef
- Ramos MI, Allen LH, Mungas DM, et al. Low folate status is associated with impaired cognitive function and dementia in the Sacramento Area Latino Study on Aging. Am J Clin Nutr 2005;82:1346–1352.
- Coppen A, Bolander-Gouaille C. Treatment of depression: time to consider folic acid and vitamin B12. J Psychopharmacol 2005;19:59–65. CrossRef
- Paulionis L, Kane SL, Meckling KA. Vitamin status and cognitive function in a longterm care population. BMC Geriatr 2005;5:16. CrossRef
- Selhub J, Jacques PF, Wilson PW, Rush D, Rosenberg IH. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. Jama 1993;270:2693–2698. CrossRef
- He K, Merchant A, Rimm EB, et al. Folate, vitamin B6, and B12 intakes in relation to risk of stroke among men. Stroke 2004;35:169–174. CrossRef
- Salles-Montaudon N, Parrot F, Balas D, Bouzigon E, Rainfray M, Emeriau JP. Prevalence and mechanisms of hyperhomocysteinemia in elderly hospitalized patients. J Nutr Health Aging 2003;7:111–116.
- Rodriguez JJ, Santolaria F, Martinez-Riera A, et al. Clinical significance of homocysteine in elderly hospitalized patients. Metabolism 2006;55:620–627. CrossRef
- Troen AM, Lutgens E, Smith DE, Rosenberg IH, Selhub J. The atherogenic effect of excess methionine intake. Proc Natl Acad Sci U S A 2003;100:15089–15094. CrossRef
- Bleie O, Refsum H, Ueland PM, et al. Changes in basal and postmethionine load concentrations of total homocysteine and cystathionine after B vitamin intervention. Am J Clin Nutr 2004;80:641–648.
- Elmadfa I, Leitzmann C. Ernährung des Menschen. Stuttgart: Eugen Ulmer GmbH & Co., 2004.
- Thews MV. Anatomie, Physiologie, Pathophysiologie des Menschen: Wissenschaftliche Verlagsgesellschaft mbH Stuttgart, 1999.
- The status of vitamins B6, B12, folate, and of homocysteine in geriatric home residents receiving laxatives or dietary fiber
JNHA - The Journal of Nutrition, Health and Aging
- Print ISSN
- Online ISSN
- Additional Links
- dietary fiber
- vitamin B12
- Industry Sectors
- Author Affiliations
- 1. Department of Nutritional Sciences, University of Vienna, Vienna, Austria
- 3. Department of Nutritional Sciences, University of Vienna, Althanstraße 14, A-1090, Vienna, Austria
- 2. “Haus der Barmherzigkeit”, Geriatric Hospital, Vienna, Austria