Vitamin B12 and folate deficiencies in older adults partly attributed to voluntary fortification policy, researchers say

By Mary Ellen Shoup contact

- Last updated on GMT

Less than 4% of study participants reported taking a folic acid or vitamin B12 supplement, according to the study.
Less than 4% of study participants reported taking a folic acid or vitamin B12 supplement, according to the study.
One in eight adults in Ireland over the age of 50 aren’t getting enough vitamin B12 from their normal diets while one in seven are deficient in folic acid, but researchers from Trinity College Dublin argued that this could be improved by adopting a mandatory food fortification policy similar to the US.

The study, published in the British Journal of Nutrition​,​ recruited a nationally representative sample of community-dwelling adults aged 50 and older living as part of The Irish Longitudinal Study on Ageing (TILDA).

Researchers collected general data from study participants (n=5895) including sex, age, residence, habitation status (living alone yes/no), income, as well as smoking and drinking habits. Data collection also included donating a blood sample. In total, folate measurements were available for 90.7 % (n 5350) and B12 measurements were available for 88·5 % (n 5219) of these participants.

The range of the study participants was 50 to 98 years of age (mean age=63.6 years). The proportion who reported currently consuming alcohol was 76.8 %, whereas 15.6 % were current smokers.

Senior author of the study, professor Anne Molloy, noted that mandatory folic acid fortification of certain foods in the US has been effective policy and something Ireland’s public health sector should consider. 

"This study shows a surprising level of inadequate folate among older persons, despite many years of voluntary folic acid fortification of certain foods on the Irish market,”​ Molloy stated.

“However, in countries such as the US, mandatory folic acid food fortification for the past 20 years has prevented millions of cases of folate deficiency without any proven adverse effects. Irish public health authorities need to act on the facts from studies such as ours," ​she said.


Out of the more than 5,000 participants, fewer than 4% reported taking a dietary supplement of either vitamin, according the study. The highest rates of vitamin B12 and folate deficiencies were observed in participants aged 80 years and older.

“Older adults can be at a particular risk of deficiency owing to increased malabsorption from atrophic gastritis, infection or medication interaction,”​ researchers wrote.

Researchers added that sex and income played a role in vitamin B12 and folate levels among participants.

“Interestingly, we also observed that men and those with a lower asset wealth also had lower folate and B12 concentrations. It has been reported that men often display a lower B-vitamin status than women, which in some studies has been attributed to a higher intake of supplements (which also appears to be a factor in the current study).

“In addition, it has been observed that older men tend to have a poorer awareness of healthy diet recommendations compared with women who were also more likely to have healthier dietary patterns.”

Effectiveness a mandatory fortification policy

Researchers argued that Ireland’s voluntary fortification policy (cereal, grains, or flour enriched with vitamins and minerals such as folate and B12) contributed to the deficiency rates found in the nationally representative sample.

“These data are in stark contrast to countries with mandatory fortification (of enriched cereal grains or flour) such as the US where rates of low folate status have been reported in only 1-2 % of those aged ≥60 years (post-fortification),”​ researchers wrote.

Lead author of the study and research fellow at TILDA, Dr Eamon Laird, hopes the study finding will help inform public health policies, particularly the adoption of mandatory folic acid and/or vitamin B12 fortification in food products such as cereal, grains, and bread products.

“To place our findings in context, in a country such as the United States where mandatory folic acid fortification occurs, rates of low folate status are around 1.2% in older adults compared with 15% in Ireland,"​ Dr Laird commented.

“Our findings will provide useful data to help inform public health policy -particularly regarding the proposition of mandatory folic acid and/or vitamin B12 fortification.”

Source:​​ British Journal of Nutrition
Published online ahead of print, doi: 10.1017/S0007114518001356
“Voluntary fortification is ineffective to maintain the vitamin B12 and folate status of older Irish adults: evidence from the Irish Longitudinal Study on Ageing (TILDA”​​
Authors: Eamon J. Laird et al. 

Related news

Related products

show more

Targeting Optimal Nutrient Absorption

Targeting Optimal Nutrient Absorption

Sabinsa Corporation | 10-Sep-2018 | Technical / White Paper

Optimizing nutrient delivery goes a long way in enhancing dosage efficiency and health benefits obtained from various formulations. Learn how BioPerine®...

Bioavailable and Stable Ubiquinol CoQH-CF Softgels

Bioavailable and Stable Ubiquinol CoQH-CF Softgels

Soft Gel Technologies, Inc. | 18-Jul-2018 | Infographic

Soft Gel Technologies, Inc. (SGTI) perfected a formula to keep the reduced form of CoQ10 stable. Our CoQH-CF softgels deliver a solubilized form of Kaneka...

Related suppliers


Post your comment

We will not publish your email address on the website

These comments have not been moderated. You are encouraged to participate with comments that are relevant to our news stories. You should not post comments that are abusive, threatening, defamatory, misleading or invasive of privacy. For the full terms and conditions for commenting see clause 7 of our Terms and Conditions ‘Participating in Online Communities’. These terms may be updated from time to time, so please read them before posting a comment. Any comment that violates these terms may be removed in its entirety as we do not edit comments. If you wish to complain about a comment please use the "REPORT ABUSE" button or contact the editors.

Follow us

Featured Events

View more


View more