Het stimuleren van gezonde voedselkeuzes : onderzoek gericht op schoolkantines en zorginstellingen

In dit rapport is onderzocht op welke manier scholen en zorginstellingen voedsel aanbieden en hoe dit aanbod het voedselkeuzegedrag van leerlingen en de eetlust van ouderen beïnvloedt

Explaining the variability in recommended intakes of folate, vitamin B12, iron and zinc for adults and elderly people

Objective To signal key issues for harmonising approaches for establishing micronutrient recommendations by explaining observed variation in recommended intakes of folate, vitamin B12, Fe and Zn for adults and elderly people. Design We explored differences in recommended intakes of folate, vitamin B12, Fe and Zn for adults between nine reports on micronutrient recommendations. Approaches used for setting recommendations were compared as well as eminence-based decisions regarding the selection of health indicators indicating adequacy of intakes and the consulted evidence base. Results In nearly all reports, recommendations were based on the average nutrient requirement. Variation in recommended folate intakes (200–400 µg/d) was related to differences in the consulted evidence base, whereas variation in vitamin B12 recommendations (1·4–3·0 µg/d) was due to the selection of different CV (10–20 %) and health indicators (maintenance of haematological status or basal losses). Variation in recommended Fe intakes (men 8–10 mg/d, premenopausal women 14·8–19·6 mg/d, postmenopausal women 7·5–10·0 mg/d) was explained by different assumed reference weights and bioavailability factors (10–18 %). Variation in Zn recommendations (men 7–14 mg/d, women 4·9–9·0 mg/d) was also explained by different bioavailability factors (24–48 %) as well as differences in the consulted evidence base. Conclusions For the harmonisation of approaches for setting recommended intakes of folate, vitamin B12, Fe and Zn across European countries, standardised methods are needed to (i) select health indicators and define adequate biomarker concentrations, (ii) make assumptions about inter-individual variation in requirements, (iii) derive bioavailability factors and (iv) collate, select, interpret and integrate evidence on requirements

Dietary sources of vitamin B-12 and their association with vitamin B-12 status markers in healthy older adults in the B-PROOF study

Low vitamin B-12 concentrations are frequently observed among older adults. Malabsorption is hypothesized to be an important cause of vitamin B-12 inadequacy, but serum vitamin B-12 may also be differently affected by vitamin B-12 intake depending on food source. We examined associations between dietary sources of vitamin B-12 (meat, fish and shellfish, eggs, dairy) and serum vitamin B-12, using cross-sectional data of 600 Dutch community-dwelling adults (≥65 years). Dietary intake was assessed with a validated food frequency questionnaire. Vitamin B-12 concentrations were measured in serum. Associations were studied over tertiles of vitamin B-12 intake using P for trend, by calculating prevalence ratios (PRs), and splines. Whereas men had significantly higher vitamin B-12 intakes than women (median (25th–75th percentile): 4.18 (3.29–5.38) versus 3.47 (2.64–4.40) µg/day), serum vitamin B-12 did not differ between the two sexes (mean ± standard deviation (SD): 275 ± 104 pmol/L versus 290 ± 113 pmol/L). Higher intakes of dairy, meat, and fish and shellfish were significantly associated with higher serum vitamin B-12 concentrations, where meat and dairy—predominantly milk were the most potent sources. Egg intake did not significantly contribute to higher serum vitamin B-12 concentrations. Thus, dairy and meat were the most important contributors to serum vitamin B-12, followed by fish and shellfish

Association between vitamin B12 intake and EURRECA’s prioritized biomarkers of vitamin B12 in young populations: a systematic review

Objective To review evidence on the associations between vitamin B12 intake and its biomarkers, vitamin B12 intake and its functional health outcomes, and vitamin B12 biomarkers and functional health outcomes. Design A systematic review was conducted by searching electronic databases, until January 2012, using a standardized strategy developed in the EURRECA network. Relevant articles were screened and sorted based on title and abstract, then based on full text, and finally included if they met inclusion criteria. A total of sixteen articles were included in the review. Setting Articles covered four continents: America (n 4), Europe (n 8), Africa (n 1) and Asia (n 3). Subjects Population groups included healthy infants, children and adolescents, and pregnant and lactating women. Results From the total number of 5815 papers retrieved from the initial search, only sixteen were eligible according to the inclusion criteria: five for infants, five for children and adolescents, and six for pregnant and lactating women. Conclusions Only one main conclusion could be extracted from this scarce number of references: a positive association between vitamin B12 intake and serum vitamin B12 in the infant group. Other associations were not reported in the eligible papers or the results were not provided in a consistent manner. The low number of papers that could be included in our systematic review is probably due to the attention that is currently given to research on vitamin B12 in elderly people. Our observations in the current systematic review justify the idea of performing well-designed studies on vitamin B12 in young populations

Low vitamin D status is associated with more depressive symptoms in Dutch older adults

Purpose: The existence of vitamin D receptors in the brain points to a possible role of vitamin D in brain function. We examined the association of vitamin D status and vitamin D-related genetic make-up with depressive symptoms amongst 2839 Dutch older adults aged ≥65 years. Methods: 25-Hydroxyvitamin D (25(OH)D) was measured, and five ‘vitamin D-related genes’ were selected. Depressive symptoms were measured with the 15-point Geriatric Depression Scale. Results were expressed as the relative risk of the score of depressive symptoms by quartiles of 25(OH)D concentration or number of affected alleles, using the lowest quartile or minor allele group as reference. Results: A clear cross-sectional and pr

A Randomized Controlled Trial to Examine the Effect of 2-Year Vitamin B12 and Folic Acid Supplementation on Physical Performance, Strength, and Falling: Additional Findings from the B-PROOF Study

Elevated homocysteine concentrations are associated with a decline in physical function in elderly persons. Homocysteine-lowering therapy may slow down this decline. This study aimed to examine the effect of a 2-year intervention of vitamin B12 and folic acid supplementation on physical performance, handgrip strength, and risk of falling in elderly subjects in a double-blind, randomized placebo-controlled trial. Participants aged ≥65 years with elevated plasma homocysteine concentrations [12–50 µmol/L (n = 2919)] were randomly assigned to daily supplementation of 500 µg vitamin B12, 400 µg folic acid, and 600 I

Cognitive performance: a cross-sectional study on serum vitamin D and its interplay with glucose homeostasis in Dutch older adults

Objectives First, the association between serum 25-hydroxyvitamin D (25[OH]D) and cognitive performance was examined. Second, we assessed whether there was evidence for an interplay between 25(OH)D and glucose homeostasis in the association with cognitive performance. Design, Setting, and Participants Associations were studied using cross-sectional data of 776 (3 domains) up to 2722 (1 domain) Dutch community-dwelling older adults, aged 65 years or older. Measurements Serum 25(OH)D, plasma glucose, and insulin concentrations were obtained. Cognitive performance was assessed with an extensive cognitive test battery. Prevalence ratios (PRs) were calculated to quantify the association between 25(OH)D and cognition; poor performance was defined as the worst 10% of the distribution of the cognitive scores. Results The overall median MMSE score was 29 (IQR 28–30). Higher serum 25(OH)D was associated with better attention and working memory, PR 0.50 (95% CI 0.29–0.84) for the third serum 25(OH)D tertile, indicating a 50% lower probability of being a poor performer than participants in the lowest tertile. Beneficial trends were shown for 25(OH)D with executive function and episodic memory. Serum 25(OH)D was not associated with plasma glucose or insulin. Plasma insulin only modified the association between serum 25(OH)D and executive function (P for interaction: .001), suggesting that the improvement in executive function with high 25(OH)D concentrations is stronger in participants with high plasma insulin concentrations compared with those with low plasma insulin concentrations. Conclusion Higher 25(OH)D concentrations significantly associated with better attention and working memory performance. This study does not demonstrate an interplay between serum 25(OH)D and glucose homeostasis in the association with cognitive performance

Effect of Vitamin B<inf>12</inf> and Folic Acid Supplementation on Bone Mineral Density and Quantitative Ultrasound Parameters in Older People with an Elevated Plasma Homocysteine Level: B-PROOF, a Randomized Controlled Trial

High plasma homocysteine (Hcy) levels are associated with increased osteoporotic fracture incidence. However, the mechanism remains unclear. We investigated the effect of Hcy-lowering vitamin B12 and folic acid treatment on bone mineral density (BMD) and calcaneal quantitative ultrasound (QUS) parameters. This randomized, double-blind, placebo-controlled trial included participants aged ≥65 years with plasma Hcy levels between 12 and 50 µmol/L. The intervention comprised 2-year supplementation with either a combination of 500 µg B12, 400 µg folic acid, and 600 IU vitamin D or placebo with 600 IU vitamin D only. In total, 1111 participants underwent repeated dual-energy X-ray assessment and 1165 participants underwent QUS. Femoral neck (FN) BMD, lumbar spine (LS) BMD, calcaneal broadband ultrasound attenuation (BUA), and calcaneal speed of sound (SOS) were assessed. After 2 years, FN-BMD and BUA had significantly decreased, while LS-BMD significantly increased (all p 80 years (estimated marginal mean 64.4 dB/MHz for the intervention group and 61.0 dB/MHz for the placebo group, p = 0.04 for difference). In conclusion, this study showed no overall effect of treatment with vitamin B12 and folic acid on BMD or QUS parameters in elderly, mildly hyperhomocysteinemic persons, but suggests a small beneficial effect on BUA in persons >80 years who were compliant in taking the supplement

Seniorenvoeding biedt volop kansen voor midden- en kleinbedrijf

De komende dertig jaar groeit het aantal vijftigplussers in Nederland met 45 procent naar 7,1 miljoen. De groep zal bijna twee keer zoveel vermogen hebben als het gemiddelde Nederlandse huishouden. Een nieuwe markt met kansen. Ooit dacht de consument bij seniorenvoeding vooral aan de saaie keuken van een bejaardenhuis of een sondevoeding voor oudere patiënten. Tegenwoordig is dat anders. De huidige senioren zijn vaak vitale consumenten, met veel aandacht voor hun kwaliteit van leven, die geld overhebben voor een goede voeding. Senioren blijken een gat in de markt, zo bleek tijdens het symposium dat het Innovatiecentrum Gezonde Voeding (ICGV) deze zomer in Venlo hiel

Vitamin B12: a novel indicator of bone health in vulnerable groups

Background: A number of modifiable predictors for osteoporosis and fractures have been identified, including nutritional factors, such as vitamin D deficiency and low calcium intake. Cobalamin deficiency has been suggested to affect bone metabolism. Pernicious anaemia, which can result in cobalamin deficiency, has been identified as a risk factor for osteoporosis. Also, it is known that homocystinuria patients are of ten diagnosed with osteoporosis. Both moderate hyperhomocysteinemia and vitamin B12 deficiency are highly prevalent in old age and may play a role in diseases characteristic for old age.Objectives: 1) To show the associations of vitamin B12 and homocysteine with measures of bone health in three different populations. 2) To assess the effect of supplementation with 1000 mg crystalline cobalamin, carried either by a milk product or a capsule, on cobalamin status in mildly cobalamin deficient Dutch elderly people .Results: Data analyses in three different populations supplied the following information. Macrobiotic-fed adolescents: adolescents (9-15 y) with a low BMD had a significantly less favorable vitamin B12 status (adjusted mean, SD: 344 :t 24 pmol/L) and MMA status (adjusted mean, P5, P95: 0.31 [0.26, 0.35] f-lIDol/L) than adolescents with a normal BMD, with levels of respectively 442 (18) and 0.20 (0.16, 0.23) f-lmol/L. Free-living elderly: An increased Hcy level appeared to be a strong and independent risk factor for osteoporotic fractures in elderly men and women of the Longitudinal Aging Study Amsterdam (n=1267, mean age: 76 yrs). Relative risks (95% CI) for the highest Hcy quartile versus lowest three homocysteine quartiles were 4.6 (1.4-14.5) in men, and 1.8 (0.8-3.7) in women. Frail elderly people: Osteoporosis (defined by BMD T-score< -2.5) occurred almost five times more of ten in frail elderly women with a marginal vitamin B12 status and seven times more of ten in women with a deficient vitamin B12 status than in women with a normal status in the VFit-study. Intervention study with vitamin B12: Crystalline cobalamin added to milk is an effective alternative for cobalamin capsules in improving cobalamin status.Conclusions: We found a relevant association between vitamin B12 metabolites and bone health in various studies with different study designs and diverse populations. Since these observed associations broaden the scope for randomized clinical trials, we conducted an intervention study in which we showed that milk enriched with vitamin B12 is an as effective treatment as cobalamin capsules