Lausanne, Switzerland 21th November 2017. The average human lifespan is increasing. However, this increase has led to a rise in age-related chronic diseases, putting elderly people at risk of disability, loss of independence and early mortality.
Poor nutritional status is a recognised risk factor for frailty among the elderly population, and the role of vitamin B12 deficiency in the development of several age-related chronic diseases has recently started to emerge. Vitamin B12 cannot be synthesised by the human body, and has to be taken in from food.
Preventive and therapeutic approaches are needed to manage this physical decline. Researchers at the Nestlé Institute of Health Sciences, the Nestlé Research Center Singapore and the National University of Singapore set out to better understand how ageing and frailty are associated with changes in vitamin B12 homeostasis and its underlying molecular mechanisms. The results of the study, published today in the Journal of Cachexia, Sarcopenia and Muscle, have conclusively demonstrated that ageing and physical frailty are associated with increased prevalence of vitamin B12 deficiency.
Their research centred on a cohort of volunteers from the Singapore Longitudinal Ageing Study, and involved measuring blood levels of methyl-malonic acid (MMA), a marker for vitamin B12 deficiency, and amnionless (AMN), the vitamin B12 co-receptor which anchors the vitamin B12 transport complex to the membrane of epithelial cells.
The study found that elderly participants had significantly greater vitamin B12 deficiency than young controls, while frail elderly had higher levels than pre-frail and robust elderly. Thus, age-related vitamin B12 deficiency is greater in people showing loss of physical function and mobility, which suggests that maintaining adequate levels of vitamin B12 is key to preventing physical decline during the ageing process.
At the mechanistic level, the study demonstrates that vitamin B12 deficiency in the elderly is caused by pathological alterations of intestinal vitamin B12 uptake and renal vitamin B12 excretion during ageing. It further demonstrates that the vitamin B12 co-receptor AMN can be detected in serum, where circulating levels increase with age and inversely correlate with vitamin B12 levels, thus establishing AMN as a new circulating marker of vitamin B12 deficiency and bioavailability during ageing. One of the potential applications of this observation is to use blood AMN as a novel biomarker to group the elderly population according to their endogenous vitamin B12 processing to determine those who will benefit from vitamin B12.
Jerome Feige, Head of the Ageing and Skeletal Muscle Health Group at NIHS, explains: “A role for low protein and vitamin D is widely described in sarcopenia, but it is important to understand how other nutritional deficiencies can affect aging and physical decline, and our work demonstrates that vitamin B12 plays a major role. Our results also showed for the first time a vitamin deficiency that is caused by changes in the body rather than because of poor nutritional intake. Whilst this might not be true for all vitamins and requires further investigation, it highlights the heterogeneity of micronutrient deficiency in the elderly and the need for more targeted interventions.”
NIHS is a biomedical research institute, part of Nestlé’s global R&D network, dedicated to fundamental research aimed at understanding health and disease and developing science-based, targeted nutritional solutions for the maintenance of health. To achieve its aim, NIHS employs state-of-the-art technologies and biological models to characterise health and disease with a holistic and integrated approach. The ultimate goal of the Institute is to develop knowledge that can empower people to better maintain their health through nutritional approaches, especially in relation to their molecular profile and lifestyle status.
|Pannérec A, Migliavacca E, De Castro A, Michaud J, Karaz S, Goulet L, Rezzi S, Ng TP, Bosco N, Larbi A and Feige JN (2017). Vitamin B12 deficiency and impaired expression of amnionless during aging. Journal of Cachexia, Sarcopenia and Muscle. 2017 DOI: 10.1002/jcsm.12260.
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Laura Camurri, Communications, NIHS