B12 folic acid
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The Role of Vitamin B12 and Folic Acid in Health
Vitamin B12 and Folic Acid in Diabetes Management
Vitamin B12 and folic acid supplementation have shown promising results in improving glycemic control and insulin resistance in patients with type 2 diabetes mellitus. A multi-arm randomized controlled clinical trial demonstrated that patients receiving either vitamin B12 (methylcobalamin) or a combination of vitamin B12 and folic acid experienced significant improvements in HbA1c levels, plasma insulin, insulin resistance, and serum adiponectin compared to those on standard oral anti-diabetic drugs1. Additionally, all groups receiving supplementation showed a significant decline in serum homocysteine levels, although no improvements in lipid profiles were observed1.
Cognitive and Motor Development in Children
Deficiencies in vitamin B12 and folic acid are linked to delayed development and neurological issues in children. A randomized placebo-controlled trial in North Indian children found that daily supplementation with both vitamins significantly improved gross motor and problem-solving skills, particularly in children who were stunted, had high plasma homocysteine levels, or were younger than 24 months at the end of the study2. Supplementation with either vitamin alone did not yield significant benefits, highlighting the importance of combined supplementation for developmental improvements2.
Cognitive Performance and Neuroprotection
Vitamin B12 and folic acid play crucial roles in brain health and cognitive function. In a study involving a pregnancy-induced hypertension rat model, combined supplementation of these vitamins along with omega-3 fatty acids improved levels of brain-derived neurotrophic factor (BDNF) and cognitive performance in adult offspring3. This suggests that maternal intake of these nutrients can reduce the risk of cognitive disorders in offspring by enhancing neurotrophin levels and cognitive function3.
Neurological Health and Disease Prevention
Vitamin B12 and folic acid are essential for central nervous system (CNS) function at all ages. They are involved in the methionine-synthase mediated conversion of homocysteine to methionine, which is crucial for nucleotide synthesis and methylation processes. Deficiencies in these vitamins can lead to megaloblastic anemia and overlapping neuropsychiatric syndromes, including mood disorders and dementias such as Alzheimer's disease and vascular dementia4. Therefore, adequate intake of these vitamins is vital for maintaining neurological health and preventing CNS disorders4.
Cancer Risk and Supplementation
While vitamin B12 and folic acid are beneficial for various health aspects, their supplementation may carry risks. Long-term follow-up of the B-PROOF trial indicated that combined supplementation of these vitamins was associated with an increased risk of overall cancer and colorectal cancer5. This finding suggests that supplementation should be carefully considered and potentially limited to individuals with proven deficiencies to avoid adverse effects5.
Cognitive Function in the Elderly
The effects of folic acid and vitamin B12 on cognitive function in the elderly have been mixed. Some studies have shown no consistent evidence of cognitive benefits from supplementation in healthy or cognitively impaired older adults6 7. However, specific subgroups, such as those with high homocysteine levels, may experience improvements in cognitive function with folic acid supplementation6. More research is needed to clarify these effects and determine the optimal use of these supplements in elderly populations.
Maternal Health and Fetal Development
Maternal supplementation with folic acid and vitamin B12 during pregnancy has been shown to promote fetal development by improving placental antioxidant capacity, angiogenesis, and amino acid transport. A study on sows demonstrated that such supplementation reduced intrauterine growth retardation and homocysteine levels in umbilical cord serum, while enhancing placental vascular density and amino acid concentrations in umbilical cord blood9. These findings underscore the importance of adequate maternal intake of these vitamins for healthy fetal development9.
Chronic Kidney Disease (CKD) Progression
Vitamin B12 levels can influence the effectiveness of folic acid treatment in slowing CKD progression. A post hoc analysis of a folic acid interventional trial found that folic acid treatment significantly reduced the odds of CKD progression in patients with higher baseline B12 levels, but not in those with lower B12 levels10. This suggests that adequate B12 status is crucial for the beneficial effects of folic acid in CKD management10.
Conclusion
Vitamin B12 and folic acid are essential nutrients with wide-ranging health benefits, from improving glycemic control in diabetes to enhancing cognitive and motor development in children. However, their supplementation should be carefully managed, especially considering potential risks such as increased cancer incidence. Adequate intake of these vitamins is crucial for neurological health, fetal development, and the management of chronic conditions like CKD. Further research is needed to optimize their use in various populations and health conditions.
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Most relevant research papers on this topic
Folic acid and vitamin B12 supplementation in subjects with type 2 diabetes mellitus: A multi-arm randomized controlled clinical trial.
Add-on supplementation with vitamin B12 improved glycemic control and insulin resistance in patients with type 2 diabetes mellitus, but not lipid profile.
RCTVitamin B12 and Folic Acid Improve Gross Motor and Problem-Solving Skills in Young North Indian Children: A Randomized Placebo-Controlled Trial
Daily supplementation with vitamin B12 and folic acid improves gross motor and problem-solving skills in young North Indian children, with higher effects in susceptible subgroups.
RCT
Large Human Trial
Rigorous JournalIncreased intake of vitamin B12, folate, and omega-3 fatty acids to improve cognitive performance in offspring born to rats with induced hypertension during pregnancy.
A maternal diet high in folate, vitamin B12, and DHA reduces the risk of cognitive disorders in adult offspring born to rats with pregnancy-induced hypertension.
RCT
Animal StudyVitamin B12, folic acid, and the nervous system
Vitamin B12 and folic acid deficiencies together play crucial roles in nervous system function and may help prevent disorders like CNS development, mood disorders, and dementias.
Highly CitedFolic Acid and Vitamin B12 Supplementation and the Risk of Cancer: Long-term Follow-up of the B Vitamins for the Prevention of Osteoporotic Fractures (B-PROOF) Trial
Folic acid and vitamin B12 supplementation may increase the risk of colorectal cancer.
RCTLarge Human TrialFolic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people.
Folic acid supplementation with or without vitamin B12 shows no adequate evidence of benefit in preventing cognitive impairment or retarding its progression in elderly healthy or demented people.
Highly CitedFolic acid with or without vitamin B12 for cognition and dementia.
Folic acid supplementation, with or without vitamin B12, may improve cognitive function in elderly individuals at risk of cognitive decline or dementia.
Systematic ReviewHighly CitedFolic acid fortification: why not vitamin B12 also?
High plasma folate levels in individuals with vitamin B12 deficiency can exacerbate their condition, suggesting that fortification policies that include folic acid should also include vitamin B12.
Observational StudyMaternal folic acid and vitamin B12 supplementation during medium to late gestation promotes fetal development via improving placental antioxidant capacity, angiogenesis and amino acid transport.
Maternal folic acid and vitamin B12 supplementation during medium to late gestation improves fetal development by reducing homocysteine levels in umbilical cord blood and promoting placental antioxidant capacity and vascular density.
RCT