title: Effectiveness of the National Program of Complementary Feeding for older adults in Chile on vitamin B12 status in older adults; secondary outcome analysis from the CENEX Study (ISRCTN48153354).
abstract: BACKGROUND
  Older people are at increased risk of vitamin B12 deficiency and the provision of fortified foods may be an effective way to ensure good vitamin B12 status in later life.
  
  
  OBJECTIVE
  To evaluate the effectiveness of a vitamin B12 fortified food provided by a national program of complementary food for older people on plasma vitamin B12 levels.
  
  
  METHODS
  A random sub-sample of 351 subjects aged 65-67 y from a large cluster randomised controlled trial provided blood samples at baseline and after 24 months of intervention. The intervention arm (10 clusters 186 participants) received a vitamin B12 fortified food designed to deliver 1.4 μg/day, while the control arm did not receive complementary food (10 clusters, 165 participants). Serum vitamin B12 and folate levels determined by radioimmunoassay were used to estimate the effect of intervention on vitamin B12 levels, adjusting for baseline levels and sex.
  
  
  RESULTS
  Attrition at 24 months was 16.7% and 23.6% in the intervention and control arms respectively (p = 0.07). Over 24 months of intervention, mean (95% CI) serum vitamin B12 decreased from 392 (359-425) pmol/dL to 357 (300-414) pmol/dL (p < 0.07) in the intervention arm and from 395 (350-440) pmol/dL to 351 (308-395) pmol/dL in the control arm. There was no significant effect of the intervention on folate status.
  
  
  CONCLUSIONS
  Our findings suggest that foods fortified with 1.4 μg/daily vitamin B12 as provided by Chile's national programme for older people are insufficient to ensure adequate vitamin B12 levels in this population. Chile has a long and successful experience with nutrition intervention programs; however, the country's changing demographic and nutritional profiles require a constant adjustment of the programs.
authors.affiliation: Nutrition and Public Health, Aging, and Genetic Epidemiology Unit, Institute of Nutrition and Food Technology, University of Chile, Avda, El Libano 5524, Casilla 138-11, Santiago, Chile. calbala@uchile.cl.
authors.forename: Hugo
authors.initials: H
authors.lastname: Sanchez
authors.forename: Cecilia
authors.initials: C
authors.lastname: Albala
authors.forename: Lydia
authors.initials: L
authors.lastname: Lera
authors.forename: Alan D
authors.initials: AD
authors.lastname: Dangour
authors.forename: Ricardo
authors.initials: R
authors.lastname: Uauy
mesh_terms: D000368:Aged; D000375:Aging; D000752:Anemia, Pernicious / Q000209:etiology / Q000517:prevention & control; D002677:Chile / Q000453:epidemiology; D015536:Down-Regulation; D005260:Female; D005492:Folic Acid / Q000097:blood / Q000627:therapeutic use; D063105:Food Assistance; D005527:Food, Fortified / Q000032:analysis; D006801:Humans; D057194:Intention to Treat Analysis; D059012:Lost to Follow-Up; D008297:Male; D009752:Nutritional Status; D009826:Old Age Assistance; D015995:Prevalence; D015397:Program Evaluation; D012727:Sex Characteristics; D014805:Vitamin B 12 / Q000097:blood / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*
chemical_list: D005492:Folic Acid; D014805:Vitamin B 12
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