CHANGES IN THE VITAMIN STATUS OF ELDERLY EUROPEANS - PLASMA VITAMIN-A, VITAMIN-E, VITAMIN-B-6, VITAMIN-B-12, FOLIC-ACID AND CAROTENOIDS

Objective: Determination of the plasma vitamin and carotenoid concentr ations of a number of elderly populations to describe their micronutri ent status and examine geographical patterns and the cross-sectional a nd longitudinal relationships with sex, age, food and alcohol intake. Design: Longitudinal study. Setting: Twelve small towns in ten Europea n countries and one in the USA. Subjects: Randomized sample of 1175 su bjects of both sexes born in the period 1913-1918, stratified accordin g to age and sex. Interventions: Blood plasma collection and determina tion of alpha-tocopherol, gamma-tocopherol, alpha-carotene, all-trans- and cis-beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanth in, vitamin B-12, folic acid and pyridoxal 5'-phosphate. From the orig inal sample examined in 1988/1989, measurements were repeated in 938 s ubjects in 1993. Results: There were very large within and between cou ntry differences in the micronutrient levels with no definite geograph ical pattern emerging. The retinol levels decreased significantly betw een 1988/1989 and 1993 (-0.2 mu mol/l, P=0.0001), unlike the total car otene levels (0.01, NS) while the alpha-tocopherol (0.7 mu mol/l, P = 0.002), folic acid (1.1 nmol/l, P < 0.01) and pyridoxal 5'-phosphate ( 12 nmol/l, P = 0.0001) levels increased significantly. Vitamin B-12 le vels increased nonsignificantly in men (17.2 pmol/l, P = 0.77) and dec reased significantly in women (- 37 pmol/l, P = 0.012). The prevalence of biochemical vitamin A deficiency was zero in both 1988/1989 and 19 93, that of vitamin E deficiency decreased from 1.1% to 0.6% and for v itamin B-6 from 23.3% to 5.7%. Vitamin B-12 biochemical deficiency inc reased from 2.7% to 7.3% and for folic acid from zero to 0.3%. Conclus ions: Changes in the median micronutrient plasma levels over a 4-y per iod varied, exceeding 30%-40% in some elderly populations. This was re flected in changes, mostly decreases, in the prevalences of vitamin de ficiency.