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Before this can occur, however, comprehensive information is needed on the prevalence and determinates of deficiency. Our study suggests that the current custom of voluntary food fortification is ineffective in preventing deficiency or low status of these vitamins among older people. The results are of relevance not just for Ireland but for all countries that do not have mandatory fortification. One in eight adults over 50 were low to deficient in vitamin B12 while one in seven were low to deficient in folate The prevalence of low or deficient folate increased with age, from 14% among those aged 50-60 years to 23% among people over 80 years old. Low folate status was also more common in smokers, the obese, and those who lived alone Low or deficient vitamin B12 was more common in smokers (14%), people who lived alone (14.3%) and those from lower socio-economic backgrounds (13%) Use of both vitamin B12 and folic acid supplementation was low, with higher rates among women than men but less than 4% overall taking supplements of either vitamin Commenting on the significance of the research, lead author of the study and Research Fellow at TILDA, Dr Eamon Laird, said: "This is the largest representative and most comprehensive study of vitamin B12 and folate status in older adults ever conducted in Ireland. There are striking differences in the prevalence of deficiency across different lifestyle factors such as obesity and smoking - both of which are modifiable risk factors. Our findings will provide useful data to help inform public health policy -particularly regarding the proposition of mandatory folic acid and/or vitamin B12 fortification. To place our findings in context, in a country such as the United States where mandatory folic acid fortification occurs, rates of low folate status are around 1.2% in older adults compared with 15% in Ireland." Professor Anne Molloy, senior author of the study noted: "This study shows a surprising level of inadequate folate among older persons, despite many years of voluntary folic acid fortification of certain foods on the Irish market. Concerns relating to excessive folic acid intake, particularly in older people, have been at the heart of current debates regarding the risks of population-wide folic acid fortification. However, in countries such as the US, mandatory folic acid food fortification for the past 20 years has prevented millions of cases of folate deficiency without any proven adverse effects. Irish public health authorities need to act on the facts from studies such as ours." Professor Rose Anne Kenny, Principal Investigator of TILDA, said: "The high rates of B-vitamin deficiency seen in the older adult population are of concern and, given that this can be easily treated with fortification, this has significant policy and practice implications for Government and health services.
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