Changes in the vitamin status of elderly Europeans: plasma vitamins A, E, B-6, B-12, folic acid and carotenoids. SENECA Investigators.

OBJECTIVE

Determination of the plasma vitamin and carotenoid concentrations of a number of elderly populations to describe their micronutrient status and examine geographical patterns and the cross-sectional and longitudinal relationships with sex, age, food and alcohol intake.

DESIGN

Longitudinal study.

SETTING

Twelve small towns in ten European countries and one in the USA.

SUBJECTS: Randomized sample of 1175 subjects of both sexes born in the period 1913-1918, stratified according to age and sex.

INTERVENTIONS: Blood plasma collection and determination of alpha-tocopherol, gamma-tocopherol, alpha-carotene, all-trans- and cis-beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanthin, vitamin B-12, folic acid and pyridoxal 5'-phosphate. From the original sample examined in 1988/1989, measurements were repeated in 938 subjects in 1993.

RESULTS

There were very large within and between country differences in the micronutrient levels with no definite geographical pattern emerging. The retinol levels decreased significantly between 1988/1989 and 1993 (-0.2 mumol/l, P = 0.0001), unlike the total carotene levels (0.01, NS) while the alpha-tocopherol (0.7 mumol/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 levels increased nonsignificantly in men (17.2 pmol/l, P = 0.77) and decreased significantly in women (-37 pmol/l, P = 0.012). The prevalence of biochemical vitamin A deficiency was zero in both 1988/1989 and 1993, that of vitamin E deficiency decreased from 1.1% to 0.6% and for vitamin B-6 from 23.3% to 5.7%. Vitamin B-12 biochemical deficiency increased from 2.7% to 7.3% and for folic acid from zero to 0.3%.

CONCLUSIONS

Changes in the median micronutrient plasma levels over a 4-y period varied, exceeding 30%-40% in some elderly populations. This was reflected in changes, mostly decreases, in the prevalences of vitamin deficiency.