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Title:   Author  item
                                            BRITO, ALEX - University Of Californiaitem
                                            MILLER, JOSHUA - Rutgers Universityitem
                                            GREEN, RALPH - University Of Californiaitem
                                            FEDOSOV, SERGEY - Aarhus Universityitem
                                            HARVEY, DANIELLE - University Of Californiaitem
                                            Shahab-Ferdows, Settiitem
                                            VERDUGO, RENATO - University Of Chileitem
                                            SANCHEZ, HUGO - University Of Chileitem
                                            ALBALA, CECILIA - University Of Chileitem
                                            UAUAY, RICARDO - University Of Chileitem
                                            Allen, Lindsay

                                                         - *A*
  Submitted to: The American Journal of Clinical Nutrition
                                    Publication Type: Peer Reviewed Journal
                                    Publication Acceptance Date: 10/14/2015
                                    Publication  Date: 1/20/2016
                                    Citation: Brito, A., Miller, J.W., Green, R., Fedosov, S.N., Harvey, D., Shahab-Ferdows, S., Verdugo, R., Sanchez, H., Albala, C., Uauay, R., Allen, L.H. 2016. Vitamin B-12 treatment of asymptomatic, deficient, elderly Chileans improves conductivity in myelinated periphreal nerves, but high serum folate impairs vitamin B-12 status response assessed by the combined indicator of vitamin B-12 status. American Journal of Clinical Nutrition. 103:250-257. doi: 10.3945/ajcn.115.116509.Interpretive Summary:
                                Technical Abstract: Since 2005 the National Feeding Program for the Elderly (PACAM) in Chile has provided a B12 fortified milk drink
(1.7 μg B12/d) which is insufficient to ensure B12 adequacy in many individuals. The objective was to evaluate
effects of adding 1 mg B12/d to PACAM vs 1 mg B12/d as a pill with PACAM on B12 status and neurophysiological
function in Chilean elderly. The cluster RCT had 3 arms: fortified PACAM (1 mg B12, n=101), pill with PACAM (1
mg B12, n=97) and placebo with PACAM (control, 1.7 ug B12, n=89). B12 status was defined as cB12, which
combines serum B12, holoTC, MMA and tHcy. cB12 and peripheral sensory and motor nerve conduction were
assessed at baseline and after 4 (efficacy), 9 and 18 mo (effectiveness). A linear mixed-effect model was
performed. Based on cB12, 7.6% of elderly were B12 deficient and 27.3% had low status at screening. Subjects
with very low serum B12 were excluded and treated. cB12 correlated more strongly (-~0.40, p<0.0001) with the
average distal latency of the sural nerve at baseline than did any individual B12 marker. cB12 did not differ among
groups at baseline. After 4 mo, B12 provided by PACAM or a pill equally (p<0.0001) improved B12 status. The
effect was maintained at 9 and 18 mo. Sensory nerve conduction latencies of the sural nerves were reduced
(p<0.0001) after 4 mo in both supplement groups. Giving elderly B12 fortified milk was as effective and
efficacious as B12 in pills for improving B12 status and peripheral nerve conduction, and cB12 was the best
biomarker of status and function. Chilean FONDECYT #1070592 and USDA, ARS WHNRC


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