Folate-vitamin B-12 interaction in relation to cognitive impairment, anemia, and biochemical indicators of vitamin B-12 deficiency
Previous reports on pernicious anemia treatment suggested that high folic acid intake adversely influences the natural history of vitamin B-12 deficiency, which affects many elderly individuals. However, experimental investigation of this hypothesis is unethical, and the few existing observational d...
Saved in:
| Published in: | The American journal of clinical nutrition Vol. 89; no. 2; p. 702S |
|---|---|
| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
01.02.2009
|
| Subjects: | |
| ISSN: | 1938-3207, 1938-3207 |
| Online Access: | Get more information |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | Previous reports on pernicious anemia treatment suggested that high folic acid intake adversely influences the natural history of vitamin B-12 deficiency, which affects many elderly individuals. However, experimental investigation of this hypothesis is unethical, and the few existing observational data are inconclusive. With the use of data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES), we evaluated the interaction between high serum folate and low vitamin B-12 status [ie, plasma vitamin B-12 < 148 pmol/L or methylmalonic acid (MMA) > 210 nmol/L] with respect to anemia and cognitive impairment. With subjects having both plasma folate < or = 59 nmol/L and normal vitamin B-12 status as the referent category, odds ratios for the prevalence of anemia compared with normal hemoglobin concentration and impaired compared with unimpaired cognitive function were 2.1 (95% CI: 1.1, 3.7) and 1.7 (95% CI: 1.01, 2.9), respectively, for those with low vitamin B-12 status but normal serum folate and 4.9 (95% CI: 2.3, 10.6) and 5.0 (95% CI: 2.7, 9.5), respectively, for those with low vitamin B-12 status and plasma folate >59 nmol/L. Among subjects with low vitamin B-12 status, mean circulating vitamin B-12 was 228 pmol/L for the normal-folate subgroup and 354 pmol/L for the high-folate subgroup. We subsequently showed increases in circulating homocysteine and MMA concentrations with increasing serum folate among NHANES participants with serum vitamin B-12 < 148 pmol/L, whereas the opposite trends occurred among subjects with serum vitamin B-12 > or = 148 pmol/L. These interactions, which were not seen in NHANES III before fortification, imply that, in vitamin B-12 deficiency, high folate status is associated with impaired activity of the 2 vitamin B-12-dependent enzymes, methionine synthase and MMA-coenzyme A mutase. |
|---|---|
| AbstractList | Previous reports on pernicious anemia treatment suggested that high folic acid intake adversely influences the natural history of vitamin B-12 deficiency, which affects many elderly individuals. However, experimental investigation of this hypothesis is unethical, and the few existing observational data are inconclusive. With the use of data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES), we evaluated the interaction between high serum folate and low vitamin B-12 status [ie, plasma vitamin B-12 < 148 pmol/L or methylmalonic acid (MMA) > 210 nmol/L] with respect to anemia and cognitive impairment. With subjects having both plasma folate < or = 59 nmol/L and normal vitamin B-12 status as the referent category, odds ratios for the prevalence of anemia compared with normal hemoglobin concentration and impaired compared with unimpaired cognitive function were 2.1 (95% CI: 1.1, 3.7) and 1.7 (95% CI: 1.01, 2.9), respectively, for those with low vitamin B-12 status but normal serum folate and 4.9 (95% CI: 2.3, 10.6) and 5.0 (95% CI: 2.7, 9.5), respectively, for those with low vitamin B-12 status and plasma folate >59 nmol/L. Among subjects with low vitamin B-12 status, mean circulating vitamin B-12 was 228 pmol/L for the normal-folate subgroup and 354 pmol/L for the high-folate subgroup. We subsequently showed increases in circulating homocysteine and MMA concentrations with increasing serum folate among NHANES participants with serum vitamin B-12 < 148 pmol/L, whereas the opposite trends occurred among subjects with serum vitamin B-12 > or = 148 pmol/L. These interactions, which were not seen in NHANES III before fortification, imply that, in vitamin B-12 deficiency, high folate status is associated with impaired activity of the 2 vitamin B-12-dependent enzymes, methionine synthase and MMA-coenzyme A mutase. Previous reports on pernicious anemia treatment suggested that high folic acid intake adversely influences the natural history of vitamin B-12 deficiency, which affects many elderly individuals. However, experimental investigation of this hypothesis is unethical, and the few existing observational data are inconclusive. With the use of data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES), we evaluated the interaction between high serum folate and low vitamin B-12 status [ie, plasma vitamin B-12 < 148 pmol/L or methylmalonic acid (MMA) > 210 nmol/L] with respect to anemia and cognitive impairment. With subjects having both plasma folate < or = 59 nmol/L and normal vitamin B-12 status as the referent category, odds ratios for the prevalence of anemia compared with normal hemoglobin concentration and impaired compared with unimpaired cognitive function were 2.1 (95% CI: 1.1, 3.7) and 1.7 (95% CI: 1.01, 2.9), respectively, for those with low vitamin B-12 status but normal serum folate and 4.9 (95% CI: 2.3, 10.6) and 5.0 (95% CI: 2.7, 9.5), respectively, for those with low vitamin B-12 status and plasma folate >59 nmol/L. Among subjects with low vitamin B-12 status, mean circulating vitamin B-12 was 228 pmol/L for the normal-folate subgroup and 354 pmol/L for the high-folate subgroup. We subsequently showed increases in circulating homocysteine and MMA concentrations with increasing serum folate among NHANES participants with serum vitamin B-12 < 148 pmol/L, whereas the opposite trends occurred among subjects with serum vitamin B-12 > or = 148 pmol/L. These interactions, which were not seen in NHANES III before fortification, imply that, in vitamin B-12 deficiency, high folate status is associated with impaired activity of the 2 vitamin B-12-dependent enzymes, methionine synthase and MMA-coenzyme A mutase.Previous reports on pernicious anemia treatment suggested that high folic acid intake adversely influences the natural history of vitamin B-12 deficiency, which affects many elderly individuals. However, experimental investigation of this hypothesis is unethical, and the few existing observational data are inconclusive. With the use of data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES), we evaluated the interaction between high serum folate and low vitamin B-12 status [ie, plasma vitamin B-12 < 148 pmol/L or methylmalonic acid (MMA) > 210 nmol/L] with respect to anemia and cognitive impairment. With subjects having both plasma folate < or = 59 nmol/L and normal vitamin B-12 status as the referent category, odds ratios for the prevalence of anemia compared with normal hemoglobin concentration and impaired compared with unimpaired cognitive function were 2.1 (95% CI: 1.1, 3.7) and 1.7 (95% CI: 1.01, 2.9), respectively, for those with low vitamin B-12 status but normal serum folate and 4.9 (95% CI: 2.3, 10.6) and 5.0 (95% CI: 2.7, 9.5), respectively, for those with low vitamin B-12 status and plasma folate >59 nmol/L. Among subjects with low vitamin B-12 status, mean circulating vitamin B-12 was 228 pmol/L for the normal-folate subgroup and 354 pmol/L for the high-folate subgroup. We subsequently showed increases in circulating homocysteine and MMA concentrations with increasing serum folate among NHANES participants with serum vitamin B-12 < 148 pmol/L, whereas the opposite trends occurred among subjects with serum vitamin B-12 > or = 148 pmol/L. These interactions, which were not seen in NHANES III before fortification, imply that, in vitamin B-12 deficiency, high folate status is associated with impaired activity of the 2 vitamin B-12-dependent enzymes, methionine synthase and MMA-coenzyme A mutase. |
| Author | Morris, Martha Savaria Selhub, Jacob Jacques, Paul F Rosenberg, Irwin H |
| Author_xml | – sequence: 1 givenname: Jacob surname: Selhub fullname: Selhub, Jacob email: jacob.selhub@tufts.edu organization: Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA. jacob.selhub@tufts.edu – sequence: 2 givenname: Martha Savaria surname: Morris fullname: Morris, Martha Savaria – sequence: 3 givenname: Paul F surname: Jacques fullname: Jacques, Paul F – sequence: 4 givenname: Irwin H surname: Rosenberg fullname: Rosenberg, Irwin H |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/19141696$$D View this record in MEDLINE/PubMed |
| BookMark | eNpVkL1PwzAQxS1URD9gZ0KemEixHcexR6goIFVigTly7Au4SuySuJW68pfjiiLB9H4nvXf3dFM08sEDQpeUzHPFi1u9Nn7OCJFzJhQvFydoQlUus5yRcvSHx2g6DGtCKONSnKExVZRTocQEfS1DqyNkOxd15zy-zyjDzkfotYku-MS4h2Q5cAzYhHfvotsBdt1Gu74DH2-w9tA5fVCLaxfMRxqNblPYJo2hH3Bo8L8bFhpnHHizP0enjW4HuDjqDL0tH14XT9nq5fF5cbfKTFHmMQNhGtBGFiXPrVRFQw00oPKCasKZVaCA5zW3ZQHWEF1SJRhnUhtFtARWsxm6_tm76cPnFoZYdW4w0LapfdgOlRAyBQhLxqujcVt3YKtN7zrd76vfr7Fvkppy2g |
| CitedBy_id | crossref_primary_10_1139_apnm_2015_0191 crossref_primary_10_1017_S1368980012003953 crossref_primary_10_3945_ajcn_111_014621 crossref_primary_10_1111_j_1753_4887_2010_00279_x crossref_primary_10_1016_j_reprotox_2018_05_004 crossref_primary_10_1111_j_1365_2362_2011_02644_x crossref_primary_10_3390_molecules26154487 crossref_primary_10_1007_s10522_010_9284_5 crossref_primary_10_3945_ajcn_111_020230 crossref_primary_10_1111_j_1753_6405_2011_00759_x crossref_primary_10_1371_journal_pone_0189230 crossref_primary_10_3390_diagnostics11020366 crossref_primary_10_1111_risa_13404 crossref_primary_10_3945_ajcn_111_013300 crossref_primary_10_1016_j_nut_2011_12_015 crossref_primary_10_3390_nu8110725 crossref_primary_10_1111_nyas_13062 crossref_primary_10_1186_s12263_020_00662_4 crossref_primary_10_3390_pediatric14010016 crossref_primary_10_1002_gps_2117 crossref_primary_10_1093_tropej_fmw038 crossref_primary_10_3233_JAD_151095 crossref_primary_10_1016_j_neubiorev_2014_08_006 crossref_primary_10_1038_ejcn_2015_231 crossref_primary_10_1136_bmjopen_2017_018962 crossref_primary_10_1080_10408444_2020_1727842 crossref_primary_10_1002_jdn_10113 crossref_primary_10_1093_hmg_ddp428 crossref_primary_10_1093_jn_nxy057 crossref_primary_10_1007_s00394_014_0781_1 crossref_primary_10_1371_journal_pone_0269645 crossref_primary_10_1007_s12126_020_09389_4 crossref_primary_10_1186_s12905_023_02796_0 crossref_primary_10_3168_jds_2021_21677 crossref_primary_10_3945_ajcn_2008_26947E crossref_primary_10_1017_S1368980014003206 crossref_primary_10_1017_S1368980014001141 crossref_primary_10_3945_ajcn_2008_26947D crossref_primary_10_3945_ajcn_2008_26947A crossref_primary_10_3945_ajcn_2008_26947B crossref_primary_10_1016_j_biochi_2013_02_008 crossref_primary_10_3390_brainsci9120370 crossref_primary_10_1073_pnas_1619582114 crossref_primary_10_1016_j_jdiacomp_2016_08_025 crossref_primary_10_1016_j_fct_2011_06_068 crossref_primary_10_3168_jds_2015_9507 crossref_primary_10_1111_jir_12925 crossref_primary_10_3945_ajcn_111_013441 crossref_primary_10_3945_ajcn_111_015222 crossref_primary_10_1093_ijnp_pyy018 crossref_primary_10_1016_j_schres_2018_01_002 crossref_primary_10_3945_jn_109_118075 crossref_primary_10_1002_biof_176 crossref_primary_10_1016_j_arr_2015_04_005 crossref_primary_10_1007_s12603_017_0979_z crossref_primary_10_3945_an_117_015610 crossref_primary_10_3390_nu9010008 crossref_primary_10_1017_S0954422424000210 crossref_primary_10_2527_af_2014_0012 crossref_primary_10_3390_nu14173535 crossref_primary_10_3945_ajcn_2009_29031 crossref_primary_10_1139_cjas_2021_0065 crossref_primary_10_1016_j_arr_2019_04_008 crossref_primary_10_1016_j_jns_2019_07_015 crossref_primary_10_1017_S1041610211002511 crossref_primary_10_1016_j_schres_2010_03_006 crossref_primary_10_1136_jim_2019_001025 crossref_primary_10_1017_S000711451600307X crossref_primary_10_17650_1818_8346_2024_19_1_70_82 crossref_primary_10_1016_j_molliq_2021_116695 crossref_primary_10_1136_jnnp_2017_316296 crossref_primary_10_1007_s12031_018_1237_5 crossref_primary_10_1016_j_jns_2025_123627 crossref_primary_10_1016_j_archger_2023_104946 crossref_primary_10_1093_nutrit_nuy026 crossref_primary_10_3945_ajcn_113_080507 crossref_primary_10_1038_ejcn_2016_194 crossref_primary_10_1016_j_mehy_2020_110374 crossref_primary_10_1080_00207454_2019_1688805 crossref_primary_10_1016_j_chroma_2015_09_049 crossref_primary_10_1038_s41430_025_01652_8 crossref_primary_10_1017_S0007114511002364 crossref_primary_10_1016_j_arr_2018_10_010 crossref_primary_10_1177_03795721241226886 crossref_primary_10_1016_j_nutres_2010_09_008 crossref_primary_10_1177_0898264313482488 crossref_primary_10_3168_jds_2016_12381 crossref_primary_10_1017_S1368980012003576 crossref_primary_10_1016_j_biochi_2016_04_010 crossref_primary_10_3390_molecules25173932 crossref_primary_10_1016_j_heliyon_2020_e03597 crossref_primary_10_1089_jmf_2015_0056 crossref_primary_10_3390_nu13061790 crossref_primary_10_3390_nu16244386 crossref_primary_10_1016_j_dscb_2025_100220 crossref_primary_10_3945_ajcn_2010_28674E crossref_primary_10_1136_jclinpath_2018_205048 crossref_primary_10_3390_nu16234220 crossref_primary_10_1007_s12603_011_0070_0 crossref_primary_10_1186_2251_6581_12_17 crossref_primary_10_1373_clinchem_2009_128678 crossref_primary_10_3390_medicina56030142 crossref_primary_10_1111_j_1753_4887_2010_00325_x crossref_primary_10_3945_ajcn_111_032268 crossref_primary_10_1136_bmjopen_2016_011247 crossref_primary_10_1016_j_tjnut_2023_10_012 crossref_primary_10_1017_S000711451300336X crossref_primary_10_3945_ajcn_111_013243 crossref_primary_10_1016_j_gene_2012_11_021 crossref_primary_10_1186_s13568_018_0592_5 crossref_primary_10_1007_s00394_023_03289_4 crossref_primary_10_1016_j_amjmed_2014_08_020 crossref_primary_10_1146_annurev_publhealth_031811_124646 crossref_primary_10_3945_jn_115_211391 crossref_primary_10_3390_cancers15041300 crossref_primary_10_1089_ars_2012_4554 crossref_primary_10_1016_j_biopha_2024_116191 crossref_primary_10_1080_17474124_2017_1263566 |
| ContentType | Journal Article |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.3945/ajcn.2008.26947C |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine Diet & Clinical Nutrition |
| EISSN | 1938-3207 |
| ExternalDocumentID | 19141696 |
| Genre | Research Support, U.S. Gov't, Non-P.H.S Journal Article Research Support, N.I.H., Extramural |
| GrantInformation_xml | – fundername: NIA NIH HHS grantid: R03 AG021536-01 |
| GroupedDBID | --- -ET -~X ..I .55 .GJ 0R~ 1HT 23M 2FS 2WC 3O- 4.4 48X 53G 5GY 5RE 5VS 6J9 85S 8R4 8R5 A8Z AABZA AACZT AAGQS AAHBH AAIKC AAJQQ AALRI AAMNW AAPGJ AAPQZ AAUQX AAUTI AAVAP AAWDT AAWTL AAXUO AAYOK ABBTP ABDNZ ABDPE ABJNI ABLJU ABOCM ABPTD ABSAR ABWST ACFRR ACGFO ACGFS ACGOD ACNCT ACPRK ACPVT ACUFI ACUTJ ADBBV ADGZP ADHUB ADRTK ADUKH ADVEK ADVLN AEGXH AENEX AETBJ AFFDN AFFNX AFFZL AFJKZ AFOFC AFRAH AFXAL AGINJ AGKRT AGNAY AGQXC AGUTN AHMBA AI. AIAGR AITUG AJEEA AKRWK ALMA_UNASSIGNED_HOLDINGS AMRAJ ANFBD AQDSO AQKUS BAWUL BAYMD BCRHZ BKOMP BTRTY C1A CDBKE CGR CUY CVF DAKXR DIK E3Z EBS ECM EIF EIHJH EJD ENERS EX3 F5P F9R FDB FECEO FLUFQ FOEOM FOTVD FQBLK FRP GAUVT GJXCC GX1 H13 HF~ HZ~ IH2 J5H KBUDW KOP KQ8 KSI KSN L7B LPU MBLQV MHKGH MV1 MVM N4W NEJ NHB NHCRO NOMLY NOYVH NPM NVLIB O9- ODMLO OHT OK1 OVD P2P P6G PCD PQQKQ PRG Q2X R0Z RHF RHI RNS ROL ROX SJN SV3 TCN TEORI TMA TNT TR2 TWZ UBH UHB UKR VH1 VXZ W2D W8F WH7 WHG WOQ WOW X7M XOL XSW YBU YHG YOJ YQJ YR5 YRY YSK YV5 YYQ YZZ Z5M ZCA ZCG ZGI ZUP ZXP ~KM 7X8 ABUFD ACVFH ADCNI AEUPX AFPUW AIGII AKBMS AKYEP EFKBS |
| ID | FETCH-LOGICAL-c573t-e6cfeac85743d895f1cefe9351a042d9e9e43b4d75edc0a71962428ac90a8e2b2 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 146 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000262608700038&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1938-3207 |
| IngestDate | Tue Oct 21 14:19:50 EDT 2025 Wed Feb 19 02:24:39 EST 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 2 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c573t-e6cfeac85743d895f1cefe9351a042d9e9e43b4d75edc0a71962428ac90a8e2b2 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| OpenAccessLink | http://doi.org/10.3945/ajcn.2008.26947C |
| PMID | 19141696 |
| PQID | 66824202 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_66824202 pubmed_primary_19141696 |
| PublicationCentury | 2000 |
| PublicationDate | 2009-02-01 |
| PublicationDateYYYYMMDD | 2009-02-01 |
| PublicationDate_xml | – month: 02 year: 2009 text: 2009-02-01 day: 01 |
| PublicationDecade | 2000 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | The American journal of clinical nutrition |
| PublicationTitleAlternate | Am J Clin Nutr |
| PublicationYear | 2009 |
| References | Am J Clin Nutr. 2009 Jun;89(6):1951 |
| References_xml | – reference: - Am J Clin Nutr. 2009 Jun;89(6):1951 |
| SSID | ssj0012486 |
| Score | 2.3620343 |
| Snippet | Previous reports on pernicious anemia treatment suggested that high folic acid intake adversely influences the natural history of vitamin B-12 deficiency,... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 702S |
| SubjectTerms | 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase - metabolism Aging - blood Anemia, Pernicious - blood Anemia, Pernicious - diagnosis Anemia, Pernicious - epidemiology Cognition Disorders - blood Cognition Disorders - diagnosis Cognition Disorders - epidemiology Drug Interactions Female Folic Acid - administration & dosage Folic Acid - blood Homocysteine - blood Humans Male Methylmalonic Acid - blood Methylmalonyl-CoA Mutase - metabolism Middle Aged Nutrition Surveys Nutritional Status Odds Ratio Prevalence Vitamin B 12 - administration & dosage Vitamin B 12 - blood Vitamin B 12 Deficiency - blood Vitamin B 12 Deficiency - diagnosis Vitamin B 12 Deficiency - epidemiology |
| Title | Folate-vitamin B-12 interaction in relation to cognitive impairment, anemia, and biochemical indicators of vitamin B-12 deficiency |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/19141696 https://www.proquest.com/docview/66824202 |
| Volume | 89 |
| WOSCitedRecordID | wos000262608700038&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LT8MwDLYGQ4gLj_EazxwQJ6KlzyQSEuI1cWHiANJuU5qkUhG0sBV-AL-cuA8QB8SBS9tL1da1HTuf_RngSGouLLMCoUFNQ88YqmKpkbZSs4SlLstg1bAJPhqJ8VjedeC07YXBssrWJ1aO2hQa98gHcSzcasL8s5dXijOjEFttBmjMQTdwgQzqNB9_Ywh-WM15dBGKoIHPeA1SBjKMBupR53UdJTZy8svfw8tqmRmu_O8FV2G5CS_Jea0Pa9CxeQ_6V5ktyTFpOECfyKil4O_B4m0Drq_Dx9CluaWl71mpnrOcXFDPJ0gnMa2bH9w1mTa1c6QsyFflEcFWy2yK-4wnROX2OVN4NiTJcB5XRUhAEBvXmOHPSJGSH88wFmkssAd0Ax6G1_eXN7QZ0UB1xIOS2linznWLyAUiRsgo9bRNrQwiTzlvYKSVNgyS0PDIGs0Ud_buhCSUlkwJ6yf-JsznRW63gURBmJjYBYyKx6FOI5kaY5TRnBnP-InXh8NW7hNnAohruC8q3maTVvJ92Kp_3eSlZuqYIHmdF8t45897d2GpxomwUGUPuqkzfrsPC_q9zGbTg0qz3HF0d_sJdZDaIw |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Folate-vitamin+B-12+interaction+in+relation+to+cognitive+impairment%2C+anemia%2C+and+biochemical+indicators+of+vitamin+B-12+deficiency&rft.jtitle=The+American+journal+of+clinical+nutrition&rft.au=Selhub%2C+Jacob&rft.au=Morris%2C+Martha+Savaria&rft.au=Jacques%2C+Paul+F&rft.au=Rosenberg%2C+Irwin+H&rft.date=2009-02-01&rft.eissn=1938-3207&rft.volume=89&rft.issue=2&rft.spage=702S&rft_id=info:doi/10.3945%2Fajcn.2008.26947C&rft_id=info%3Apmid%2F19141696&rft_id=info%3Apmid%2F19141696&rft.externalDocID=19141696 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1938-3207&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1938-3207&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1938-3207&client=summon |