Research Links B Vitamins with Diabetes and Cognition
The increasing incidence of diabetes mellitus is a global public health concern. 347 million people worldwide have diabetes. WHO projects that diabetes will bet the 7th leading cause of death in 2030. In 1990, diabetes ranked 15th among leading diseases and injuries in terms of years of life lost due to premature mortality (YLLs). In 2010, it is number 7 after the top 4: ischemic heart disease, lung cancer, stroke, and chronic obstructive pulmonary disease.
Once diabetes is diagnosed, the economic and personal burden of diabetes can be minimized by maintaining moderate blood glucose control. Insulin is required for those with pancreatic insufficiency (Type 1). Others may be able to maintain near normal blood glucose levels with diet, exercise, and oral medications. There are 6 classes of drugs generally used to lower blood glucose levels. Metformin is a proven therapy and probably the most widely prescribed drug for diabetes worldwide.
A new study by Moore and colleagues investigated the interactions among metformin, dietary supplement use and cognitive impairment. Participants were recruited from the Australian Imaging, Biomarkers and Lifestyle Study (AIBL). They report that individuals with diabetes had poorer cognitive performance than those without diabetes. In addition, metformin use was associated with impaired cognitive performance. They observed an interaction between vitamin B12 and calcium use. Over 100 years ago, B vitamins were associated with a spectrum of cognitive disorders.
More recently, Moorthy and colleagues found higher vitamin B levels to be associated with better attention and executive function scores and lower depression scores in adults. Folic acid and vitamin B12 supplementation helped prevent cognitive decline in community-dwelling older adults (Walker et al. 2012). The B vitamin-cognition relationship doesn’t apply just to older adults. Significant correlations between folate concentrations and measures of cognitive performance have been observed in children (Nguyen et al. 2013).
Research is still affirming the importance of B vitamins in maintaining neurological function. Diseases and medications can affect nutrient requirements. Regardless of whether you have diabetes or not, did you remember to choose enriched/fortified foods or to use a multi-supplement with B vitamins today?
Moore EM, Mander AG, Ames D, Kotowicz MA, Carne RP, Brodaty H, Woodward M, Boundy K, Ellis KA, Bush AI, Faux NG, Martins R, Szoeke C, Rowe C, Watters DA, the AIBL Investigators. Increased risk of cognitive impairment in patients with diabetes is associated with metformin. 2013 Diabetes Care doi:10.2337/dc13-0229
The State of US Health, 1990-2010. Burden of Diseases, Injuries and Risk Factors. 2013 JAMA doi:/10.1001/jama.2013.13809
Moorthy D, Peter I, Scott TM, Parnell LD, Lai C-Q, Crott JW, Ordovas JM, Selhub J, Griffith J, Rosenberg IH, Tucker KL, Troen AM. Status of vitamin B-12 and B-6 but not of folate, homocysteine, and the methylenetetrahydrofolate reductase C677T polymorphism are associated with impaired cognition and depression in adults. 2012 J Nutr doi:10.3945/jn.112.161828
Walker JG and colleagues. Oral folic acid (400 μg) and vitamin B-12 (100 μg) daily supplementation to prevent cognitive decline in community-dwelling older adults with depressive symptoms – the Beyond Ageing Project: a randomized controlled trial. 2012 Am J Clin Nutr doi:10.3945/ajcn.110.007799
Nguyen CT, Gracely EJ, Lee BK. Serum folate but not vitamin B12 concentrations are positively correlated with cognitive test scores in children aged 6-16 years. 2013 J Nutr doi:10.3945/jn.112.166165