Counsellors working with older adults note that clients whose overall nutrition is good appear to be less depressed, have better ability to think and plan, and seem to have less adverse effects from alcohol, when compared to other seniors who are drinking at similarly moderately high levels.
Why is that? The answer in part may be vitamin deficiency. One of the common harms related to alcohol misuse among some older adults who drink is vitamin deficiency, particularly folate, B6, and B12.
Folate and Depression
Problem alcohol use and depression frequently go hand in hand. There is considerable research on the role of folate in depression and dementia (1). Studies suggest that folate deficiency may occur in up to one third of patients with severe depression, and that treatment with the vitamin may enhance recovery of the mental state. (2) There can also be important racial or ethnic differences among seniors in their folate levels and folate levels have a significant relationship on cognitive and affective function among older persons. (3)
Helping older adults who have alcohol problems improve their nutrition generally (and to improve their folate, B6, B12 status in particular) may go a long way to improving their health, particularly their cognition and level of depression.
Folate and Cancer
Folate may also protect against breast cancer in postmenopausal women who drink alcohol. (4), (5) Alcohol interferes with folate transport and metabolism.
For men, research indicates a direct relationship between past and current alcohol use and risk of colon cancer, and significant connection between higher levels drinking and colon cancer when there is folate deficiency. If the folate deficiency isn't there, the risk of this form of cancer does not seem to be there. (6)
Folate and Major Chronic Disease
Research suggests that adequate folate intake may also be important in the primary prevention of major chronic diseases, especially among women who have more than two drinks a day. Among women, folate intake has the greatest benefit for the heaviest drinkers (more than 2 drinks a day) (7).
Which Foods Provide Folate?
Leafy greens such as spinach and turnip greens, dry beans and peas, fortified cereals and grain products, and some fruits (oranges and tomato juice) and vegetables are rich food sources of folate. See this USDA list of good sources of folate: http://vm.cfsan.fda.gov/~dms/facttb.html
Some tend to be the pricier foods, but others such as baked beans with pork, or burritos with beans may be within the price range of many seniors.
Unfortunately Canada's Food Guide is too vague to give seniors much helpful information in this area, at present.
Internet Resources on Folate
The American website "National Institutes of Health" produces a nice summary on dietary supplements, including folate. See: www.cc.nih.gov/ccc/supplements/folate.html#what
The website notes that certain medications can interfere with folate utilization, including:
Anti-convulsant medications (such as dilantin, phenytoin, and primidone)
Metformin (sometimes prescribed to control blood sugar in type 2 diabetes)
Sulfasalazine (used to control inflammation associated with Crohn's disease and ulcerative colitis)
Triamterene (a diuretic)
Methotrexate (which is used for severe psoriasis and adult rheumatoid arthritis).
The antacid/ulcer medication Ranitidine (for example, Zatac (TM)) inhibits folic acid absorption. Therefore people taking antacids are often advised to supplement their diet with folic acid.(8)
(1) Alpert J. E., & Fava, M. (May, 1997). Nutrition and depression: the role of folate. Nutrition Review, 55 (5),145-9.
(2) Bottiglieri, T., Laundy M., & Crellin, R. et al. (August, 2000). Homocysteine, folate, methylation, and monoamine metabolism in depression, Journal of Neurology, Neurosurgery & Psychiatry, 69(2), 228-232.
(3) Lindeman, R.D., Romero L. J., & Koehler, K.M., et al. (February, 2000). Serum vitamin B12, C and folate concentrations in the New Mexico elder health survey: correlations with cognitive and affective functions. J American College of Nutrition. 19(1),68-76.
(4) Boughton, B. (2001). Dietary folate protects against breast cancer in women who drink alcohol. Lancet Oncology, 2(9), 528.
(5) Sellers, T. A., Kushi, L.H.& Cerhan, J. R. et al. (2001). Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology, 12(4) 420-428.
(6) 4. Jiang, R., Hu, F.B. & Giovanucci, E. et al (2001). Joint effects of alcohol, folate intake on risk of major chronic disease in women. American Journal of Epidemiology, 153(11) s 28.
(7) Giovannucci, E., Rimm, E.B., & Ascherio, A. et al. (1995). Alcohol, low-methionine-low-folate diets, and risk of colon cancer in men. Journal of the National Cancer Institute, 87(4) 265-273.
(8) Healthnotes (see: Ranitidine) www.mycustompak.com/healthNotes/Index.htm
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