Dietary intake and status of folate and vitamin B12 and their association with homocysteine and cardiovascular disease in European populations

Eur J Clin Nutr. 2009 Jan;63(1):18-30. doi: 10.1038/sj.ejcn.1602897. Epub 2007 Sep 12.


Background/objectives: Folate and vitamin B12 have been suggested to play a role in chronic diseases like cardiovascular diseases. The objectives are to give an overview of the actual intake and status of folate and vitamin B12 in general populations in Europe, and to evaluate these in view of the current vitamin recommendations and the homocysteine concentration.

Methods: Searches in Medline with 'folic acid', 'folate' and 'vitamin B12', 'B12' or 'cobalamin' as key words were combined with the names of the European countries. Populations between 18 and 65 years were included.

Results: Sixty-three articles reporting on studies from 15 European countries were selected. Low folate intakes were observed in Norway, Sweden, Denmark and the Netherlands. Low intakes of vitamin B12 were not common and only seen in one small Greek study. In the countries with a low intake of folate, the recommended levels were generally not achieved, which was also reflected in the folate status. Vitamin B12 intake was not strongly associated with the vitamin B12 status, which can explain why in the Netherlands and Germany the vitamin B12 status was inadequate, despite sufficient intake levels. In countries with a low folate intake in particular, the Hcy concentration was higher than ideal.

Conclusions: Populations from the Nordic countries, the Netherlands, Germany and Greece may need to improve their intakes of folic acid, B12 or both to either meet the recommendations or to optimize their statuses. This could be achieved via a food-based approach, food fortification or supplements.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiovascular Diseases / prevention & control*
  • Diet*
  • Europe
  • Folic Acid / administration & dosage*
  • Folic Acid / blood
  • Homocysteine / blood*
  • Humans
  • Middle Aged
  • Nutritional Requirements
  • Vitamin B 12 / administration & dosage*
  • Vitamin B 12 / blood
  • Young Adult


  • Homocysteine
  • Folic Acid
  • Vitamin B 12