Many older adults have a vitamin B12 deficiency. Reasons for this include which of the follow-ing? (Select all that apply.)

Question

a. Normal age-related changes in the stom-ach include a lower production of gastric acid making vitamin B12 absorption less efficient
b. The major source of vitamin B12 is sun-light, and older adults are less likely to be outdoors and absorb vitamin B12 in this manner
c. Proton pump inhibitors, a frequently pre-scribed medication in older adults, impairs absorption of vitamin B12 from food
d. Most older adults do not consume five servings of fruits and vegetables daily, which is the main dietary source of vita-min B12
e. Certain antibiotics and anticonvulsant medication increase the risk of vitamin B12 deficiency

Answer 1

ANS: A, C, E
A normal age-related change in the stomach is the production of less gastric acid, which makes vitamin B12 absorption less efficient. For most older adults, intake of vitamin B12 is usually ade-quate. Use of proton pump inhibitors and H2 receptor blockers for more than a year can lead to lower serum vitamin B12 levels by impairing absorption of the vitamin from food. Certain antibi-otics and anticonvulsants can also increase the risk of vitamin B12 deficiency. While it is true that older adults may be outdoors less, the major source of vitamin B12 is not sunlight. While it is also true that older adults may not consume five servings of fruits and vegetables daily, fruit and vegetables are the major sources of vitamins A, C, and E and potassium.