Folate and B12 status in women during British Army basic training: a prospective cohort study exploring implications for endurance performance and bone density and metabolism

O’Leary, TJ, Waters, HL, Coombs, CV, Jackson, S, Izard, RM, Walsh, NP ORCID: 0000-0002-3681-6015, Carswell, AT, Oliver, SJ, Tang, JC, Fraser, WD and Greeves, JP (2026) Folate and B12 status in women during British Army basic training: a prospective cohort study exploring implications for endurance performance and bone density and metabolism. British Journal of Nutrition. ISSN 0007-1145

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Abstract

TThis study investigated changes in serum folate and B12, and associations with endurance performance and bone outcomes, in women during military training. Women (n 137) had serum folate and B12, haematological markers and endurance performance (2·4 km run) measured at the start (week 1) and end (week 13) of British Army basic training. Whole-body areal bone mineral density and markers of bone metabolism were measured at week 1. Training decreased serum folate (mean change (95 % CI), −2·3 (−3·0, −1·6) nmol ∙ l−1, P < 0·001), B12 (−16 (−32, 0) pmol ∙ l−1, P = 0·042), Hb (−0·7 (−0·9, −0·5) g ∙ dl−1, P < 0·001) and erythrocyte count (−0·2 (−0·3, −0·2) × 10^9 ∙ l−1, P < 0·001), but had no effect on mean corpuscular volume (P = 0·438) or erythrocyte distribution width (P = 0·088). There was no association between serum folate, serum B12, Hb or erythrocyte count with run time (P ≥ 0·518). Serum B12 was not associated with areal bone mineral density or bone metabolism at week 1 (P ≥ 0·152). Higher serum folate was associated with lower plasma c-telopeptide cross-links of type I collagen (standardised β (95 % CI) = −0·31 (−0·48, −0·15), P < 0·001), but not whole-body bone mineral density or plasma procollagen type I N-terminal propeptide (P ≥ 0·152). Serum folate and B12 decreased after military training in women, resulting in a high prevalence of folate deficiencies at the end of training. Low serum folate may contribute to increased bone resorption, the implications of which are unclear.

Item Type:	Article
Uncontrolled Keywords:	B vitamins; Bone; Endurance; Musculoskeletal injury; Nutrition; B vitamins; Bone; Endurance; Musculoskeletal injury; Nutrition; 32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; Dietary Supplements; Complementary and Integrative Health; Osteoporosis; 0702 Animal Production; 0908 Food Sciences; 1111 Nutrition and Dietetics; Nutrition & Dietetics; 3003 Animal production; 3006 Food sciences; 3210 Nutrition and dietetics
Subjects:	H Social Sciences > HQ The family. Marriage. Woman Q Science > QP Physiology
Divisions:	Sport and Exercise Sciences
Publisher:	Cambridge University Press
Date of acceptance:	30 January 2026
Date Deposited:	25 Mar 2026 10:28
Last Modified:	25 Mar 2026 10:28
DOI or ID number:	10.1017/S0007114526106515
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28287

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