Hostname: page-component-699b5d5946-zvthx Total loading time: 0 Render date: 2026-03-04T03:23:15.750Z Has data issue: false hasContentIssue false
Accepted manuscript

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

Published online by Cambridge University Press:  13 February 2026

Thomas J O’Leary*
Affiliation:
Army Health and Performance Research, Army Headquarters, Andover, United Kingdom Division of Surgery and Interventional Science, UCL, London, UK
Hannah L Waters
Affiliation:
Army Health and Performance Research, Army Headquarters, Andover, United Kingdom
Charlotte V Coombs
Affiliation:
Army Health and Performance Research, Army Headquarters, Andover, United Kingdom
Sarah Jackson
Affiliation:
Army Health and Performance Research, Army Headquarters, Andover, United Kingdom
Rachel M Izard
Affiliation:
Defence Science and Technology, Ministry of Defence, Porton Down, United Kingdom
Neil P Walsh
Affiliation:
Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
Alexander T Carswell
Affiliation:
Norwich Medical School, University of East Anglia, Norwich, United Kingdom
Samuel J Oliver
Affiliation:
Institute for Applied Human Physiology, College of Medicine and Health, Bangor University, Bangor, United Kingdom
Jonathan CY Tang
Affiliation:
Norwich Medical School, University of East Anglia, Norwich, United Kingdom Norfolk and Norwich University Hospital, Norwich, United Kingdom
William D Fraser
Affiliation:
Norwich Medical School, University of East Anglia, Norwich, United Kingdom Norfolk and Norwich University Hospital, Norwich, United Kingdom
Julie P Greeves
Affiliation:
Army Health and Performance Research, Army Headquarters, Andover, United Kingdom Division of Surgery and Interventional Science, UCL, London, UK Norwich Medical School, University of East Anglia, Norwich, United Kingdom
*
Corresponding author: Thomas J O’Leary PhD, Army Health and Performance Research, Army Headquarters, Andover, Hampshire, SP11 8HT, United Kingdom. Email: thomas.oleary100@mod.gov.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the 'Save PDF' action button.

This 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), haemoglobin (−0.7 [−0.9, −0.5] g∙dL-1, p < 0.001), and red blood cell (RBC) 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, haemoglobin, or RBC 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.

Information

Type
Research Article
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society

Footnotes

deceased