Abstract
BACKGROUND AND AIM: Deficiencies in folate and vitamin B12 are widespread in Bangladesh. These micronutrients are essential for the synthesis of neurotransmitters and myelin, and for one-carbon metabolism, which supports synthesis of proteins and nucleotides during periods of rapid growth. Micronutrient deficiency has been associated with poorer cognitive function in adults and children, but this association has not been fully characterized in adolescents. This study aims to examine associations between the predictors of red blood cell (RBC) folate, plasma folate, and plasma B12, and the outcome of cognitive function in Bangladeshi adolescents. METHODS: The Metals, Arsenic, & Nutrition in Adolescents Study (MANAS) is a cross-sectional study of 572 Bangladeshi adolescents aged 14-16 years. Venous blood was collected for measurement of RBC folate, plasma folate, and plasma B12. Participants completed the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and an abbreviated Cambridge Neuropsychological Test Automated Battery (CANTAB), with subtests assessing cognitive function. Linear models were employed to assess associations. RESULTS:For CANTAB outcome measures, positive associations were observed between plasma folate and Spatial Recognition Memory (SRM) (β=1.32, p0.05), and between B12 and Spatial Working Memory (SWM) (β=2.10, p0.05). No significant associations were observed between folate and B12 nutritional predictors and the WISC-IV outcome measures. CONCLUSIONS:The positive associations between folate and SRM and between B12 and SWM are consistent with previous findings linking folate and B12 deficiencies to memory deficits. Mild SRM impairments may include difficulty noticing that an object has been moved, whereas mild SWM impairments might include difficulty recalling where an object was placed. This research suggests that further investigation into the associations between folate and B12 nutritional status and measures of cognitive function in adolescents is needed. Additionally, these findings suggest that nutritional interventions involving B12 and folate supplementation may have a positive impact on overall adolescent health and cognition. KEYWORDS: Micronutrient deficiencies, Cognitive function, Neurotoxicology, Adolescent cognitive neurotoxicology, Folate and B12 deficiency, Nutritional status
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