Abstract
Many children in low- and middle-income countries may have inadequate intake of vitamin B12 and folate; data confirming these inadequacies are limited. We used biochemical, demographic, behavioral and anthropometric data to describe the folate and vitamin B12 concentrations among six- to 23-month-old Nepalese children. Vitamin B12 (serum B12 < 150 pmol/L) and folate deficiencies (red blood cell (RBC) folate < 226.5 nmol/L) were assessed. We used logistic regression to identify predictors of vitamin B12 deficiency. The vitamin B12 geometric mean was 186 pmol/L; 30.2% of children were deficient. The mean RBC folate concentration was 13,612 nmol/L; there was no deficiency. Factors associated with vitamin B12 deficiency included: (a) age six to 11 months (adjusted odds ratio (aOR) 1.51; 95% confidence interval (CI): 1.18, 1.92) or 12–17 months (aOR 1.38; 95% CI: 1.10, 1.72) compared to 18–23 months; (b) being stunted (aOR 1.24; 95% CI: 1.03, 1.50) compared to not being stunted; (c) and not eating animal-source foods (aOR 1.85; 95% CI: 1.42, 2.41) compared to eating animal-source foods the previous day. There was a high prevalence of vitamin B12 deficiency, but no folate deficiency. Improving early feeding practices, including the consumption of rich sources of vitamin B12, such as animal-source foods and fortified foods, may help decrease deficiency.
Highlights
Folate and vitamin B12 are essential micronutrients which are critical especially during infancy and early childhood as these are periods of rapid growth, development, and increased demand
It may be contributing to the high prevalence of anemia found in these children, there were no significant differences in vitamin B12 deficiency by anemia status
B12 deficiency has been reported among breastfed six- 30-month-old Indian children (36% deficiency defined as vitamin B12 < 150 pmol/L) [26] and among one- to six-year-old Mexican children
Summary
Folate and vitamin B12 are essential micronutrients which are critical especially during infancy and early childhood as these are periods of rapid growth, development, and increased demand. Deficiency of folate and vitamin B12 can result in megaloblastic anemia, poor growth, and increased infections [1,2,3,4]; deficiency of vitamin B12 can potentially cause irreversible neurologic damage to the developing brain [4,5]. A mother’s strict vegetarian diet may be associated with vitamin B12 deficiency both in the mother and in the newborn, because of the increased demand during pregnancy and lactation [7].
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