Vit B12 Research Articles

Nutritional Status for less‐explored micronutrients in underprivileged Guatemalan preschool children: Vitamin B12

BackgroundIron, vitamin A, iodine, zinc and folate are prominent on the public health nutrition agenda. Marginal or deficient vit B12 status was reported in 68% of peri‐urban Guatemalan lactating mothers and 49% of the infants.ObjectiveTo assess vit B12 status in a convenience sample of 3–6 y/o preschoolers in disadvantaged urban and rural communities receiving subsidized meals.Methods104 serum samples were obtained from boys and girls in 3 sites in the Central Highlands of Guatemala, 47 from 2 urban (U) centers and 57 from a rural (R) center. Circulating levels of vit B12 were measured by a chemiluminescent enzyme immunoassay method (Immulite 1000, Siemens, IL). Respective cutoff criteria for deficient and marginal for vit B12 were <200 pg/mL and 200–300 ng/mL. The contribution of dietary vit B12 from center menus was estimated.ResultsOverall mean vit B12 concentration (pg/mL) was 459±271 (median: 357): 583±294 (median: 527)(U) and 339±181 (median: 289)(R) (p<0.001). Globally, 8.6% had deficient and 26.9% had marginal values, for a 35.6% subnormal prevalence. Deficient plus marginal rates by setting were 10.6% (U) and 56.0% (R), respectively, with all 9 deficient subjects of rural origin. The 1 or 2 meals offered by the centers provided averages of 0.15 – 1.50 μg vit B12/d.ConclusionSlightly over one‐third of preschoolers had low vit B12 status, with a marked excess of low status in the rural setting.

Vit B12 treatment

To the Editor I would like to make few comments about the treatment of a 9-month-old breast-fed infant with vitamin B12 deficiency reported by Quentin et al in the recent issue of the journal [1]. His anemia (7.4 g/dl), low blood vitamin B12 level (63 pg/ml), white blood cell count (1,300/μl), elevated serum homocysteine, and methylmalonic acid levels were all compatible with the diagnosis. Since he did not have intrinsic factor deficiency, he responded promptly to 1 mg/d of vit B12 in 4 days by reticulocytosis and elevation of serum B12 level (1,416 pg/ml). But the mother seems to be neglected. If vit B12 were also given to the mother, the infant would not require any more B12 treatment because breast milk would supply the requirement. With this approach two birds would be killed with one stone. Actually the infant was given extra vitamin B12. Since its half-life is over 350 days, the daily requirement is about 1 μg. Therefore he was overtreated, I believe. In addition, in Table 1 “Inherited error of vit B12 metabolism” and “Deficiency of cobalamine metabolism” are mentioned. Could the authors please explain the difference between them?

Reply to the correspondence letter by S. Özsoylu ‘Vit B12 treatment’

I would like to respond to the letter of the editor of Professor Sinasi Ozsoylu. Both mother and child were treated since the two of them were deficient. The mother received an oral supplement of 1,000 mcg/day over 5 days. Few days after supplementation of vitamin B12, food diversification of the boy was successfully started so he did not receive exclusive breastfeeding any longer. To make sure that his supplies were sufficient he received oral supplementation. The boy was not overtreated as shown by close biological and clinical monitoring. I do not understand why you think the boy received treatment for 350 days, since this is not specified in our article. Supplementation started at the age of 9 months. After 6 weeks of treatment, blood counts and immunoglobin G levels were normal. Bone marrow examination still showed mild dyserythropoiesis, but no more sideroblasts. Treatment resulted in a rapid improvement in weight gain. Neurological examination normalised within 3 weeks after the start of treatment. At this point oral substitution was switched to 1 mg per week. Presently, the boy is doing well with a monthly oral vitamin B12 dosage of 1 mg and iron supplements. Finally, I would like to specify the following terms used in Table 1. ‘Inherited error of vitamin B12 metabolism’ includes transcobalamin II deficiency and Imerslund–Grasbeck disease. ‘Deficiency of cobalamin metabolism’ includes CbIb deficiency, CbIG deficiency and cobalamin C deficiency.

Role of Homocysteine Measurement for Early Diagnosis of Vitamin B12 Deficiency in the First Days of Life

Background: Vitamin B12 (vit B12) deficiency is one of the major causes of megaloblastic anaemia and should be avoided as early as possible since a supplementation of mother and child can prevent neurological symptoms of the baby. Furthermore, the neurological symptoms of affected children are (partially) reversible. Elevated methylmalonic acid in urine and homocysteine (Hcy) in plasma are sensitive indicators. In the State of Qatar, extended newborn screening of classical homocystinuria was realized for all 73,994 neonates in last 4.5 years. Newborns with slightly elevated Hcy levels in dried blood spots (DBS) were followed up with regard to possible vit B12 deficiency. In addition, the propionylcarnitine (C3) levels were analysed. Methods: Determination of Hcy in DBS was performed using liquid chromatography electrospray tandem mass spectrometry. C3 levels were obtained from general newborn screening. The vit B12 levels in plasma were analysed spectrophotometrically. Results: In all, 117 cases with mildly elevated Hcy levels were found. 65 were diagnosed with vit B12 deficiency. Only 9 of these 65 newborns had abnormal C3 levels. No correlation was found in this group between Hcy and C3 levels. Conclusion: Extended neonatal screening of Hcy is a useful tool for early diagnosis and treatment of vit B12 deficiency.

Unusual Cause of Childhood Anemia: Imerslund Grasbeck Syndrome

Imerslund Grasbeck syndrome (IGS) is a rare autosomal recessive childhood disorder characterized by selective Vitamin (vit) B 12 malabsorption with asymptomatic proteinuria without any structural renal pathology. The patients stay healthy for decades with life-long parenteral vit B12. We report a case of young female who presented with pancytopenia and proteinuria, evaluated in local hospitals as chronic hemolytic anemia (autoimmune cause), finally diagnosed as IGS on complete evaluation. She was treated with injectable vit B12 (1000 μg cyanocobalalmin) and showed drastic recovery. IGS should be considered in patients with megaloblastic anemia not responding to oral vit B12 and associated proteinuria.

Clinical observation on acupuncture treatment of alopecia areata

To observe the clinical effects of acupuncture therapy for alopecia areata. Seventy-eight patients were randomly divided into two groups. 43 cases in the treatment group were treated by acupuncture and pricking of plum-blossom needle therapy. 35 cases in the control group were treated with oral administration of Cystine tablets, Vit B1, and topical wash with Minoxidil Solution. The therapeutic effects were assessed after 4-month treatment in the two groups. The curative effect and total effective rate were 58.1% and 97.7% in the treatment group, and 34.3% and 77.1% in the control group respectively, with statistical differences in the curative rate and total effective rate between the two groups (both P<0.05). Acupuncture is better than medications in the treatment of alopecia areata.

Vitamin B12 Screening in Cervical Spine Surgery Patients

Introduction Vitamin B12 is very vital for the nervous system. Its deficiency can manifest with neurological symptoms like pain and paresthesias and in severe cases may cause not completely restorable neurological damage, especially in elderly patients. Methods The charts of 702 patients who underwent cervical spine surgery retrospectively reviewed and data collected . All patients were preoperatively seen by an internist who ordered Vit B12 levels for some of them. We used two thresholds for the diagnosis of vitamin B12 deficiency, 200 and 300 pg/mL as recommended by Yao et al. 1992. Data were also collected on gender, payor status, myelopathy, hemoglobin level, corpuscular parameters and glycosylated hemoglobin level (HbA1c). Vitamin B12 levels were compared between patients with HbA1c levels ≥ 6.1% and <6.1%. Differences between patients ≥ and < than the median age were studied. The median age of the patient cohort was 52. Results Hemoglobin level was recorded for 659 patients. Vit B12 levels were ordered for 291 patients only. Overall, 13.7% had decreased hemoglobin level (anemia), 30.2% had decreased Vit B12 levels by the 300 threshold, 6.9% had decreased Vit B12 levels by the 200 threshold, 6.3% decreased MCV (microcytosis), and 2.8% increased MCV (macrocytosis). Only four patients (0.7%), of whom older than 52, had decreased hemoglobin level and increased MCV (macrocytic anemia) and one patient (0.4%), who was also older than 52, had decreased hemoglobin level, increased MCV and Vit B12 level < 200 pg/mL (macrocytic anemia duo to Vit B12 deficiency). Dividing the patient sample into three age groups, <40, 40-59, and ≥ 60 years, we investigated the trend of cobalamin deficiency by age and found an increase in cobalamin deficiency after 40 from 0% to 7.4% (200 threshold). Uninsured patients (25%) using the 200 pg/mL threshold and workers’ compensation (54.5%) and uninsured patients (50.0%) had the highest rate of Vit B12 deficiency using the 300 pg/mL threshold. The few patients with macrocytic anemia (N=4) and macrocytic anemia due to Vit B12 deficiency (N=1) had health coverage. Conclusion Vit B12 deficiency in cervical spine surgery patients may not necessarily mean macrocytic anemia but may precede macrocytic anemia. Therefore, Vit B12 deficiency screening on the preoperative visit is warranted especially in uninsured or older patients or both. Preoperative treatment may be indicated and correlation with postoperative outcome is suggested for future research.

Pyridoxine mitigates cadmium induced hepatic cytotoxicity and oxidative stress

Therapeutic potential of pyridoxine (vit B6) was evaluated against cadmium induced hepatic cytotoxicity in culture and oxidative stress in rats. Nonmalignant “Chang” liver cell culture was exposed to Cd (cadmium chloride) that produced cytotoxicity in terms of increase in cell growth inhibition rate, alanine aminotransferase, lactate dehydrogenase and lipid peroxidation, which was significantly mitigated by pyridoxine in a concentration dependent manner. Acute exposure to Cd (6.5 mg/kg body weight; ip once only) produced a condition of hepatic oxidative stress by substantially increasing lipid peroxidation and oxidized glutathione level along with corresponding decrease in reduced glutathione and various antioxidant enzymes, i.e., superoxide dismutase, catalase, glutathione-S-transferase and glucose-6-phosphate dehydrogenase. Cadmium administration significantly increased the leakage of liver marker enzymes in serum, i.e., transaminases, alkaline phosphatase and lactate dehydrogenase. Therapy with pyridoxine after 3 h of Cd administration decreased the release of serum transaminases, alkaline phosphatase and lactate dehydrogenase towards control. Administration of pyridoxine inhibited lipid peroxidation and formation of oxidized glutathione, increased the reduced glutathione level and restored the activities of aforesaid antioxidant enzymes towards control. The observations clearly demonstrated that pyridoxine treatment mitigates cadmium induced hepatic cytotoxicity and oxidative stress and provides evidence that it may be used clinically against Cd-induced hepatic toxicity.

Altered nutrient status in alcohol‐exposed pregnant women

This ongoing collaborative study investigates the nutrient and oxidative stress status of alcohol‐exposed Ukrainian pregnant women and whether micronutrient supplementation with and without choline, a nutrient critical for brain development, will reduce Fetal Alcohol Spectrum Disorders in the offspring. Analysis to date of maternal baseline plasma samples shows that alcohol‐exposed women (N=49) had lower Zn and Cu concentrations, and Total Radical‐trapping Antioxidant Potential (TRAP) vs. controls (N=40). There were no differences in Fe, ferritin, Mg, Ca, or ceruloplasmin activity. Methyl‐donor nutrients (choline, betaine, DMG, folate, Vit B12, and homocysteine), Vit A, E and select carotenoids, and oxidative stress (TBARS, protein carbonyls) and inflammation (hsCRP) indices were similar. Absolute oz. of alcohol/drinking day during the 2 wks prior to interview was associated with higher Vit A and ferritin, and lower Vit B12. The low Zn, Cu and Vit B12 in ethanol‐exposed women may contribute to adverse fetal development. It has been reported that alcohol increases body Fe stores, which can lead to oxidative stress. In our study, alcohol intake was associated with increased ferritin in pregnant women, which, when coupled with lower TRAP, may increase oxidative stress‐induced teratogenesis. These data will be updated as sample size requirements are met.Supported by NIAAA‐U01‐AA014835‐05 and HD01743.

Nutritional Contributions of Pork to the Diets of the US Population

A typical 3‐oz serving of pork is an excellent source of protein, and a good or excellent source of several vitamins and minerals. Many cuts of pork, including several cuts of chops and ham, meet the USDA criteria for lean meat. Data from the 2003–06 NHANES were used to estimate pork consumption by the US population age 2 years and older and the nutritional contributions of pork to the diet. More than 50% of the US population reported eating pork, either alone or in a mixed dish. Processed pork was most commonly consumed, with 58% of the population consuming it, while 16% of the population reported eating fresh pork. Lean (fresh or processed) pork was consumed by 28% of the population. Two‐day mean intakes by consumers were 38 g for lean (fresh or processed) pork, 38 g for all fresh pork and 45 g for all processed pork. Analyses of usual intake (using C‐Side) of nutrients from pork indicate that pork provides on average 11 to 18% of the total daily intake of protein, thiamin, selenium, vit B6, vit B12, niacin, zinc and phosphorus on the days people consume pork. Analyses of 2‐day intake data show that lean pork cuts account for 10% of total protein and 3% of total energy, fat and saturated fat in the diets of lean pork consumers, along with 7 to 14% of consumers’ daily intake of phosphorus, zinc, selenium, thiamin, niacin and vit B6. These results indicate that pork is an important source of several key nutrients. Supported by the National Pork Board.

The effect of oral nutritional supplementation on selected pathology and anthropometric markers of health status in middle aged men

This study was aimed at determining whether treatment with nutritional supplementation would improve pathology measures of disease risk. A total of twenty (20) healthy males, 30-60 years of age, served as participants. Participants were randomly divided into an Active Group (AG) (n=10) and a Placebo Group (PG) (n=10). Participants took the treatment (with active or placebo ingredients) for 90 days. On day 1 and 90th day blood samples were collected and analysed for cardiovascular disease risk markers (HDL, LDL, Triglycerides, total cholesterol and C reactive protein). To evaluate renal function urea, electrolytes creatinine and g GFR were analysed. White cell count and differential count were used as indicators of immune function. Vit B12 and s-folate were also analysed. No significant differences were found between the pre-test and post-test readings in the PG, whilst the AG experienced significant differences between the pre- and posttest in sodium and s-folate readings. On sodium readings the AG presented more cases with significantly lower levels during the post-test whilst s-folate was statistically higher during the post-test. No significant changes were found in any of the other pathology disease markers. It can be concluded despite the significant improvement in folic acid and sodium level observed in the AG participants that the nutritional supplement rich in folic acid, Vit B6, Vit B1, Vit B12, zinc, calcium, amino acid, Vit E and Vit C used for a period of 90 days has no effect on selected pathology markers of health status in middle-aged sedentary men. Key words: Supplementation, groups, health status, sedentary, sodium, s-folate.

A strange case of normocytic anemia

This case-report underlines the difficulties of a correct diagnosis in a complex vitamin malnutrition that is seldom suspected in patients living in developed Countries with a good social and economic situation. A 79-year-old woman was admitted to hospital with progressive fatigue, dyspnea till orthopnea, pallor and lumbar pain. On physical examination the patient was awake, conscious and pale with severe dyspnea and the laboratory findings revealed severe anemia normochromic and normocytic; chest radiography shows cardiomegaly. An abdomen echography showed hepatomegaly and an increased gallbladder volume with multiple gallstones and “biliary mud”. The patients received infusion of 4 Units of blood and started terapy for secondary congestive heart failure. The third day the temperature increased till 39°C and the urine of the patient shown clear hematuria; considering the hypothesis of hemolytic anemia was started methylprednisolone EV. Blood analysis was made in order to clarify anemia etiology: low blood levels of Vit B12, hypersideremia and very low Unsatured Iron Binding Capacity. A further investigation revealed that her diet had exclusively consisted of potatoes and fresh cheese since years. We started therapy with VitB12 and Folate and the patient was discharge fourteen days after admission. We feel that the importance of this clinical case lies in the diagnostic investigation for the cause of anemia, often more difficult than generally perceived.

Nutritional care of the elite child and adolescent athlete: Part II: Special dietary issues and competition nutrition

This article (second of two parts) presents a review of literature and resources on special dietary issues and sport performance. Young athletes preparing for competition adopt various dietary plans. Those adopting a vegetarian diet should be screened for possible low energy and specific micronutrient (e.g Fe, Ca, vit B12) intakes which can be avoided with a well-balanced diet and appropriate supplementation. Vegetarianism has also been linked with disordered eating (DE). The prevalence of DE is rising amongst male athletes and black female athletes. Adolescent athletes are at great risk of developing DE due to dramatic life changes, increased vulnerability and low self-esteem during the adolescence period. Meal skipping, especially breakfast and unhealthy food choices are prominent in this group of athletes. Education and motivation regarding healthier and more nutrient dense food choices away from home is needed. Pre-event carbohydrate loading is not needed when an adequate carbohydrate-rich diet is followed. Low or high glycaemic index (GI) carbohydrate can be eaten pre-event. Fluids should be consumed regularly from one day pre-event to ensure euhydration. The ACSM recommends ingesting ~ 5-7ml.kg-1 slowly 4-hours pre-event. During long-term events as well as during the recovery period the ingestion of carbohydrate with high or medium GI at frequent intervals is promoted. To prevent voluntary dehydration regular ingestion of a flavoured carbohydrate-electrolyte drink is recommended at quantities individualized according to body weight losses surrounding the event.

Nutritional care of the elite child and adolescent athlete: Part II: Special dietary issues and competition nutrition

This article (second of two parts) presents a review of literature and resources on special dietary issues and sport performance. Young athletes preparing for competition adopt various dietary plans. Those adoptinga vegetarian diet should be screened for possible low energy and specific micronutrient (e.g Fe, Ca, vit B12) intakes which can be avoided with a well-balanced diet and appropriate supplementation. Vegetarianism has also been linked with disordered eating (DE). The prevalence of DE is rising amongst male athletes and black female athletes. Adolescent athletes are at great risk of developing DE due to dramatic life changes, increased vulnerability and low self-esteem during the adolescence period. Mealskipping, especially breakfast and unhealthy food choices are prominent in this group of athletes. Education and motivation regarding healthier and more nutrient dense food choices away from home is needed. Pre-event carbohydrate loading is not needed when an adequate carbohydrate-rich diet is followed. Low or high glycaemic index (GI) carbohydrate can be eaten pre-event. Fluids should be consumed regularly from one day pre-event to ensure euhydration. The ACSM recommends ingesting ~5-7ml.kg-1 slowly 4-hours pre-event. During long-term events as well as during the recovery period the ingestion of carbohydrate with high or medium GI at frequent intervals is promoted. To prevent voluntary dehydration regular ingestion of a flavoured carbohydrate-electrolyte drink is recommended at quantities individualized according to body weight losses surrounding the event.

Periodic fever responds to vitamin B12 treatment

Periodic fever of childhood is a group of diseases that cause repeated febrile illnesses with various associated symptoms. In our article, we present the case of a 6-year-old girl with unusual appearance of periodic fever syndrome. Our patient suffered from repeated episodes of high fever from the age of 2 years old. Each episode usually lasted 24-48 h, the interval between events was 1-3 weeks long. During high fever episodes the child usually felt well, without associated accompanying complaints. As a rule, the physical examination did not reveal any pathologic finding explaining the fever. During the 4 years of follow-up the patient sustained treatment attempts with prednisone for a number of months and half a year with colchicine without any response. We considered treatment with sublingual tablets of vitamin B12 (VIT B12). Beyond all expectation, we witnessed complete resolution of attacks during the first 2 months following treatment. After a long episode-free period, the parents withheld the treatment on their own accord, and in a short time the disease recurred. We advised to renew the treatment with VIT B12, and during approximately half year of follow-up there were no recurrences of periodic fever. we believe that our observation raises interest in systematic evaluation of the therapeutic role of VIT B12 as a treatment option for disorders of the periodic fever spectrum.

Vitamins B6 and B12 supplementation to prevent chemotherapy-induced neuropathy (CiN): Interim analysis of the taxane cohort

e20621 Background: Chemotherapy-induced neuropathy (CiN) is common with heavy metals, taxanes, and vinca alcaloids. Pyridoxine (Vit B6) is used for diabetic neuropathy and cyanocobalamine (Vit B12) is required for synthesis of myelin and maintenance of the integrity of neuronal tissue. We hypothesized that supplementing patients (pts) with these 2 vitamins will prevent CiN. There were 3 pt cohorts depending on the chemotherapy regimen. Pts receiving any taxane enrolled in the taxane cohort (N=46), pts receiving vincristine or vinblastine enrolled in the vinca cohort (N=7), and all other pts receiving a platinum enrolled in the heavy metal cohort (N=25). The taxane cohort is reported here. Methods: Pts starting treatment with a taxane were randomized to a 1/6 of 100% of the daily recommended dose of a multivitamin/day (placebo) versus the same plus Vit B6, 50 mg tid, and Vit B12, 1 mg q 3–4 weeks (MV+Vit), during 4 cycles of chemotherapy. No other supplements were allowed. Taxane Fact G and a formal neurologic examination were performed prior to, and after 2 &amp; 4 cycles of chemotherapy. Statistical methods were based on least squared means with ANCOVA and t-test (Cella, JCO, 2008). Results: To date, 46 pts treated with taxanes were randomized; 22 to placebo and 24 to MV+Vit. 13 and 16 pts completed 2 cycles and 8 and 6 pts completed 4 cycles, respectively. On the neuro examination, the only significant difference between placebo and MV+Vit was in the cold sensation (p=0.0097). The physical well being and the neuro modules of the Taxane Fact G significantly worsened after 4 cycles of chemotherapy in the placebo group (p=0.0289 and 0.0173, respectively), but this significant trend was not observed in the MV+Vit group (p=0.8318 and p=0.0866). The study will accrue 76 pts per cohort. Conclusions: The preliminary trends in this study suggest that vitamin supplementation with Vit B6 and B12 may reduce CiN during taxane-based chemotherapy. No significant financial relationships to disclose.

The development of geriatric nutritional risk Index (GNRI) for Korean elderly

This study was performed to identify and develop GNRI for Korean elderly. Based on literature review, factors for GNRI were identified and indices were assessed by a cross‐sectional survey. The survey involved elderly women (¡Ã 60, n=94) in Gwangju area, Korea. Socio‐demographics, lifestyle characteristics, health conditions, dietary intakes, anthropometric measures, and clinical biochemistry parameters were examined relation to nutritional risk index. The risk factors related to nutritional status were abdominal fat, RBC, HbA1c, HDL‐cholesterol, and ferritin using stepwise multiple linear regression. Based on literature review and data analyses, three NRIs were identified. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tends to be lower on aging (protein, folate, Vit B12). (Funded by the Korea Research Foundation)

Relationship of dietary micronutrient intake with fasting plasma glucose and HbA1c: DIALBEST Trial Preliminary Results

The objective of this study was to examine the relationship of dietary micronutrient intake with HbA1c and fasting plasma glucose (FPG) in Latino patients with type 2 diabetes in total sample (TS) versus plausible reporters (PR). Demographic information and one 24hr dietary recall was gathered for 159 patients =21 yrs, HbA1c =7, residing in Hartford county (M=25%; F=75%). Participants with reported energy intake (EI) within 1 SD of estimated energy requirement (EER) were called PR; others were implausible reporters (IR). Means for TS; age=56 yrs, BMI=34 kg/m², HbA1c=9.6%, FPG=10.6 mmol/dl (190 mg/dl); were similar to means for PR; age=56 yrs, BMI=34 kg/m², HbA1c=9.5%, FPG=10.2 mmol/dl (183 mg/dl). Mean EITS=1467 kcal and mean EI/EERTS=0.74. Mean EIPR=1834 kcals and mean EI/EERPR was=0.92. FPG was positively correlated with HbA1c in TS (r=0.5) and PR (r=0.6) (p&lt;0.001). In TS, retinol, Vit D, Vit B6, thiamine, riboflavin, niacin, and folate intake were associated with FPG (r = 0.2 to 0.3, p&lt;0.01). In PR, retinol (r = ‐0.03), Mg (r = 0.03) and Vit K (r = 0.03) were associated with FPG (p&lt;0.05). Mean intakes; retinol=306 mcg, Vit K=38 mcg, Mg=277 mg; for PR were below DRI. Findings suggest caution in interpretation of nutrient‐biomarker associations when samples include IR. Funding: Connecticut NIH Export Center of Excellence for Eliminating Health Disparities among Latinos (NIH‐NCMHD grant # P20MD001765).

Volume and Variety of Beverages Consumed by Third‐and‐Fourth‐Grade Urban Schoolchildren in Quetzaltenango, Guatemala

BackgroundWithin the context of what children consume across their entire diet has come a concern for what is consumed in liquid form. Beverage consumption is relevant both to the adequacy of hydration and the genesis of overweight/obesity.AimTo describe the volume, variety and nutrient contribution of the beverages consumed by 3rd and 4th grade urban schoolchildren.MethodsWe conducted a cross‐sectional study in 449 students. Intake data comprised a single 24‐h pictorial self‐recording, complemented by a nutritionist to quantify portions. Nutritional values for foods and beverages were calculated using the INCAP and USDA food composition tables.Results54 beverage items were consumed across 12 categories of drinks. A mean of 1185±425 mL of beverages were drunk on the evaluated day; 21% of all dietary energy was consumed in liquid form. Plain water was the only non‐caloric beverage. Coffee contributed the largest volume (27%), followed by plain water (14%) and commercial fruit drink (7%). Carbonated soda drinks provided 10% of beverages energy, less than the 25% from grain‐based gruels. The contribution of micronutrients from beverages ranged from 7% for vit B2 to 55% for vit A.ConclusionsThe dominance of sweetened drinks in the beverage profile of these urban schoolchildren is motive for public health concern.Funded in part by Sight &amp; Life, Basel and Nestlé Waters Co, Paris

Pharmacological Dose of Vitamin B12 Is as Effective as Low-Dose Folinic Acid in Correcting Hyperhomocysteinemia of Hemodialysis Patients

Various regimens of folic acid-based and vitamin B12 (Vit B12) supplementations have been tried for lowering plasma homocysteine (Hcy) levels in uremic patients. However, the therapeutic potency of low-dose folic acid and Vit B12 alone is not properly understood. In this study, seventy-five patients on chronic hemodialysis (HD) therapy were randomized into three groups. The FNA group received intravenous (IV) supplementation with folinic acid 3 mg weekly; the Vit B12 group received IV supplementation with vitamin B12 1 mg weekly; and the combination group received IV supplementation with both agents weekly. Blood levels of Hcy, folic acid, and Vit B12 were measured monthly for three months. After three months of treatment, plasma levels of Hcy decreased significantly in all three groups when compared with their baselines (all p < 0.05). The final Hcy level was significantly lower in the combination group (11.5 ± 2.3 μmol/L) when compared with that of the FNA group (15.9 ± 5.6 μmol/L, p < 0.05) but not with the Vit B12 group (15.9 ± 11.6 μmol/L), although their baseline levels were similar. The percentage decreases of tHcy at the end of the treatment in the FNA group, Vit B12 group, and combination group were 16.4%, 29.3%, and 38.9% respectively. Our study showed that IV pharmacologic dose of Vit B12 alone is as effective as low-dose folic acid in correcting hyperhomocysteinemia in chronic HD patients, and combining both drugs in low doses may have added effects.