title: Cobalamin and folate status in infants and young children in a low-to-middle income community in India.
abstract: BACKGROUND
  Population-based data on the prevalence of cobalamin and folate deficiency in India are lacking.
  
  
  OBJECTIVE
  The objective was to measure the prevalence of cobalamin and folate deficiency among children aged 6-30 mo residing in a low-to-middle income community in North India.
  
  
  METHODS
  Children aged 6-30 mo (n = 2482) were identified through a community survey in a low-to-middle socioeconomic area in New Delhi, India. Non-fasting venous blood samples were collected before enrollment in another trial.
  
  
  RESULTS
  The median (interquartile range; IQR) cobalamin concentration in 6-11-mo-old children was substantially lower in breastfed (183; 120-263 pmol/L) than in nonbreastfed (334; 235-463 pmol/L) children. Cobalamin concentrations decreased progressively with increasing age in the nonbreastfed children. Median (IQR) plasma folate concentrations in the 6-11-mo-old group were higher in breastfed (20.3; 11.7-34.4 nmol/L) than in nonbreastfed (5.3; 3.4-7.7 nmol/L) children (P < 0.001). Folate concentrations decreased with increasing age in the breastfed children. In the nonbreastfed children, folate concentrations increased with increasing age. Low concentrations of plasma cobalamin (<150 pmol/L) were detected in 36% of breastfed and 9% of nonbreastfed children (P < 0.001). The proportions of children with plasma folate concentrations <5 nmol/L in these 2 subgroups were 6% and 33%, respectively (P < 0.001).
  
  
  CONCLUSIONS
  In north Indian preschool children, cobalamin and folate concentrations were commonly low and were associated with elevated total homocysteine and methylmalonic acid concentrations. Because low cobalamin and folate concentrations have functional consequences, population-based measures for improving cobalamin and folate concentrations need to be seriously considered.
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sunita
authors.initials: S
authors.lastname: Taneja
authors.forename: Nita
authors.initials: N
authors.lastname: Bhandari
authors.forename: Tor A
authors.initials: TA
authors.lastname: Strand
authors.forename: Halvor
authors.initials: H
authors.lastname: Sommerfelt
authors.forename: Helga
authors.initials: H
authors.lastname: Refsum
authors.forename: Per M
authors.initials: PM
authors.lastname: Ueland
authors.forename: Jörn
authors.initials: J
authors.lastname: Schneede
authors.forename: Rajiv
authors.initials: R
authors.lastname: Bahl
authors.forename: Maharaj Kishan
authors.initials: MK
authors.lastname: Bhan
mesh_terms: D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000097:blood; D005494:Folic Acid Deficiency / Q000453:epidemiology*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood; D009752:Nutritional Status; D012959:Socioeconomic Factors; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000453:epidemiology*
chemical_list: D006710:Homocysteine; D008764:Methylmalonic Acid; D005492:Folic Acid; D014805:Vitamin B 12