Cobalamin and folate status in infants and young children in a low-to-middle income community in India.
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.
Taneja
Sunita
S
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Bhandari
Nita
N
Strand
Tor A
TA
Sommerfelt
Halvor
H
Refsum
Helga
H
Ueland
Per M
PM
Schneede
Jörn
J
Bahl
Rajiv
R
Bhan
Maharaj Kishan
MK
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*
D006710:Homocysteine; D008764:Methylmalonic Acid; D005492:Folic Acid; D014805:Vitamin B 12