title: Vitamin B-12, folic acid, and growth in 6- to 30-month-old children: a randomized controlled trial.
abstract: BACKGROUND
  Folate and vitamin B-12 are important for growth. Many children in low- and middle-income countries have inadequate intakes of these nutrients.
  
  
  METHODS
  We undertook a randomized, placebo controlled double-blind trial in 1000 North Indian children, 6 to 35 months of age, providing twice the recommended daily allowance of folic acid and/or vitamin B-12, or placebo, daily for 6 months. By using a factorial design, we allocated children in a 1:1:1:1 ratio in blocks of 16. We measured the effect of giving vitamin B-12, folic acid, or the combination of both on linear and ponderal growth. We also identified predictors for growth in multiple linear regression models and effect modifiers for the effect of folic acid or vitamin B-12 supplementation on growth.
  
  
  RESULTS
  The overall effect of either of the vitamins was significant only for weight; children who received vitamin B-12 increased their mean weight-for-age z scores by 0.07 (95% confidence interval: 0.01 to 0.13). Weight-for-age z scores and height-for-age z scores increased significantly after vitamin B-12 supplementation in wasted, underweight, and stunted children. These subgrouping variables significantly modified the effect of vitamin B-12 on growth. Vitamin B-12 status at baseline predicted linear and ponderal growth in children not receiving vitamin B-12 supplements but not in those who did (P-interaction < .001).
  
  
  CONCLUSIONS
  We provide evidence that poor vitamin B-12 status contributes to poor growth. We recommend studies with larger doses and longer follow-up to confirm our findings.
authors: Division for Medical Services, Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway;
authors: Tor A
authors: TA
authors: Strand
authors: Society for Applied Studies, New Delhi, India; sunita.taneja@sas.org.in.
authors: Sunita
authors: S
authors: Taneja
authors: Society for Essential Health Action and Training, New Delhi, India;
authors: Tivendra
authors: T
authors: Kumar
authors: Centre for International Health, University of Bergen, Bergen, Norway;
authors: Mari S
authors: MS
authors: Manger
authors: Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Department of Pharmacology, University of Oxford, Oxford, United Kingdom; and.
authors: Helga
authors: H
authors: Refsum
authors: Diabetes Unit, King Edward Memorial Hospital, Pune, Maharashtra, India.
authors: Chittaranjan S
authors: CS
authors: Yajnik
authors: Society for Applied Studies, New Delhi, India;
authors: Nita
authors: N
authors: Bhandari
mesh_terms: D001827:Body Height / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects*; D002675:Child, Preschool; D003906:Developing Countries; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D007194:India; D007223:Infant; D016014:Linear Models; D008297:Male; D014805:Vitamin B 12 / Q000008:administration & dosage*
chemical_list: D005492:Folic Acid; D014805:Vitamin B 12
keywords: India; children; folate; growth; homocysteine; intervention; vitamin B-12