title: Vitamin Status among Breastfed Infants in Bhaktapur, Nepal.
abstract: Vitamin deficiencies are known to be common among infants residing in low- and middle-income countries but relatively few studies have assessed several biochemical parameters simultaneously. The objective of the study was to describe the status of vitamins (A, D, E, B₆, B12 and folate) in breastfed infants. We measured the plasma concentrations of trans retinol, 25 hydroxy vitamin D, α-tocopherol, pyridoxal 5'-phosphate, cobalamin, folate, methylmalonic acid, homocysteine, hemoglobin and C-reactive protein from 467 randomly selected infants. One in five (22%) was deficient in at least one vitamin. Mean (SD) plasma folate concentration was 73 (35) nmol/L, and no infant in the sample was folate deficient. Vitamin B₆ deficiency and vitamin B12 deficiency was found in 22% and 17% of the infants, respectively. Elevated plasma methylmalonic acid or total homocysteine concentration was found in 82% and 62% of infants, respectively. Fifteen percent of infants were vitamin A deficient and 65% were marginally deficient in vitamin A. Fewer than 5% of infants had low plasma vitamin D concentration or vitamin E concentration (α-tocopherol <9.3 µmol/L). Our results illustrate the importance of continued supplementation campaigns and support the expansion of food fortification and dietary diversification programs that target children and women in Nepal.
authors.affiliation: Department of Child Health, Institute of Medicine, Tribhuvan University, Maharajgunj, P.O. Box 1524, Kathmandu 44600, Nepal. manjeswori@gmail.com.
authors.forename: Manjeswori
authors.initials: M
authors.lastname: Ulak
authors.affiliation: Centre for International Health, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway. ram.chandyo@uib.no.
authors.forename: Ram K
authors.initials: RK
authors.lastname: Chandyo
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. a.thorne-lyman@cgiar.org.|World Fish, Malaysia, GPO 10670, Bayan Lepas, Penang 11960, Malaysia. a.thorne-lyman@cgiar.org.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Thorne-Lyman
authors.affiliation: Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, 0130 Oslo, Norway. sigrun.henjum@hioa.no.
authors.forename: Sigrun
authors.initials: S
authors.lastname: Henjum
authors.affiliation: Section for Pharmacology, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway. per.ueland@ikb.uib.no.
authors.forename: Per M
authors.initials: PM
authors.lastname: Ueland
authors.affiliation: Bevital AS, c/o Helse Bergen, Jonas Lies veg 87, 5020 Bergen, Norway. bjorn.midttun@uib.no.
authors.forename: Øivind
authors.initials: Ø
authors.lastname: Midttun
authors.affiliation: Department of Child Health, Institute of Medicine, Tribhuvan University, Maharajgunj, P.O. Box 1524, Kathmandu 44600, Nepal. prakashsunder@hotmail.com.
authors.forename: Prakash S
authors.initials: PS
authors.lastname: Shrestha
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. mina@hsph.harvard.edu.|Department of Epidemiology and Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. mina@hsph.harvard.edu.
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
authors.affiliation: Department of Epidemiology and Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. lag111@mail.harvard.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Graybill
authors.affiliation: Centre for International Health, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway. tor.strand@uib.no.|Innlandet Hospital Trust, 2629 Lillehammer, Norway. tor.strand@uib.no.
authors.forename: Tor A
authors.initials: TA
authors.lastname: Strand
mesh_terms: D000328:Adult; D000367:Age Factors; D001361:Avitaminosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001942:Breast Feeding; D019587:Dietary Supplements; D005260:Female; D005527:Food, Fortified; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D009390:Nepal / Q000453:epidemiology; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D012959:Socioeconomic Factors; D014815:Vitamins / Q000008:administration & dosage / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014815:Vitamins
keywords: Nepal; homocysteine; infant; methylmalonic acid; vitamins