title: High Prevalence of Vitamin B12 Deficiency and No Folate Deficiency in Young Children in Nepal.
abstract: Many children in low- and middle-income countries may have inadequate intake of vitamin B12 and folate; data confirming these inadequacies are limited. We used biochemical, demographic, behavioral and anthropometric data to describe the folate and vitamin B12 concentrations among six- to 23-month-old Nepalese children. Vitamin B12 (serum B12 < 150 pmol/L) and folate deficiencies (red blood cell (RBC) folate < 226.5 nmol/L) were assessed. We used logistic regression to identify predictors of vitamin B12 deficiency. The vitamin B12 geometric mean was 186 pmol/L; 30.2% of children were deficient. The mean RBC folate concentration was 13,612 nmol/L; there was no deficiency. Factors associated with vitamin B12 deficiency included: (a) age six to 11 months (adjusted odds ratio (aOR) 1.51; 95% confidence interval (CI): 1.18, 1.92) or 12-17 months (aOR 1.38; 95% CI: 1.10, 1.72) compared to 18-23 months; (b) being stunted (aOR 1.24; 95% CI: 1.03, 1.50) compared to not being stunted; (c) and not eating animal-source foods (aOR 1.85; 95% CI: 1.42, 2.41) compared to eating animal-source foods the previous day. There was a high prevalence of vitamin B12 deficiency, but no folate deficiency. Improving early feeding practices, including the consumption of rich sources of vitamin B12, such as animal-source foods and fortified foods, may help decrease deficiency.
authors.affiliation: Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA. uyt0@cdc.gov.|Division of Nutrition, Physical Activity & Obesity, Centers for Disease Control and Prevention, 4770, Buford Hwy, Chamblee, GA 30341, USA. uyt0@cdc.gov.
authors.forename: Bernadette N
authors.initials: BN
authors.lastname: Ng'eno
authors.affiliation: Division of Nutrition, Physical Activity & Obesity, Centers for Disease Control and Prevention, 4770, Buford Hwy, Chamblee, GA 30341, USA. hgk3@cdc.gov.
authors.forename: Cria G
authors.initials: CG
authors.lastname: Perrine
authors.affiliation: Division of Nutrition, Physical Activity & Obesity, Centers for Disease Control and Prevention, 4770, Buford Hwy, Chamblee, GA 30341, USA. rnw2@cdc.gov.
authors.forename: Ralph D
authors.initials: RD
authors.lastname: Whitehead
authors.affiliation: Child Health Division, Ministry of Health and Population, Kathmandu 44600, Nepal. subedi.giriraj@gmail.com.
authors.forename: Giri Raj
authors.initials: GR
authors.lastname: Subedi
authors.affiliation: Nutrition Section, UNICEF, UN House, Pulchowk, Lalitpur, P.O. Box 1187, Kathmandu 44600, Nepal. smebrahtu@outlook.com.
authors.forename: Saba
authors.initials: S
authors.lastname: Mebrahtu
authors.affiliation: Nutrition Section, UNICEF, UN House, Pulchowk, Lalitpur, P.O. Box 1187, Kathmandu 44600, Nepal. pdahal@unicef.org.
authors.forename: Pradiumna
authors.initials: P
authors.lastname: Dahal
authors.affiliation: Division of Nutrition, Physical Activity & Obesity, Centers for Disease Control and Prevention, 4770, Buford Hwy, Chamblee, GA 30341, USA. mjefferds@cdc.gov.
authors.forename: Maria Elena D
authors.initials: ME
authors.lastname: Jefferds
mesh_terms: D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D005492:Folic Acid / Q000097:blood*; D005494:Folic Acid Deficiency / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D014805:Vitamin B 12 / Q000097:blood*; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D005492:Folic Acid; D014805:Vitamin B 12
keywords: animal source foods; red blood cell folate; serum B12