Contribution of food sources to the vitamin B₁₂ status of South Indian children from a birth cohort recruited in the city of Mysore

Abstract

Objective: There is evidence that subclinical vitamin B 12 (B 12 ) deficiency is common in India. Vegetarianism is prevalent and therefore meat consumption is low. Our objective was to explore the contribution of B 12 -source foods and maternal B 12 status during pregnancy to plasma B 12 concentrations. Design: Maternal plasma B 12 concentrations were measured during pregnancy. Children's dietary intakes and plasma B 12 concentrations were measured at age 9·5 years; B 12 and total energy intakes were calculated using food composition databases. We used linear regression to examine associations between maternal B 12 status and children's intakes of B 12 and B 12 -source foods, and children's plasma B 12 concentrations. Setting: South Indian city of Mysore and surrounding rural areas. Subjects: Children from the Mysore Parthenon Birth Cohort (n 512, 47·1 % male). Results: Three per cent of children were B 12 deficient (<150 pmol/l). A further 14 % had 'marginal' B 12 concentrations (150-221 pmol/l). Children's total daily B 12 intake and consumption frequencies of meat and fish, and micronutrient-enriched beverages were positively associated with plasma B 12 concentrations (P = 0·006, P = 0·01 and P = 0·04, respectively, adjusted for socio-economic indicators and maternal B 12 status). Maternal pregnancy plasma B 12 was associated with children's plasma B 12 concentrations, independent of current B 12 intakes (P < 0·001). Milk and curd (yoghurt) intakes were unrelated to B 12 status. Conclusions: Meat and fish are important B 12 sources in this population. Micronutrient-enriched beverages appear to be important sources in our cohort, but their high sugar content necessitates care in their recommendation. Improving maternal B 12 status in pregnancy may improve Indian children's status. KeywordsIndia Vitamin B 12 Child Source Vitamin B 12 (B 12 ), or cobalamin, plays a key role in cellular metabolism and DNA synthesis (1) . It is produced in nature only by microbial synthesis and animal products are the principal dietary sources for man. Uncooked plant-based foods contaminated with B 12 -synthesising bacteria, and fermented foods, may also be important sources (2,3) . In India, vegetarian diets have been associated with an increased risk of B 12 deficiency and a high prevalence of B 12 deficiency has been attributed to low meat intakes for religious or economic reasons (2,4) . Prevalence rates of deficiency of 47-71 % have been reported among adults (4)(5)(6)(7)(8)(9) . There is no standard definition of deficiency among children and there is a paucity of data on B 12 status among Indian children. However, recent studies using adult cut-offs have reported that 2-44 % of infants and school-age children are deficient (10)(11)(12)(13)(14) . A study in Pune, India showed normal B 12 absorption in the majority (90 %) of individuals studied (15) . Severe B 12 deficiency, as seen in pernicious anaemia, is characterised by megaloblastic anaemia and/or neurological dysfunction. However, subclinical cobalamin defici...

Prevalence of vitamin D and B12 deficiency in pregnant women in Jammu, India

“…Page 1247 positive association between B12 levels and their children sampled at 9.5 years of age 16. Similar findings were reported by Yusufji et al, from Vellore 17.…”

Prevalence of vitamin B12 deficiency in healthy Indian school‐going adolescents from rural and urban localities and its relationship with various anthropometric indices: a cross‐sectional study

“…There is a dearth of large-scale global studies (especially in Indian adolescents) regarding the relationship between serum B12 concentration with area of residence, anthropometric indices and dietary vitamin B12 intake (17)(18)(19) . In the present study, we hypothesise that serum vitamin B 12 concentration in Indian school-going adolescents belonging to rural and urban households might be governed by their respective nutritional status.…”

Vitamin B12 Intake From Animal Foods, Biomarkers, and Health Aspects

“…This study also studied individual animal food groups, and fully adjusted differences in plasma vitamin B12 for low vs. high consumers were significant only for meat, but not for dairy, fish, cows liver, and eggs (32). In line with these findings, a study conducted in India ( n = 512) also showed statistically significant positive associations of the meat and fish group with plasma vitamin B12 in fully adjusted models, but not for other animal products (34). Others observed inverse associations between vitamin B12 intake from milk with plasma Hcy, but not for vitamin B12 intake from red meat or cheese (35).…”

“…When considering different animal products within individual studies among children, differences in vitamin B12 concentrations were most pronounced when comparing high vs. low intake of dairy products, followed by meat and fish intake (32), and dairy products showed stronger correlations with vitamin B12 and holoTC concentrations compared to liver pate, meat and fish (33). In another study, only a combined group of meat and fish was associated with vitamin B12 concentrations, whereas the individual components fish, chicken, eggs, and dairy were not related to plasma vitamin B12 (34).…”

“…Dairy consumption seems to be the strongest determinant of vitamin B12 concentrations. However, when comparing the magnitude of the relation of dairy, meat, fish or egg consumption with vitamin B12 status it is essential to adjust statistical analyses for vitamin B12 intake from other animal food products, which was done in 5 studies (3, 34, 35, 43, 49). In addition, the specific individual food items representing dairy, meat, and fish consumption could not always be derived from the individual studies, which hampers direct comparison between studies.…”