Folate and Vitamin B₁₂Status in Latin America and the Caribbean

Abstract

Background: The current magnitude of folate and vitamin B 12 deficiency in Latin America and the Caribbean is uncertain. Objective: To summarize data on plasma or serum vitamin B 12 and folate concentrations in Latin America and the Caribbean reported since 1990, a period that covers the era before and after the introduction of folic acid fortification. Methods: A systematic review was conducted in 2012 and updated in 2014. Studies and surveys using biochemical biomarkers and conducted in apparently healthy individuals were identified. Results: Folate deficiency in Latin America and the Caribbean appears not to be a public health problem (prevalence < 5%) after the introduction of folic acid fortification. However, there is some indication that high rates of low or marginal vitamin B 12 status remain in most locations and across population groups. Conclusions: Adding vitamin B 12 as a fortificant with folic acid may be the best strategy in areas where vitamin B 12 deficiency is an established concern.

Folate Deficiency Is Prevalent in Women of Childbearing Age in Belize and Is Negatively Affected by Coexisting Vitamin B-12 Deficiency: Belize National Micronutrient Survey 2011

“…Our study also found that the prevalence of vitamin B-12 deficiency and marginally deficient status (17.2%, and 33.2%, respectively) were of public health concern, although similar to those reported in Guatemala and other Latin American countries (35, 36, 40). Furthermore, vitamin B-12 concentrations in our study were lower than those reported from Guatemala (233 compared with 341 pmol/L).…”

Valores séricos de ácido fólico en un grupo de pacientes mayores de 18 años de edad en un hospital de alta complejidad

“…Así mismo, las más elevadas en hombres se detectan en mayores de 55 años, lo que podría explicarse por algunas condiciones crónicas (como falla renal), por ser personas que reciben suplemento vitamínico o por alguna relación entre las cantidades detectadas y la fortificación de ciertos alimentos de consumo masivo en el país [11], tal como sucede en algunos Estados, donde el ácido fólico está elevado de forma secundaria a la fortificación de alimentos [25].…”

“…Se estima un déficit nutricional de ácido fólico junto con otras vitaminas del complejo B [11]; sin embargo, no se han medido sus concentraciones en muestras poblacionales o en grupos de mujeres no embarazadas. Así mismo, aunque se ha explorado la relación entre el ácido fólico, el metabolismo de la homocisteína, la vitamina B12 y el riesgo cardiovascular en diversas poblaciones [12,13], no se han determinado las concentraciones de este ácido en muestras poblacionales masculinas del país.…”

Should vitamin B12 status be considered in assessing risk of neural tube defects?

“…For example, in South and Central America, national rates of deficiency plus marginal deficiency (i.e., serum vitamin B 12 < 221 pmol/L) among women of reproductive age vary between 3% in Costa Rica, 8% in Mexico, 12% in Argentina, and 37% in Colombia. 89 In Belize, the national prevalence of deficiency using the same upper cutoff was 50% in a recent study, 59 Venezuela, vitamin B 12 deficiency was reported to be 11% nationwide. 90 In India, Nepal, and Bhutan, the prevalence of vitamin B 12 deficiency is reported to be extremely high 76,[91][92][93][94] and was more than 80% in one study of Indian adolescents in a low-income area.…”

“…A comprehensive review of the global prevalence of vitamin B 12 deficiency is not intended here, but some examples are presented to give a sense of the problem to be addressed. For example, in South and Central America, national rates of deficiency plus marginal deficiency (i.e., serum vitamin B 12 < 221 pmol/L) among women of reproductive age vary between 3% in Costa Rica, 8% in Mexico, 12% in Argentina, and 37% in Colombia . In Belize, the national prevalence of deficiency using the same upper cutoff was 50% in a recent study, and, in Venezuela, vitamin B 12 deficiency was reported to be 11% nationwide .…”