Folic acid and vitamin B-12 supplementation and common infections in 6-30-mo-old children in India: a randomized placebo-controlled trial

Taneja, Sunita; Strand, Tor A.; Kumar, Tivendra; Mahesh, Madhu; Mohan, Sanjana Brahmawar; Manger, Mari S; Refsum, Helga; Yajnik, Chittaranjan S; Bhandari, Nita

doi:10.3945/ajcn.113.059592

Cited by 51 publications

(60 citation statements)

References 26 publications

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“…The present findings come from the baseline data of a randomized double-blind, placebo-controlled preventive field trial with a factorial design that evaluated the effect of supplementation with folic acid, vitamin B 12 , or both on childhood infections. The results of the study have been published elsewhere [17].…”

Section: Study Site and Participantsmentioning

confidence: 99%

Prevalence and predictors of anemia in a population of North Indian children

et al. 2014

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Section: Study Site and Participantsmentioning

confidence: 99%

Prevalence and predictors of anemia in a population of North Indian children

et al. 2014

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“…Additional details about the intervention, methods, and results on common infections are provided in the publication reporting the primary objective of the study. 8 …”

Section: Randomization and Maskingmentioning

confidence: 99%

“…Details of the study setting and the effect of the intervention on morbidity has been published previously. 8 A door-to-door survey was conducted to identify children of either gender. Families consenting and not moving away over the next 6 months were considered for enrollment.…”

Section: Study Populationmentioning

confidence: 99%

Vitamin B-12, Folic Acid, and Growth in 6- to 30-Month-Old Children: A Randomized Controlled Trial

et al. 2015

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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. WHAT'S KNOWN ON THIS SUBJECT:Micronutrient deficiencies, including deficiencies of vitamin B-12 and folate, are common worldwide and may be a contributing factor to the estimated 165 million stunted children. WHAT THIS STUDY ADDS:Routine supplementation of vitamin B-12 improved linear and ponderal growth in subgroups of young Indian children. We provide evidence that vitamin B-12 deficiency is a contributor to poor growth in low-and middle-income countries.

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“…Details of the population have been described previously [16]. This randomized double-blind placebo-controlled trial with a factorial design enrolled 1000 children, and evaluated the impact of supplementation with folic acid, vitamin B12, or both on childhood infections [16].…”

Section: Subjectmentioning

confidence: 99%

“…The main outcomes were the effect on the risk of acute lower respiratory infections (ALRI), clinical pneumonia and diarrhea. Enrolled participants were followed biweekly for respiratory and diarrheal morbidity [16]. Using data from this study we examined the extent to which vitamin-D deficiency (<10 ng/ml) at baseline predicted these outcomes during the 6 months follow-up period.…”

Section: Introductionmentioning

confidence: 99%

Vitamin-D Deficiency Predicts Infections in Young North Indian Children: A Secondary Data Analysis

Chowdhury

Taneja

Bhandari

et al. 2016

Preprint

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Recent studies have demonstrated a relationship between poor vitamin D status and respiratory infections and diarrhea among young children. Acute lower respiratory infections (ALRI) and diarrhea are among the two most important causes of death in under-5 children. In this analysis, we examine the extent to which vitamin-D deficiency (<10 ng/ml) predicts these outcomes using data from a randomized controlled trial (RCT) of daily folic acid and/ or vitamin B12 supplementation for six months in 6 to 30 months old children conducted in Delhi, India. Of the 960 subjects who had vitamin-D concentrations measured, 331(34.5%) were vitamin-D deficient. We found, after controlling for relevant potential confounders (age, sex, breastfeeding status, wasting, stunting, underweight, anemia status at base line and season), the risk of ALRI was significantly higher among vitamin-D deficient (OR 1.26; 95% CI: 1.03 to 1.55) compared to vitamin-D-replete children in the six months follow-up period. Vitamin-D status was not significantly associated with episodes of diarrhea and clinical pneumonia. The extent of causal relationship of vitamin-D status and ALRI needs to be explored in further studies.

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Folic acid and vitamin B-12 supplementation and common infections in 6-30-mo-old children in India: a randomized placebo-controlled trial

Cited by 51 publications

References 26 publications

Prevalence and predictors of anemia in a population of North Indian children

Prevalence and predictors of anemia in a population of North Indian children

Vitamin B-12, Folic Acid, and Growth in 6- to 30-Month-Old Children: A Randomized Controlled Trial

Vitamin-D Deficiency Predicts Infections in Young North Indian Children: A Secondary Data Analysis

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