Low Maternal Vitamin B-12 Status Is Associated with Offspring Insulin Resistance Regardless of Antenatal Micronutrient Supplementation in Rural Nepal,

Stewart, Christine P; Christian, Parul; Schulze, Kerry; Arguello, Margia; LeClerq, Steven C.; Khatry, Subarna K.; West, Keith P.

doi:10.3945/jn.111.144717

Cited by 110 publications

(93 citation statements)

References 25 publications

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“…Data linking lower B 12 concentrations to greater adiposity, glucose intolerance and adult cognitive decline, and lower maternal B 12 status to insulin resistance and poorer cognitive function in children, come mainly from associations in observational studies (5,18,20,30,46) . However, supplementation with physiological doses of B 12 in a rural Indian population produced a marked fall in plasma homocysteine, suggesting functional benefit (47) .…”

Section: Implications Of the Dietary Findingsmentioning

confidence: 99%

“…Low status among Indian and Nepalese mothers during pregnancy was associated with increased insulin resistance in † Current address: Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK. their children (5,18) . B 12 deficiency is associated with raised plasma homocysteine levels, which is a risk factor for CVD (19) .…”

Section: Introductionmentioning

confidence: 99%

“…Recent research has related low B 12 status with an increased risk of adiposity and gestational diabetes in India (17) . Low status among Indian and Nepalese mothers during pregnancy was associated with increased insulin resistance in their children (5,18) . B 12 deficiency is associated with raised plasma homocysteine levels, which is a risk factor for CVD (19) .…”

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confidence: 99%

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

Christian

Krishnaveni

Kehoe

et al. 2014

Public Health Nutr.

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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...

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Section: Implications Of the Dietary Findingsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Christian

Krishnaveni

Kehoe

et al. 2014

Public Health Nutr.

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“…27 Finally, bariatric surgery may increase the risk of small for gestational age infants, perhaps in part due to nutrient deficiencies resulting from malabsoption after surgery. 28 The American College of Obstetrics and Gynecology Practice Bulletin and a clinical practice guideline produced by a consortium of the American Association for Clinical Endocrinologists, The Obesity Society, and the American Society for Metabolic and Bariatric Surgery recommend micronutrient screening in pregnant women after bariatric surgery.…”

Section: Figmentioning

confidence: 99%

Laboratory Testing for and Diagnosis of Nutritional Deficiencies in Pregnancy Before and After Bariatric Surgery

Gadgil

Chang

Richards

et al. 2014

Journal of Women's Health

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Objective: Bariatric surgery can reduce the risk of obesity-related complications of pregnancy, but may cause essential nutrient deficiencies. To assess adherence to laboratory testing guidelines, we examined frequency of testing for and diagnosis of deficiency during preconception and pregnancy using claims data in women with a delivery and bariatric surgery. Methods: Retrospective analysis of claims from seven Blue Cross Blue Shield plans between 2002 and 2008. We included women with a delivery and bariatric surgery within the study period. We used common procedural terminology (CPT) and ICD-9 codes to define laboratory testing and deficiencies for iron, folate, vitamin B12, vitamin D, and thiamine. Using Student's t-test and chi-square testing, we compared frequency of laboratory tests and diagnoses during 12 months preconception and 280 days of pregnancy between women with pregnancy before versus after surgery. We used multivariate logistic regression to evaluate for predictors of laboratory testing. Results: We identified 456 women with pregnancy after bariatric surgery and 338 before surgery. The frequency of testing for any deficiency was low (9%-51%), but higher in those with pregnancy after surgery ( p < 0.003). The most common deficiency was vitamin B12 (12%-13%) with pregnancy after surgery ( p < 0.006). Anemia and number of health provider visits were independent predictors of laboratory testing. Conclusion: Women with pregnancy after bariatric surgery were tested for and diagnosed with micronutrient deficiencies more frequently than those with pregnancy before surgery. However, most laboratory testing occurred in less than half the women and was triggered by anemia. Increased testing may help identify nutrient deficiencies and prevent consequences for maternal and child health.

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“…There is some evidence that high maternal folate during pregnancy is associated with higher adiposity in the child (Yajnik 2008, Krishnavenni 2014 and that low maternal B 12 status is associated with increased insulin resistance in the child (Yajnik et al, 2008, Stewart et al, 2011. This could be due to epigenetic programming or due to altered mitochondrial handling of fatty acids, promoting lipogenesis in the adipose tissue.…”

Section: Lipogenesis and Insulin Resistancementioning

confidence: 99%

Foetal Programming and Consequences

Yagnik¹

2016

Proceedings of the Indian National Science Academy

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The burden of chronic non-communicable diseases (NCDs) such as diabetes, obesity and cardiovascular diseases is rising rapidly in low-and middle-income countries (LMICs). LMICs also have a high occurrence of undernutrition and infectious diseases which together form the 'double burden' of diseases. The connection between undernutrition and NCDs is puzzling but explained by David Barker's idea of intrauterine programming. This idea [now expanded into 'Developmental Origins of Health and Disease' (DOHaD)] focuses on maternal health and nutrition as major determinants of the offspring's health. India offers a unique opportunity to study these links. Studies in India have shown that Indian babies are thin but fat (more adipose tissue) compared to European babies, and maternal nutrition during pregnancy is a determinant of offspring's size and body composition. Both, maternal-foetal undernutrition and overnutrition are associated with increased adiposity and insulin resistance in the children. Micronutrients like vitamin B 12 , folate and vitamin D may be particularly important. Improving nutritional status of the young generation (especially that of young women in reproductive age) offers a potential for intergenerational prevention of NCDs.

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Low Maternal Vitamin B-12 Status Is Associated with Offspring Insulin Resistance Regardless of Antenatal Micronutrient Supplementation in Rural Nepal,

Cited by 110 publications

References 25 publications

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

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

Laboratory Testing for and Diagnosis of Nutritional Deficiencies in Pregnancy Before and After Bariatric Surgery

Foetal Programming and Consequences

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Low Maternal Vitamin B-12 Status Is Associated with Offspring Insulin Resistance Regardless of Antenatal Micronutrient Supplementation in Rural Nepal,

Cited by 110 publications

References 25 publications

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

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

Laboratory Testing for and Diagnosis of Nutritional Deficiencies in Pregnancy Before and After Bariatric Surgery

Foetal Programming and Consequences

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Product

Resources

About

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

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