Objective: Vitamin B 12 deficiency is associated with many adverse health outcomes and is highly prevalent worldwide. The present study assesses the prevalence of vitamin B 12 deficiency and marginal deficiency in Colombian children and women and examines the sociodemographic correlates of serum vitamin B 12 concentrations in these groups. Design: Cross-sectional, nationally representative survey. Setting: Colombia. Subjects: Children <18 years old (n 7243), pregnant women (n 1781), and nonpregnant women 18-49 years old (n 499). Results: The overall prevalence of vitamin B 12 deficiency (serum vitamin B 12 <148 pmol/l) and marginal deficiency (serum vitamin B 12 = 148-221 pmol/l) was, respectively, 6·6 % (95 % CI 5·2 %, 8·3 %) and 22·5 % (95 % CI 21·1 %, 23·9 %). Pregnant women had the highest prevalence of deficiency (18·9 %; 95 % CI 16·6 %, 21·5 %) compared with non-pregnant adult women (18·5 %; 95 % CI 4·4 %, 53·1 %) and children (2·8 %; 95 % CI 2·3 % %, 3·3 %). In multivariable analyses among children, mean serum vitamin B 12 was positively associated with female sex (12 pmol/l higher compared with males; P = 0·004), secondary or higher education of the household head (12 pmol/l higher compared with primary or less; P = 0·009) and food security (21 pmol/l higher compared with severe food insecurity; P = 0·003). In multivariable analyses among pregnant women, mean serum vitamin B 12 was positively associated with education of the household head and inversely associated with living in the National territories, Eastern or Pacific regions. Conclusions: The prevalence of vitamin B 12 deficiency and marginal deficiency in Colombian women and children is substantial. The burden falls largely on adult women, those with lowest education and those living in the poorest, most rural regions of the country.
Keywords
Vitamin B 12Deficiency Prevalence Representative survey ColombiaVitamin B 12 plays an important role in neurocognitive development and function (1) , and its deficiency has been associated with a number of poor health outcomes including anaemia, congenital malformations, neurological deficits and hyperhomocysteinaemia (2)(3)(4)(5) . Animal foods, fortified foods and supplements are the main sources of vitamin B 12 . Consequently, vitamin B 12 deficiency may be more prevalent in vegetarians, vegans, and people living in low-income communities where they may have limited purchasing power to acquire animal food sources or may not have access to fortified foods or supplements.Some studies suggest that vitamin B 12 deficiency and marginal deficiency are highly prevalent worldwide (6) . In the few countries where nationally representative data exist, the prevalence of vitamin B 12 deficiency (serum vitamin B 12 < 130 to <150 pmol/l) ranges from 11 % to 15 % in women from Germany, the UK (6) and Vietnam (7) , to 31 % among elderly from the UK. Regional surveys found vitamin B 12 deficiency in 49 % of adults in India, 40 % of children in Kenya, 28 % of pregnant women in Nepal and 20 % of women in New Zealand ...