vitamin-b-12 and Malnutrition

The present review focuses on the side effects that ex-obese patients face following bariatric surgery. We searched through the principal medical indexes (SCOPUS, Web of Science, PubMed, MEDLINE) using the following words, both alone and in combinations: bariatrics; bariatric surgery; anemia; vitamin B12; cobalamin; folate; folic acid; iron; iron supplements; gut microbiota; lactalbumin; α-lactalbumin. To perform exhaustive research, we considered articles published since 1985. Bariatric surgery induces states of nutritional deficiencies. In particular, the surgery results in a drastic fall in the levels of iron, cobalamin, and folate. Despite the dietary supplements which can counteract such decrease, some limitations exist in the nutraceutical approach. Indeed, the gastrointestinal side effects of supplements, the alterations in the microbiota, and the reduced absorption induced by the surgery may impair the effect of dietary supplements, exposing the patients to the risk of developing nutritional deficiencies. Recent literature reports the effect of promising molecules to counteract such limitations, which include α-lactalbumin, a whey protein with prebiotic activities, and new pharmaceutical forms of iron supplements, namely micronized ferric pyrophosphate. If on the one hand, α-lactalbumin enhances intestinal absorption and helps in restoring a physiological microbiota, micronized ferric pyrophosphate has a high tolerability and low or null risk of gastrointestinal side effects. Bariatric surgery represents a valid solution to obesity and obesity-related disease. However, the procedure may induce deficiencies in micronutrients. Data exists on the promising activities of α-lactalbumin and micronized ferric pyrophosphate, which may help in preventing bariatric-induced anemia.

Topics: Anemia; Bariatric Surgery; Dietary Supplements; Folic Acid; Humans; Iron; Lactalbumin; Malnutrition; Obesity; Obesity, Morbid; Vitamin B 12

Although Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most prevalent bariatric surgical procedures, high-level evidence is scarce regarding the assessment of postoperative nutritional risk in RYGB versus SG. Therefore, we performed a systematic review and meta-analysis to compare the risk of anemia and related micronutrient deficiencies after RYGB and SG. We analyzed 10 randomized controlled trials that compared RYGB and SG with reported incidence of postoperative anemia and/or anemia-related micronutrient deficiencies (iron, vitamin B

Topics: Anemia; Folic Acid; Gastrectomy; Gastric Bypass; Humans; Malnutrition; Micronutrients; Obesity; Obesity, Morbid; Randomized Controlled Trials as Topic; Retrospective Studies; Vitamin B 12; Vitamins

Congenital anomalies affect over 2% of pregnancies, with congenital heart disease (CHD) the most common. Understanding of causal factors is limited. Micronutrients are essential trace elements with key roles in growth and development. We aimed to investigate whether maternal micronutrient deficiencies increase the risk of fetal CHD through systematic review of published literature.. We performed a systematic review registered at PROSPERO as CRD42021276699. Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library were searched from their inception until September 7, 2021. Case control trials were included with a population of biological mothers of fetuses with and without CHD. The exposure was maternal micronutrient level measured in pregnancy or the postpartum period. Data extraction was performed by one author and checked by a second. Risk of bias assessment was performed according to the Scottish Intercollegiate Guidelines Network guidance. We performed a narrative synthesis for analysis.. 726 articles were identified of which 8 met our inclusion criteria. Final analysis incorporated data from 2,427 pregnancies, 1,199 of which were complicated by fetal CHD assessing 8 maternal micronutrients: vitamin D, vitamin B12, folate, vitamin A, zinc, copper, selenium, and ferritin. Studies were heterogenous with limited sample sizes and differing methods and timing of maternal micronutrient sampling. Definitions of deficiency varied and differed from published literature. Published results were contradictory.. There is not enough evidence to confidently conclude if maternal micronutrient deficiencies increase the risk of fetal CHD. Further large-scale prospective study is required to answer this question.

Topics: Copper; Female; Ferritins; Folic Acid; Heart Defects, Congenital; Humans; Malnutrition; Maternal Nutritional Physiological Phenomena; Micronutrients; Observational Studies as Topic; Pregnancy; Selenium; Trace Elements; Vitamin A; Vitamin B 12; Vitamin D; Zinc

Over the last few years, epidemiological studies have shown that infection with. We conducted a systematic review and meta-analysis to estimate the association between. A systematic literature search was conducted for relevant articles using PubMed, Web of Science, and Scopus database from inception to March 2020. The OR with 95% CIs was determined by meta-analysis of data extracted from the selected studies.. From 2384 primary articles, 6 studies were selected for systematic reviews and 4 studies distinctively (with 1274 participants: 553 cases and 721 controls) were selected for meta-analysis. The meta-analysed fixed effect model estimated the odds of having. CRD42019135683.

Topics: Adolescent; Adult; Anemia, Iron-Deficiency; Case-Control Studies; Data Management; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Malnutrition; Micronutrients; Observational Studies as Topic; Pregnancy; Pregnancy Outcome; Risk Factors; Vitamin B 12; Young Adult

Obesity is associated with the gut microbiota and decreased micronutrient status. Bariatric surgery is a recommended therapy for obesity. It can positively affect the composition of the gut bacteria but also disrupt absorption of nutrients. Low levels of micronutrients can affect metabolic processes, like glycolysis, TCA cycle, and oxidative phosphorylation, that are associated with the immune system also known as immunometabolism.. MEDLINE, PUBMED, and Google Scholar were searched. Articles involving gut microbiome, micronutrient deficiency, gut-targeted therapies, transcriptome analysis, micronutrient supplementation, and bariatric surgery were included.. Studies show that micronutrients play a pivotal role in the intestinal immune system and regulating immunometabolism. Research demonstrates that gut-targeting therapies may improve the microbiome health for bariatric surgery populations. There is limited research that examines the role of micronutrients in modulating the gut microbiota among the bariatric surgery population.. Investigations are needed to understand the influence that micronutrient deficiencies have on the gut, particularly immunometabolism. Nutritional transcriptomics shows great potential in providing this type of analysis to develop gut-modulating therapies as well as more personalized nutrition recommendations for bariatric surgery patients.

Topics: Bariatric Surgery; Citric Acid Cycle; Female; Folic Acid; Functional Food; Gastrointestinal Microbiome; Glycolysis; Humans; Immune System; Intestines; Iron; Male; Malnutrition; Micronutrients; Nutritional Status; Obesity, Morbid; Oxidative Phosphorylation; Probiotics; Thiamine; Transcriptome; Vitamin B 12; Vitamin D

Topics: Enterostomy; Fluid Therapy; Humans; Intestinal Absorption; Intestine, Small; Ischemia; Malnutrition; Nutritional Support; Short Bowel Syndrome; Vitamin B 12

Among children with moderate acute malnutrition (MAM) the level of serum cobalamin (SC) and effect of food supplements are unknown. We aimed to assess prevalence and correlates of low SC in children with MAM, associations with hemoglobin and development, and effects of food supplements on SC.. A randomized 2 × 2 × 3 factorial trial was conducted in Burkina Faso. Children aged 6 to 23 months with MAM received 500 kcal/d as lipid-based nutrient supplement (LNS) or corn-soy blend (CSB), containing dehulled soy (DS) or soy isolate (SI) and 0%, 20%, or 50% of total protein from milk for 3 months. Randomization resulted in baseline equivalence between intervention groups. Data on hemoglobin and development were available at baseline. SC was available at baseline and after 3 and 6 months. SC was available from 1,192 (74.1%) of 1,609 children at baseline. The mean (±SD) age was 12.6 (±5.0) months, and 54% were females. Low mid-upper arm circumference (MUAC; <125 mm) was found in 80.4% (958) of the children and low weight-for-length z-score (WLZ; <-2) in 70.6% (841). Stunting was seen in 38.2% (456). Only 5.9% were not breastfed. Median (IQR) SC was 188 (137; 259) pmol/L. Two-thirds had SC ≤222 pmol/L, which was associated with lower hemoglobin. After age and sex adjustments, very low SC (<112 pmol/L) was associated with 0.21 (95% CI: 0.01; 0.41, p = 0.04) and 0.24 (95% CI: 0.06; 0.42, p = 0.01) z-score lower fine and gross motor development, respectively. SC data were available from 1,330 (85.9%) of 1,548 children followed up after 3 months and 398 (26.5%) of the 1,503 children after 6 months. Based on tobit regression, accounting for left censored data, and adjustments for correlates of missing data, the mean (95% CI) increments in SC from baseline to the 3- and 6-month follow-up were 72 (65; 79, p < 0.001) and 26 (16; 37, p < 0.001) pmol/L, respectively. The changes were similar among the 310 children with SC data at all 3 time points. Yet, the increase was 39 (20; 57, p < 0.001) pmol/L larger in children given LNS compared to CSB if based on SI (interaction, p < 0.001). No effect of milk was found. Four children died, and no child developed an allergic reaction to supplements. The main limitation of this study was that only SC was available as a marker of status and was missing from a quarter of the children.. Low SC is prevalent among children with MAM and may contribute to impaired erythropoiesis and child development. The SC increase during supplementation was inadequate. The bioavailability and adequacy of cobalamin in food supplements should be reconsidered.. ISRCTN Registry ISRCTN42569496.

Topics: Burkina Faso; Child; Dietary Supplements; Female; Hemoglobins; Humans; Infant; Male; Malnutrition; Vitamin B 12; Zea mays

A growing body of research evidence suggests that elevated homocysteine level (hyperhomocysteinemia) is an independent risk factor for cardiovascular diseases. The current study aimed to investigate the prevalence and associated risk factors for hyperhomocysteinemia among adolescent Afghan refugees aged 10−19 years. In total, 206 healthy adolescent boys and girls were randomly recruited from a refugee village in Peshawar, Pakistan, in 2020. Socio-demographic data, anthropometric assessment, and blood sample collection were performed following standard methods. Serum homocysteine was assessed using a chemiluminescent microparticle immunoassay, with hyperhomocysteinemia defined as levels ≥ 15 µmol/L. The overall prevalence of hyperhomocysteinemia was 25%, with mean homocysteine levels significantly (p = 0.004) higher among boys (14.1 µmol/L) than girls (11.8 µmol/L). Multivariate logistic regression analysis revealed a significant association between hyperhomocysteineimia and serum levels of vitamin B12 (OR 0.29; 95% CI of 0.14 to 0.62; p < 0.01) and folate (OR 0.1; 95% CI of 0.03 to 0.27; p < 0.001). Overall, our study findings indicate high prevalence of hyperhomocysteinemia among adolescent Afghan refugees who are potentially at high risk of developing cardiovascular diseases in future. There is a dire need to develop and implement nutritional and public health strategies to control hyperhomocysteinemia, protect against related diseases and complications in future, and ensure healthy lives and well-being among these vulnerable populations.

Topics: Adolescent; Cardiovascular Diseases; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Male; Malnutrition; Micronutrients; Prevalence; Refugees; Vitamin B 12

To prospectively study the clinical and developmental profile; hematological profile and the B-12 status using multiple parameters in children with Infantile tremor syndrome (ITS).. In this observational study (NCT02762682) (July 2015 through December 2016) children (and their mothers) with a clinical diagnosis of ITS were evaluated clinically; and development was assessed by CAPUTE scales. A complete blood count (CBC); peripheral blood smear examination; markers of vitamin B12 status (serum B12, homocysteine, folate); acylcarnitines [using Tandem mass spectrometry (TMS)] and urine methylmalonic acid (MMA) [Gas chromatography mass spectrometry (GCMS)] were estimated. A control group of children and their mothers were sampled for comparison.. A total of 286 individuals were enrolled for this study. One-hundred-ten children with ITS were screened and 92 (20 with tremors; age 12.7 ± 5 mo, 61 boys) children and their mothers were enrolled. Fifty-one children and their mothers were enrolled as controls. The median clinical linguistic & auditory milestone-developmental quotient (CLAM-DQ) was 32 (IQR 20.6-45.5) and median cognitive adaptive test-developmental quotient (CAT-DQ) was 36.2 (IQR 18.7-49.0). All babies except 9 (ovo-veg) had vegetarian mothers. Head circumference below 2 SD (WHO standards) was seen in 84% and below 3 SD in 58%. The CBC findings were; Hb- 8.3 ± 1.6 g/dl, Thrombocytopenia-29 (32%), mean corpuscular volume (MCV)- 92.2 ± 13.4, MCV- more than 95 fL-38(42%), Red cell distribution width (RDW)- 21.6 ± 6.5, and macrocytes on peripheral smear in 68%. In 89 (97%) out of 92 children had laboratory features of deficient B12 status. Two-thirds of the mothers also had evidence of B12 deficiency.. ITS is, in all likelihood is a consequence of vitamin B12 defeciency. It has a significant impact on head growth and development of affected infants.

Topics: Adolescent; Adult; Biomarkers; Child; Child, Preschool; Erythrocyte Indices; Female; Folic Acid; Homocysteine; Humans; India; Male; Malnutrition; Methylmalonic Acid; Mothers; Prospective Studies; Tremor; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Many children suffer from nutritional deficiencies that may negatively affect their academic performance. This cluster-randomized controlled trial aimed to test the effects of micronutrient-fortified milk in Chinese students. Participants received either micronutrient-fortified (n = 177) or unfortified (n = 183) milk for six months. Academic performance, motivation, and learning strategies were estimated by end-of-term tests and the Motivated Strategies for Learning Questionnaire. Blood samples were analyzed for micronutrients. In total, 296 students (82.2%) completed this study. Compared with the control group, students in the intervention group reported higher scores in several academic subjects (p < 0.05), including languages, mathematics, ethics, and physical performance at the end of follow-up. Students in the intervention group showed greater self-efficacy and use of cognitive strategies in learning, and reported less test anxiety (p < 0.001). Moreover, vitamin B2 deficiency (odds ratio (OR) = 0.18, 95% confidence interval (CI): 0.11~0.30) and iron deficiency (OR = 0.34, 95% CI: 0.14~0.81) were less likely in the students of the intervention group, whereas vitamin D, vitamin B12, and selenium deficiencies were not significantly different. "Cognitive strategy" had a partial mediating effect on the test scores of English (95% CI: 1.26~3.79) and Chinese (95% CI: 0.53~2.21). Our findings suggest that micronutrient-fortified milk may improve students' academic performance, motivation, and learning strategies.

Topics: Adolescent; Anemia, Iron-Deficiency; Animals; Asian People; Body Mass Index; Child; China; Cluster Analysis; Diet; Educational Status; Female; Follow-Up Studies; Food, Fortified; Humans; Iron; Logistic Models; Male; Malnutrition; Micronutrients; Milk; Nutritional Status; Prevalence; Riboflavin; Riboflavin Deficiency; Selenium; Students; Surveys and Questionnaires; Vitamin A; Vitamin B 12; Vitamin D

Inadequate energy intake and poor diet quality are important causes of chronic child undernutrition. Strategies for improving diet quality using lipid-based nutrient supplements (LNS) are currently being tested in several countries. To date, information on children's dietary intakes during LNS use is available only from Africa. In this study, we collected 24-h dietary recalls at baseline, 3, 6, 9 and 12 months on Honduran children (n = 298) participating in a cluster-randomised trial of LNS. Generalised estimating equations were used to examine differences in number of servings of 12 food groups in the LNS and control arms, and multi-level mixed effects models were used to compare macro- and micronutrient intakes. Models accounted for clustering and adjusted for child's age, season and breastfeeding status. Mean daily servings of 12 food groups did not differ by study arm at baseline and remained similar throughout the study with the exception of groups that were partially or entirely supplied by LNS (nuts and nut butters, fats, and sweets). Baseline intakes of energy, fat, carbohydrates, protein, folate and vitamin A, but not vitamin B12, iron and zinc were lower in the LNS than control arm. The change in all macro- and micronutrients from baseline to each study visit was larger for the LNS arm than the control, except for carbohydrates from baseline to 9 months. These findings indicate that LNS improved the macro- and micronutrient intakes of young non-malnourished Honduran children without replacing other foods in their diet.

Topics: Breast Feeding; Child, Preschool; Cluster Analysis; Dietary Carbohydrates; Dietary Fats; Dietary Proteins; Dietary Supplements; Energy Intake; Folic Acid; Follow-Up Studies; Food Quality; Honduras; Humans; Infant; Infant Formula; Infant Nutritional Physiological Phenomena; Iron, Dietary; Malnutrition; Mental Recall; Micronutrients; Vitamin A; Vitamin B 12; Zinc

Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children.. A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months' blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data.. At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence.. These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children.

Topics: Child Development; Cluster Analysis; Dietary Fats; Dietary Supplements; Female; Folic Acid; Follow-Up Studies; Honduras; Humans; Infant; Infant Nutritional Physiological Phenomena; Iron; Lipids; Male; Malnutrition; Micronutrients; Nutritional Status; Riboflavin; Rural Population; Treatment Outcome; Vitamin B 12; Vulnerable Populations; Zinc

To define the vitamin B12 levels and other micronutrients status in severe acute malnutrition (SAM) children.. This was a prospective hospital based cross-sectional study.. Children with severe acute malnutrition as per WHO criteria.. (i) Pernicious anemia (ii) Autoimmune gastritis (iii) SAM children on exclusive vitamin B12 supplementation. All enrolled children underwent a detailed clinical history, general physical examination with more emphasis on clinical features of vitamin B12 and other micronutrients deficiencies. Three ml of venous blood was collected to estimate vitamin B12 and other micronutrients. Primary outcome was percentage of deficiency of serum vitamin B12, zinc, copper, selenium, manganese, molybdenum and cobalt in SAM children.. Fifty children were included in the study. The mean age of children was 15.60±12.90 mo with male to female ratio 0.85:1. The common clinical presentation in order of frequency were upper respiratory infection (URI) symptoms 35 (70%), hepatomegaly 24 (48%), Hyperpigmentation 17 (34%), angular cheilitis 14 (28%), tremors 11 (22%), edema 07 (14%), and hypotonia 05 (10%). Anemia was found in 44 (88%) children. Prevalence of vitamin B12 deficiency was 34%. Other micronutrient deficiencies observed were cobalt 24 (100%), copper 05 (12%), zinc 04 (9.5%), and molybdenum 03 (12.5%). No statistical significance was found between clinical symptoms and levels of vitamin B12 with different age and sex.. Prevalence of low vitamin B12 and cobalt were more common than other micronutrients.

Topics: Child; Cobalt; Copper; Cross-Sectional Studies; Female; Humans; Male; Malnutrition; Manganese; Micronutrients; Molybdenum; Prevalence; Prospective Studies; Selenium; Severe Acute Malnutrition; Vitamin B 12; Zinc

A well-nourished workforce is instrumental in eradicating hunger, alleviating poverty, and spurring economic growth. A fifth of the total workforce in high-income countries are migrant workers. Despite the accessibility of nutritious foods in high-income countries, migrant workers often rely on nutrient-poor diets largely consisting of empty calories, which in turn leads to vitamin and mineral deficiency, also called hidden hunger, and resultant productivity loss. Here, we study the magnitude of hidden hunger in male migrant construction workers in Singapore and investigate the impact of consuming fortified rice for 6 consecutive months on the nutrition and health status of these workers.. 140 male migrant workers aged 20-51 years of either Bangladeshi or Indian ethnicity from a single dormitory in Singapore volunteered to participate in the study. In total, 133 blood samples were taken at the start of the study and were used to assess vitamin B12, hemoglobin, ferritin, folate, and zinc levels; a sub-sample underwent for homocysteine testing. Anthropometric measurements and vital signs, such as blood pressure, were recorded before and after the intervention.. The results show that vitamin and mineral deficiency was present, especially folate (59% of workers deficient) and vitamin B12 (7% deficient, 31% marginally deficient). The consumption of fortified rice significantly improved the vitamin, iron and zinc level in the workers and significantly reduced the systolic blood pressure amongst the Bangladeshi migrant workers, specifically.. Our study demonstrates that fortified rice may have a positive impact on male migrant construction worker health and nutrition status at the workplace.

Topics: Construction Industry; Folic Acid; Food, Fortified; Humans; Iron; Male; Malnutrition; Micronutrients; Minerals; Nutritional Status; Oryza; Singapore; Transients and Migrants; Vitamin B 12; Vitamins; Zinc

Dietary intake and biomarkers of micronutrient status of 100 non-pregnant women of reproductive age (NPWRA) were assessed to determine optimal levels of iron, zinc, vitamin B12, and folic acid to include in multiply-fortified salt (MFS) that will be evaluated in an upcoming trial. Weighed food records were obtained from participants to measure intake of micronutrients and discretionary salt, and to assess adequacy using Indian Nutrient Reference Values (NRVs). Statistical modeling was used to determine optimal fortification levels to reduce inadequate micronutrient intake while limiting intake above the upper limit. Fasting blood samples were obtained to assess iron, zinc, vitamin B12, and folate status. In usual diets, inadequate intake of iron (46%), zinc (95%), vitamin B12 (83%), and folate (36%) was high. Mean intake of discretionary salt was 4.7 g/day. Prevalence estimates of anemia (37%), iron deficiency (67%), zinc deficiency (34%), vitamin B12 insufficiency (37%), and folate insufficiency (70%) were also high. Simulating the addition of optimized MFS to usual diets resulted in percentage point (pp) reductions in inadequate intake by 29 pp for iron, 76 pp for zinc, 81 pp for vitamin B12, and 36 pp for folate. MFS holds potential to reduce the burden of micronutrient deficiencies in this setting.

Topics: Female; Folic Acid; Folic Acid Deficiency; Food, Fortified; Humans; Iron; Malnutrition; Micronutrients; Prevalence; Sodium Chloride; Sodium Chloride, Dietary; Vitamin B 12; Zinc

Micronutrient deficiencies are common after Roux-en-Y gastric bypass (RYGB). This study explores whether vitamin and mineral deficiency was associated with adherence to recommended supplementation 12 years after RYGB.. The cross-sectional Bariatric Surgery Observation Study (BAROBS) was conducted in 2018-2020 at three hospitals in Central Norway. We report data on 490 patients' self-reported adherence to recommended supplements and vitamin and mineral levels in the blood. The patients, who had RYGB between 2003 and 2009, were recommended an over-the-counter multivitamin-mineral supplement, calcium/vitamin D (1000 mg/20 µg) and vitamin B. Twelve years after RYGB, adherence to supplements, though in sub-optimal doses of new recommendations, decreases the probability of vitamin and mineral deficiency, especially for thiamine, vitamin B

Topics: Adult; Calcium; Cross-Sectional Studies; Female; Folic Acid; Gastric Bypass; Humans; Male; Malnutrition; Middle Aged; Obesity, Morbid; Vitamin B 12; Vitamin D; Vitamins

In low-income countries, undernutrition and infections play a major role in childhood anemia. Stunted children may be at particular risk of anemia. In a cross-sectional study nested in a nutrition trial among 12-59-month-old stunted children in eastern Uganda, we measured hemoglobin (Hb) and markers of iron, cobalamin, folate and vitamin A status. We assessed low micronutrient status, socio-demography, stunting severity, inflammation and malaria as correlates of Hb and anemia using linear and logistic regression analyses, respectively. Of 750 stunted children, the mean ± SD age was 32.0 ± 11.7 months and 55% (n = 412) were male. The mean Hb was 104 ± 15 g/L and 65% had anemia, Hb < 110 g/L. In a multivariable model with age, sex and inflammation, the following were associated with lower Hb: serum ferritin < 12 µg/L (-5.6 g/L, 95% CI: -8.6; -2.6), transferrin receptors > 8.3 mg/L (-6.2 g/L, 95% CI: -8.4; -4.0), plasma folate <20 nmol/L (-4.6 g/L, 95% CI: -8.1;-1.1), cobalamin < 222 pmol/L (-3.0 g/L, 95% CI: -5.4; -0.7) and serum retinol-binding protein < 0.7 µmol/L (-2.0 g/L, 95% CI: -4.1; 0.2). In addition, severe stunting, inflammation and malaria were negative correlates. Anemia is common among stunted children in eastern Uganda; micronutrient deficiencies, inflammation and malaria are associated with low Hb.

Topics: Child, Preschool; Cross-Sectional Studies; Female; Folic Acid; Growth Disorders; Hemoglobins; Humans; Infant; Inflammation; Male; Malnutrition; Micronutrients; Trace Elements; Uganda; Vitamin B 12

Vitamin B-12 is a water-soluble vitamin that plays important roles in intermediary metabolism. Vitamin B-12 deficiency has many identifiable causes, including autoimmune and other gastrointestinal malabsorption disorders, dietary deficiency, and congenital defects in genes that are involved in vitamin B-12 trafficking and functions. Another putative cause of vitamin B-12 deficiency is the high-folate-low vitamin B-12 interaction, first suspected as the cause for observed relapse and exacerbation of the neurological symptoms in patients with pernicious anemia who were prescribed high oral doses of folic acid. We propose that this interaction is real and represents a novel cause of vitamin B-12 depletion with specific etiology. We hypothesize that excessive intake of folic acid depletes serum holotranscobalamin (holoTC), thereby decreasing active vitamin B-12 in the circulation and limiting its availability for tissues. This effect is specific for holoTC and does not affect holohaptocorrin, the inert form of serum vitamin B-12. Depletion of holoTC by folic acid in individuals with already low vitamin B-12 status further compromises the availability of vitamin B-12 coenzymes to their respective enzymes, and consequently a more pronounced state of biochemical deficiency. This hypothesis is drawn from evidence of observational and intervention studies of vitamin B-12-deficient patients and epidemiological cohorts. The evidence also suggests that, in a depleted state, vitamin B-12 is diverted to the hematopoietic system or the kidney. This most likely reflects a selective response of tissues expressing folate receptors with high affinity for unmetabolized folic acid (UMFA; e.g., hematopoietic progenitors and renal tubules) compared with those tissues (e.g., liver) that only express the reduced folate carrier, which is universally expressed but has poor affinity for UMFA. The biochemical and physiological mechanisms underlying this interaction require elucidation to clarify its potential public health significance.

Topics: Folic Acid; Homocysteine; Humans; Malnutrition; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Childhood and adolescence require adequate amount of micronutrients for normal growth and development. The primary objective of study was to assess the prevalence of deficiencies of Vitamins (Vitamin A, 25 Hydroxy Vitamin D, Vitamin B12 and Folate) and minerals (Calcium, Zinc, Selenium and Iron), among urban school going children aged 6-11 and 12-16 years in ten cities of India. Secondary objective was to find the association between micronutrient deficiencies with sociodemographic and anthropometric indicators.. A multi-center cross-sectional study was conducted across India. Participants in the age groups of 6 to 11 years (group 1) and 12 to 16 years (group 2) were selected from randomly chosen schools from each center. Data on socio economic status, anthropometric measures was collected. Blood samples were collected for biochemical analysis of micronutrients. Point estimates and 95% confidence intervals was used to assess the prevalence of deficiencies. Associations were observed using chi square, student t test and ANOVA test.. From April 2019 to February 2020, 2428 participants (1235 in group 1 and 1193 group 2) were recruited from 60 schools across ten cites. The prevalence of calcium and iron deficiency was 59.9% and 49.4% respectively. 25 Hydroxy Vitamin D deficiency was seen in 39.7% and vitamin B12 in 33.4% of subjects. Folate, Selenium and Zinc were deficient in 22.2%, 10.4% and 6.8% of subjects respectively. Vitamin A deficiency least (1.6%). Anemia was prevalent in 17.6% subjects and was more common among females.. One or more micronutrient deficiencies are found in almost one half of school going children in urban area. Hence efforts must be made to combat these on priority.. CTRI/2019/02/017783.

Topics: Adolescent; Anemia, Iron-Deficiency; Calcium; Child; Cross-Sectional Studies; Female; Folic Acid; Humans; India; Malnutrition; Micronutrients; Nutritional Status; Prevalence; Schools; Selenium; Vitamin B 12; Zinc

Impact of micronutrient deficiency on childhood malignancy is unexplored. We estimated the prevalence of baseline micronutrient deficiency in children with cancer and its impact on event-free survival (EFS) and overall survival (OS).. Total 535 children [326 (60.9%) haematological and 209 (39.1%) solid malignancies] were enrolled with median follow-up of 66 months. Vitamin B. Selenium deficiency was independently predictive of adverse outcomes in childhood cancer, particularly in haematological malignancies. Zinc deficiency adversely affected solid tumours. The adjunct use of micronutrient supplementation in paediatric malignancies should be explored.

Topics: Child; Copper; Folic Acid; Hematologic Neoplasms; Humans; Longitudinal Studies; Malnutrition; Micronutrients; Neoplasms; Prevalence; Prospective Studies; Selenium; Vitamin B 12; Vitamins; Zinc

To estimate beef consumption and its influence on carbon and water footprints, as well as to improve the nutritional quality of the Brazilian diet.. The amount of beef and other foods consumed was evaluated by two 24-hour food records in a representative sample of the Brazilian population ≥ 10 years of age (n = 32,853) from 2008 to 2009. The environmental impact of the diet considered the coefficients of the carbon footprint (gCO2 and/kg) and the water footprint (liters/kg) of the foods, as well as their nutritional quality considering the nutrient composition of each food associated with the prevention of nutritional deficiencies or the increase/decrease in chronic disease risk. Linear and logistic regression models, crude and adjusted for sex, age, education, income, region, and area, were used to respectively study the association of fifths of the caloric contribution of beef with the environmental impacts of the diet and inadequate nutrient intake.. Carbon and water footprints and protein, iron, zinc, vitamin B12, saturated fat, and sodium contents were higher in the fraction of the diet composed of beef, whereas fiber and added sugar contents were higher in the fraction composed by the other foods. Dietary beef contribution was directly associated with the carbon and water footprints of the diet and the risk of saturated fat and sodium excess, besides fiber insufficiency, inversely associated with the risk of protein, iron, zinc, and vitamin B12 insufficiency.. Reducing beef consumption in Brazil would also reduce the carbon and water footprints of the diet, as well as the risk of chronic diseases related to food. Therefore, in order not to increase the risk of nutritional deficiencies, monitoring the increased intake of other foods rich in protein, iron, zinc, and vitamin B12 is suggested.

Topics: Animals; Brazil; Carbon; Cattle; Diet; Energy Intake; Environment; Humans; Iron; Malnutrition; Nutritive Value; Sodium; Vitamin B 12; Water; Zinc

Despite broad appreciation of their clinical utility, it has been unclear how vitamin B12 and folic acid (FA) function at the molecular level to directly prevent their hallmark symptoms of deficiency like anemia or birth defects. To this point, B12 and FA have largely been studied as cofactors for enzymes in the one-carbon (1C) cycle in facilitating the de novo generation of nucleotides and methylation of DNA and protein. Here, we report that B12 and FA function as natural antagonists of aryl hydrocarbon receptor (AhR). Our studies indicate that B12 and FA bind AhR directly as competitive antagonists, blocking AhR nuclear localization, XRE binding, and target gene induction mediated by AhR agonists like 2,3,7,8-tetrachlorodibenzodioxin (TCDD) and 6-formylindolo[3,2-b]carbazole (FICZ). In mice, TCDD treatment replicated many of the hallmark symptoms of B12/FA deficiency and cotreatment with aryl hydrocarbon portions of B12/FA rescued mice from these toxic effects. Moreover, we found that B12/FA deficiency in mice induces AhR transcriptional activity and accumulation of erythroid progenitors and that it may do so in an AhR-dependent fashion. Consistent with these results, we observed that human cancer samples with deficient B12/FA uptake demonstrated higher transcription of AhR target genes and lower transcription of pathways implicated in birth defects. In contrast, there was no significant difference observed between samples with mutated and intact 1C cycle proteins. Thus, we propose a model in which B12 and FA blunt the effect of natural AhR agonists at baseline to prevent the symptoms that arise with AhR overactivation.

Topics: Animals; Basic Helix-Loop-Helix Transcription Factors; Carbazoles; Congenital Abnormalities; Female; Folic Acid; Folic Acid Deficiency; Gene Expression; Humans; Male; Malnutrition; Mice; Mice, Inbred C57BL; Neoplasms; Polychlorinated Dibenzodioxins; Receptors, Aryl Hydrocarbon; Vitamin B 12; Vitamin B 12 Deficiency

Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms is not well known. The goal of this study was to summarize evidence from a dental practice of iron, vitamin B12 and folic acid deficiency in patients presenting with compatible oral manifestations.. 250 patients who presented with burning mouth syndrome, angular cheilitis, recurrent aphthous stomatitis, papillar atrophy of the tongue dorsum or mucosal erythema were identified. Patients underwent clinical examination, and the blood samples were taken.. 250 patients (208 females; 42 males, mean age 44.1 years) with at least one corresponding symptom or sign were identified. The nutritional deficiency of one or more nutrients was found in 119 patients (47.6%). Seven times more females than males were noted to have one type of deficiency (104 females, 15 males). Iron deficiency as defined was diagnosed in 62 patients (24.8%), vitamin B12 or folic acid deficiency in 44 patients (17.6%) and both deficiencies (iron + vitamin B12/folic acid) in 13 patients (5.2%). The only predictive factor was gender and only for iron deficiency. The presence of more than one deficiency was noted in 10 patients (4.9%).. The most commonly observed deficiency in dental practice over the course of 11 years was an iron deficiency in the female population. Age, diet and reported co-morbidities did not show statistically significant predictable value in recognizing these deficiencies.

Topics: Adult; Czech Republic; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Iron Deficiencies; Male; Malnutrition; Mouth Diseases; Practice Patterns, Dentists'; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Biomarkers; Female; Folic Acid; Health Surveys; Homocysteine; Humans; Infant; Malabsorption Syndromes; Male; Malnutrition; Methylmalonic Acid; Physical Examination; Practice Guidelines as Topic; Pregnancy; Referral and Consultation; Risk Factors; United Kingdom; Vitamin B 12; Vitamin B 12 Deficiency; Vulnerable Populations

Both insomnia and malnutrition are quite common and can cause similar negative consequences, such as falls, depression, and cognitive impairment in older adults, but there is no study investigating the relationship between the 2. The aims were to investigate relationships between insomnia/insomnia severity and Mini Nutritional Assessment (MNA) score and serum nutrient levels.. Aged 65 years or older, 575 outpatients were included.. MNA scores >23.5, 17-23.5, and <17 were categorized as normal nutritional status, malnutrition risk, and malnutrition, respectively. Serum vitamin B. The mean age was 73.1 ± 7.7 years, with 73.2% being female. The prevalence of patients with no insomnia, mild insomnia, moderate insomnia, and severe insomnia were 34.4%, 20.9%, 30.1%, and 14.6%, respectively. After adjusting for gender, education, number of drugs, Charlson Comorbidity Index, presence of depression, and Mini-Mental State Examination scores, patients with insomnia had lower MNA scores than those without insomnia (OR = 0.84, 95% CI: 0.7-0.9, P < .001). There were significant relationships between moderate/severe insomnia and the presence of malnutrition and risk of malnutrition (OR = 1.6, 95% CI: 1.0-2.5, P = .046; OR = 1.6, 95% CI: 1.0-2.7, P = .042) and MNA scores (OR = 0.83, 95% CI: 0.7-0.9, P < .001)/OR = 0.82, 95% CI: 0.7-0.9, P < .001). There was no significant difference between insomnia severity status and serum vitamin D, vitamin B. There is a close relationship between MNA scores and insomnia or insomnia severity in older adults. Therefore, when evaluating an older patient with insomnia, malnutrition should be evaluated, or insomnia should also be questioned in an older patient with malnutrition. Thus, more effective management of the 2 can be possible.

Topics: Aged; Female; Folic Acid; Humans; Male; Malnutrition; Nutrition Assessment; Nutritional Status; Severity of Illness Index; Sleep Initiation and Maintenance Disorders; Vitamin B 12; Vitamin D

The aim of this study was to evaluate the prevalence of anemia and other vitamin deficiencies among elderly home care patients and to evaluate the causes of anemia and effect of malnutrition as a contributing factor.. Anemia was defined according to the World Health Organization. Hemogram, serum iron, iron binding capacity, ferritin and transferrin saturation values, serum vitamin B12, folic acid and vitamin D levels were evaluated. It was tried to differentiate as absolute iron deficiency anemia, anemia of chronic disease, anemia of unknown cause and vitamin B12 deficiency anemia. Malnutrition was evaluated by Mini Nutritional Assessment test.. Total of 472 patients (mean age 81,4±7,4 years) were included in the study. Anemia was detected in 179 (%37,9) patients, 22,7% of males and 45,5 % of female. Prevalence of iron deficiency anemia, vitamin B12, folic acid and vitamin D deficiencies were found 43%, 46%, 19% and 91% respectively. 22,8% of all patients were malnourished, 17,5% were under malnutrition risk. In patients with anemia 16,2% chronic disease anemia and 37,4% unknown anemia were detected.. With or without malnutrition, iron deficiency anemia, vitamin B12 deficiency and vitamin D deficiency were common in the home care elderly patients.

Topics: Aged; Anemia; Anemia, Iron-Deficiency; Chronic Disease; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Home Care Services; Homes for the Aged; Humans; Male; Malnutrition; Nutrition Assessment; Nutritional Status; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D Deficiency

The study aim was to determine the prevalence of abnormal serum biochemistries associated with micronutrient deficiencies before and after laparoscopic sleeve gastrectomy (LSG).. Two hundred and one patients had LSG surgery between May 2011 and May 2014. Using a prospective cohort study design, data were collected on ferritin, hemoglobin (Hgb), mean cell volume (MCV), calcium, albumin, 25-hydroxyvitamin D (25-OH-D), PTH, and vitamin B. Patients were female (81.6%) with mean ± SD, BMI (48.8 ± 6.8 kg/m. Abnormal serum biochemistries indicative of micronutrient deficiencies were prevalent before surgery; reduced abnormal values were observed after surgery, likely due to an increased use of multivitamins.

Topics: Adult; Dietary Supplements; Female; Ferritins; Gastrectomy; Humans; Laparoscopy; Male; Malnutrition; Middle Aged; Nutrition Therapy; Obesity, Morbid; Postoperative Period; Prospective Studies; Vitamin B 12; Vitamin D; Vitamins

Retinal vascular occlusions are uncommon in young people and require more in-depth investigation into the cause. Studies have revealed that a high level of circulating homocysteine poses a risk for retinal vaso-occlusive events across a wide age range. This case report reflects on how the interplay of genetic mutation and vitamin deficiency can cause a pathological level of homocysteine with resultant branch retinal artery occlusion in a young patient.. A 16-year-old boy presented to eye casualty with acute inferior visual field loss in the left eye. Visual acuity remained normal at 6/6 each eye and the event was painless. Initial assessment, and retinal photography revealed a left superior hemi-field branch retinal artery occlusion with macular sparing. Given the patient's age, extensive investigation into the cause was carried out. Positive findings were of an elevated level of homocysteine as a result of vitamin B12 and folic acid deficiency as well as a genetic mutation in the MTHFR gene (encoding MTHFR enzyme which is vital in normal homocysteine metabolism). Vitamin B12 and folic acid were replaced which in turn normalized the patient's homocysteine levels. At two months, the patient's visual fields had also improved, and no further vascular event had occurred.. This case report has highlighted the link between hyperhomocysteinaemia and retinal artery occlusion. However, despite vitamin replacement being shown to normalize homocysteine levels, no evidence exists to date as to whether this will reduce the risk of further retinal vascular occlusion.

Topics: Adolescent; Folic Acid; Folic Acid Deficiency; Genetic Predisposition to Disease; Genotype; Homocysteine; Humans; Hyperhomocysteinemia; Male; Malnutrition; Methylenetetrahydrofolate Reductase (NADPH2); Retinal Artery Occlusion; Vision Disorders; Visual Acuity; Visual Field Tests; Visual Fields; Vitamin B 12; Vitamin B 12 Deficiency

Vitamin B12 deficiency during pregnancy has been associated with poor fetal outcome. Here we investigate the influence of a one-carbon (1C) imbalanced diet (low B12, high folate, high methionine) on maternal B12 status, fetal outcome, B12 distribution, and on the 24-h distribution of synthetic cyano-B12 (CN-B12) and natural hydroxo-B12 (HO-B12). Female Wistar rats were mated while on a 1C balanced (

Topics: Animals; Diet; Female; Fetus; Kidney; Liver; Malnutrition; Placenta; Pregnancy; Pregnancy Complications; Rats; Rats, Wistar; Uterus; Vitamin B 12; Vitamin B 12 Deficiency

Severe B

Topics: Adult; Aftercare; Diagnosis, Differential; Diet, Vegetarian; Feeding Behavior; Humans; Hydroxocobalamin; Injections, Intramuscular; Life Support Care; Male; Malnutrition; Pancytopenia; Retinal Hemorrhage; Treatment Outcome; Vision Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Multi-nutrient insufficiencies as a consequence of nutritional and economic factors are common in India and other developing countries. We have examined the impact of multi-nutrient insufficiency on markers of one carbon (1C) metabolism in the blood, and response to a methionine load in clinically healthy young women.. Young women from Pune, India (n=10) and Cleveland, USA (n=13) were studied. Blood samples were obtained in the basal state and following an oral methionine load (50 mg/kg of body weight in orange juice). Plasma concentrations of vitamin B12, folate and B6 were measured in the basal state. The effect of methionine load on the levels of methionine, total homocysteine, cysteine, glutathione and amino acids was examined.. Indian women were significantly shorter and lighter compared with the American women and had lower plasma concentration of vitamins B12, folate and B6, essential amino acids and glutathione, but higher concentration of total homocysteine. The homocysteine response to methionine load was higher in Indian women. The plasma concentrations of glycine and serine increased in the Indian women after methionine (in juice) load. A significant negative correlation between plasma B6 and homocysteine (r= -0.70), and plasma folate and glycine and serine levels were observed in the Indian group (P<0.05) but not in the American group.. Multi-nutrient insufficiency in the Indian women caused unique changes in markers of whole body protein and 1C metabolism. These data would be useful in developing nutrient intervention strategies.

Topics: Adult; Amino Acids; Biomarkers; Body Height; Carbon; Female; Folic Acid; Food; Glutathione; Homocysteine; Humans; India; Malnutrition; Methionine; Ohio; Vitamin B 12; Vitamin B Complex

Undernutrition as well as low levels of vitamin B12 and folic acid are common problems among older adults. However, recommended routine nutritional status assessment tools may result in inadequate vitamin serum levels to go unnoticed. Therefore, the aim of this study is to evaluate the inadequacy of serum levels of vitamin B12 and folic acid within Mini Nutritional Assessment (MNA) classification categories among older adults. A cross-sectional study was conducted with 97 older adults residing in care homes in Portugal. Undernutrition was identified through the MNA, and serum levels of vitamin B12 and folic acid were measured using chemiluminescence. Cognitive function, depressive symptoms and functional characteristics were also assessed using the Abbreviated Mental Test Score, the Epidemiologic Studies Depression Scale and the Barthel Index, respectively. The mean age of older adults was 82.2 (6.3) years; 3.1% were undernourished and 26.8% were at undernutrition risk. In the MNA normal nutritional status group, 11.8% presented vitamin B12 deficiency (<200 pg/ml), 32.4% had low serum levels (200-400 pg/ml) and 4.4% had folic acid deficiency (<3 ng/ml). A high proportion of older adults with low serum levels of vitamin B12 presenting normal nutritional status by MNA was identified. This finding emphasizes the need to evaluate serum vitamin B12 levels, independently of the MNA results.

Topics: Aged; Aged, 80 and over; Cognition; Cognition Disorders; Cross-Sectional Studies; Depression; Female; Folic Acid; Folic Acid Deficiency; Geriatric Assessment; Hematinics; Humans; Luminescence; Male; Malnutrition; Nutrition Assessment; Nutritional Status; Portugal; Reference Values; Vitamin B 12; Vitamin B 12 Deficiency

Chronic arsenic toxicity is a serious environmental health problem across the world. Bangladesh and India (particularly the state of West Bengal) are the worst affected countries with such problem. The present study reports plasma-aminothiols (p-aminothiols) like L-cysteine (L-Cys), cysteinyl glycine (Cys-gly), total homocysteine (t-Hcy) and glutathione (GSH) status, and the inverse relationship of t-Hcy with B-vitamins (B1, B6, B9 and B12) in arsenic exposed population of West Bengal, India. Reverse phase HPLC was used to measure p-aminothiols and serum B-vitamins in different arsenic exposed population. Arsenic in drinking water and urine were measured by flow injection analysis system - Atomic Absorption Spectrometry (FIAS-AAS) and Transversely heated graphite atomizer (THGA-AAS) techniques, respectively. Water arsenic exposure was >50 µg/L in 50% population, of which majority (33.58%) belong to the range of >50-500 µg/L and more than 8% were even >1000 µg/L. Urine arsenic (µg/g creatinine) levels increased with arsenic exposure. The variability among p-aminothiols was also observed with higher exposure to arsenic in drinking water. A significant difference between exposed and control population was noticed for plasma L-Cys. The difference of B-vitamins between the population exposed to <50 and >50 µg/L arsenic in drinking water was also found to be significant. B9 and B12 deficiency with increased consumption of arsenic in water corroborates the anemic conditions commonly observed among arsenic exposed population. The aminothiol status indicated oxidative stress in exposed population. This study demonstrated progressive increase in plasma t-Hcy as well as inverse relationships of serum B-vitamins with increased water arsenic concentration.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Arsenic; Bangladesh; Calibration; Case-Control Studies; Chromatography, High Pressure Liquid; Creatinine; Cysteine; Dipeptides; Drinking Water; Environmental Exposure; Environmental Health; Female; Folic Acid; Glutathione; Homocysteine; Humans; India; Male; Malnutrition; Middle Aged; Nutritional Status; Socioeconomic Factors; Vitamin B 12; Vitamin B Complex; Young Adult

To assess serum B12, folate and the associated homocysteine (Hcy) levels among women of childbearing age in the UK and examine their association with dietary intake in relation to the UK Recommended Nutrient Intakes (RNIs) for B12 and folate.. Cross-sectional study.. Data from two publicly available National Diet and Nutrition Surveys (NDNS 2000/2001 and 2008/2012) were used. These were population-based surveys of randomly selected samples of adults which were carried out in their households.. Women of childbearing age (aged 19-39 years), representative of the UK population. Those who were pregnant or breastfeeding were excluded.. The associations between micronutrient intakes and blood levels of B12, folate and Hcy were assessed by correlation and stepwise linear regression. B12 intake was divided into quintiles and plotted against blood B12 and Hcy concentrations to determine the threshold of any associations.. 299 women from the first NDNS cohort had complete intake and biomarker data. The prevalence of serum vitamin B12 (≤150 pmol/L) and serum folate (≤10 nmol/L) deficiency and hyperhomocysteinemia (≥12 µmol/L) was 12.4%, 6.4% and 21.2%, respectively, despite seemingly adequate B12 intakes (median 3.8 μg/day, 96% consumed more than the UK RNI of 1.5 μg/day). B12 concentrations increased across all quintiles of intake with serum levels in quintiles 4 and 5 (median intake 4.9 and 7.1 μg/day, respectively) significantly higher than quintile 1. However, Hcy concentrations levelled off between quintiles 4 and 5. Comparison of micronutrient intake between the two surveys found that folate intake has reduced in the more recent cohort.. The UK RNI for B12 intake should be increased for women of childbearing age with intakes of around 5-7 μg/day likely to be associated with stable biomarker levels. B12 levels should also be measured in women preconceptionally or in early pregnancy given the high rates of deficiency.

Topics: Adult; Cross-Sectional Studies; Diet; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Malnutrition; Nutrition Policy; Nutrition Surveys; Prevalence; United Kingdom; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

the question on whether undernutrition remains linked to depressive symptoms, considering the effect of deficiencies of vitamin B12 and folate, is of practical relevance because they are potentially preventable and treatable. This study aims to evaluate whether undernutrition is linked to depressive symptoms, considering the effect of vitamin B12 and folate plasma levels.. a cross-sectional study was conducted in a sample of 84 older adults living in care homes. Data about nutritional status using Mini-Nutritional Assessment, serum folic acid and Vitamin B12 levels, cognitive ability, functional dependency, symptoms and /or depressive behaviour was obtained. Depression symptoms were measured using the 20-item version of the Center for Epidemiologic Studies Depression scale.. fifty three older adults were at depression risk (63.1%). Of those, 34% were at undernutrition risk. Although a high frequency of older adults with low plasma levels of vitamin B12 (42.9%) and lower levels of folic acid (5.9%) was found, no significant differences concerning the existence of depressive symptoms were found. In the multivariable analysis, an increase in depression risk was observed amongst participants nutritionally at risk OR = 3.47 (1.05-11.46), whereas having low levels of folic acid and Vitamins B12 were not associated with depression risk.. amongst undernourished older adults, an increase in risk of depression was observed independently of folic acid and vitamin B12 status. These results highlight the need to implement preventive strategies, particularly directed at older adults living in care home.. Antecedentes: la cuestión del posible vínculo entre la desnutrición y los síntomas depresivos, considerando el efecto de las deficiencias de vitamina B12 y de folato, es de importancia práctica porque estas son potencialmente prevenibles y tratables. Este estudio tiene como objetivo evaluar si la desnutrición está relacionada con los síntomas depresivos, teniendo en cuenta el efecto de los niveles plasmáticos de vitamina B12 y de folato. Método: un estudio transversal se llevó a cabo en una muestra de 84 adultos mayores que viven en hogares de cuidado. Se obtuvieron datos sobre el estado nutricional utilizando Mini-Nutritional Assessment, los niveles séricos de ácido fólico y vitamina B12, la capacidad cognitiva, la dependencia funcional, y/o los síntomas de comportamiento depresivo. Los síntomas de depresión se midieron utilizando la versión de 20 ítems de la Escala de Depresión del Centro de Estudios Epidemiológicos. Resultados: cincuenta y tres adultos mayores estaban en riesgo de depresión (63,1%). De ellos, el 34% estaban en riesgo de desnutrición. Aunque se encontró una alta frecuencia de adultos mayores con bajos niveles plasmáticos de vitamina B12 (42,9%) y niveles más bajos de ácido fólico (5,9%), no se encontraron diferencias significativas en relación con la existencia de síntomas depresivos. En el análisis multivariable se observó un aumento en el riesgo de depresión entre los participantes con riesgo nutricional OR = 3,47 (1,05 a 11,46), mientras tener bajos niveles de ácido fólico y vitamina B12 no se asociaron con el riesgo de depresión. Conclusión: entre los adultos mayores desnutridos se observó un aumento en el riesgo de depresión, independientemente del ácido fólico y del estado de la vitamina B12. Estos resultados ponen de manifiesto la necesidad de implementar estrategias preventivas, especialmente dirigidas a los adultos mayores que viven en hogares de cuidado.

Topics: Aged; Aged, 80 and over; Anthropometry; Cross-Sectional Studies; Depression; Dietary Supplements; Female; Folic Acid; Geriatric Assessment; Humans; Life Style; Male; Malnutrition; Muscle Strength; Nutritional Status; Population Surveillance; Portugal; Risk Factors; Vitamin B 12

Maternal under-nutrition increases the risk of developing metabolic diseases. We studied the effects of chronic maternal dietary vitamin B12 restriction on lean body mass (LBM), fat free mass (FFM), muscle function, glucose tolerance and metabolism in Wistar rat offspring. Prevention/reversibility of changes by rehabilitating restricted mothers from conception or parturition and their offspring from weaning was assessed. Female weaning Wistar rats (n = 30) were fed ad libitum for 12 weeks, a control diet (n = 6) or the same with 40% restriction of vitamin B12 (B12R) (n = 24); after confirming deficiency, were mated with control males. Six each of pregnant B12R dams were rehabilitated from conception and parturition and their offspring weaned to control diet. While offspring of six B12R dams were weaned to control diet, those of the remaining six B12R dams continued on B12R diet. Biochemical parameters and body composition were determined in dams before mating and in male offspring at 3, 6, 9 and 12 months of their age. Dietary vitamin B12 restriction increased body weight but decreased LBM% and FFM% but not the percent of tissue associated fat (TAF%) in dams. Maternal B12R decreased LBM% and FFM% in the male offspring, but their TAF%, basal and insulin stimulated glucose uptake by diaphragm were unaltered. At 12 months age, B12R offspring had higher (than controls) fasting plasma glucose, insulin, HOMA-IR and impaired glucose tolerance. Their hepatic gluconeogenic enzyme activities were increased. B12R offspring had increased oxidative stress and decreased antioxidant status. Changes in body composition, glucose metabolism and stress were reversed by rehabilitating B12R dams from conception, whereas rehabilitation from parturition and weaning corrected them partially, highlighting the importance of vitamin B12 during pregnancy and lactation on growth, muscle development, glucose tolerance and metabolism in the offspring.

Topics: Animals; Animals, Newborn; Antioxidants; Blood Glucose; Body Composition; Body Weight; Catalase; Female; Glucose; Homocysteine; Insulin; Liver; Male; Malnutrition; Maternal Nutritional Physiological Phenomena; Models, Animal; Oxidative Stress; Phosphoenolpyruvate Carboxykinase (ATP); Pregnancy; Rats; Rats, Wistar; Superoxide Dismutase; Vitamin B 12

Cobalamin (Cb) blood levels are frequently measured among inpatients, but the relevance of Cb determination has not been correctly assessed in this clinical setting.. We aimed to prospectively evaluate current indications compared to traditional guidelines for assessing Cb blood levels among inpatients from internal medicine departments.. This study was conducted in French departments of internal medicine between 2008 and 2009. Inpatients who underwent Cb blood level determination during a 6-week study period were eligible.. 380 consecutive adult patients were included. The three most common indications for Cb assessment were anaemia (62.6%), cognitive impairment (20.2%) and undernutrition (17.4%). Traditional indications (ie, macrocytic non-regenerative anaemia, isolated macrocytosis, dementia and proprioceptive disorders) accounted for only 33.9% of all tests. Cb deficiency was identified in 40 (10.5%) of the 380 patients tested. Overall, traditional indications were not associated with a significantly higher prevalence of patients with low Cb levels than current guidelines (14% vs 8.8%; p=0.119). Non-regenerative macrocytic anaemia was the only indication with a significantly better performance compared to all other indications (11 of 62 patients (17.7%) vs 29 of 318 patients (9.1%); OR 2.15 (1.01-4.57), p=0.047). The main aetiological causes of Cb deficiency were intake deficiency, pernicious anaemia and food-Cb malabsorption. Homocysteine or methylmalonic acid dosage testing was very rarely performed.. Traditional indications did not perform better than other indications observed in current practice for identifying low Cb levels among inpatients from internal medicine departments. Future studies are needed to establish robust guidelines for inpatient screening.

Topics: Aged; Aged, 80 and over; Anemia; Cognition Disorders; Data Collection; Female; France; Humans; Inpatients; Internal Medicine; Male; Malnutrition; Mass Screening; Middle Aged; Prospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Concern over micronutrient inadequacies in Uganda has prompted the introduction of mass fortification.. To use food intake to determine nutrient inadequacies in children aged 24 to 59 months and nonpregnant women of reproductive age, and to model the adequacy of mass fortification.. Data were collected by the 24-hour recall method in three regions. Usual nutrient intakes were calculated by adjusting actual intake distribution for the intraindividual variance. The impact of fortification on intake adequacy was simulated.. The nutrients with the highest prevalence of inadequate intake across regions were vitamin A (30% to 99%), vitamin B12 (32% to 100%), iron (55% to 89%), zinc (18% to 82%), and calcium (84% to 100%). According to simulations, fortification of vegetable oil and sugar with vitamin A would reduce the prevalence of vitamin A inadequacy in the Western and Northern regions; in Kampala it would eliminate vitamin A inadequacy but would cause 2% to 48% of children to exceed the Tolerable Upper Intake Level (UL). The proposed fortification of wheat flour would reduce the prevalence of inadequate intakes of thiamine, riboflavin, folate, and niacin in Kampala, but would have little impact in the other two regions due to low flour consumption.. Micronutrient fortification of vegetable oil and sugar in all regions and of wheat flour in Kampala would reduce the prevalence of micronutrient inadequacies. However, the wheat flour formulation should be modified to better meet requirements, and the vitamin A content in sugar should be reduced to minimize the risk of high intakes. Maize flour may be suitable for targeted fortification, but prior consolidation of the industry would be required for maize flour to become a good vehicle for mass fortification.

Topics: Calcium, Dietary; Carbohydrates; Child, Preschool; Diet; Female; Flour; Food; Food, Fortified; Humans; Iron, Dietary; Malnutrition; Micronutrients; Nutritional Status; Triticum; Uganda; Vitamin A; Vitamin B 12; Zea mays; Zinc

We designed this study, to evaluate the interaction (relation) between vitamin B12 and folic acid levels and length of hospital stay in elderly inpatients.. In this cross-sectional study, the Mini Nutritional Assessment-Short Form (MNA-SF) test was used to evaluate nutritional status of 615 (239 men, 376 female; mean age 72.89 ± 8.93 y) inpatients of a university hospital. Length of stay and blood samples in elderly inpatients were evaluated.. Only 33.8% of the patients were classified as having an adequate nutritional status; 44.3% had a risk of malnutrition, and 21.8% were classified as malnourished. Low MNA-SF score was related to length of stay, but vitamin B12 and folic acid were not related to risk of malnutrition and length of stay.. MNA-SF score is associated with length of stay; however, vitamin B12 level, per se, is not associated with length of hospital stay in elderly inpatients.

Topics: Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Folic Acid; Geriatric Assessment; Humans; Length of Stay; Male; Malnutrition; Middle Aged; Nutrition Assessment; Nutritional Status; Prevalence; Vitamin B 12

Vitamin B12 belongs to the biologically active compounds related to cyanocobalamin group. The bioavailability of B12 from different food products varies considerably, for example from the chicken meat it ranges from 61 to 66%, from fish meat is 42%, and from eggs below 9% only. The deficiency of vitamin B12 could easily be overcame by the appropriate diet or food supplements.. The aim of this study was to characterize the fortified with vitamin B12 food products available on the market and to assess the possibilities of increasing the intake of this vitamin by including such products into the daily diet.. The study was carried out in winter 2011, at eleven Warsaw supermarkets. Information about food products was based on label declarations. There were 220 products fortified with vitamin B12 from various food categories, like breakfast cereals, fruit juice, non-alcoholic beverages, cereals bars, candies, instant cocoa and tea, margarine, as well as soya products. Breakfast cereals (40%) and juice, non-alcoholic beverages (30%) were the largest groups. RESULTS. The highest amount of vitamin B12 was found in some candies (max. 4,5 microg/100 g) and instant tea (max. 3,75 microg/100g). The lowest amount was found in some fruit beverages (min. 0,12 microg/100 g). There is possibility of increasing the vitamin B12 intake by consuming various fortified products: for instance a glass of soya drink (20,8% RDA), a cup of soya pudding (15%), a glass of instant tea (14%), apple juice (12,5%), a cereal bar (10%), a bowl of corn flakes (9,8%) or a slice of bread with margarine (7,5%). The intake of one average portion of chosen food products fortified with vitamin B12 provides about 0,18-0,5 microg (7,5-20,8% Polish RDA for adults).. The wide public education is essential for increasing the role of these products in nutrition, it is especially recommendable to vegetarian and elderly people.

Topics: Diet; Food Analysis; Food, Fortified; Humans; Malnutrition; Nutritional Requirements; Nutritional Status; Nutritive Value; Poland; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged, 80 and over; Anemia; Female; Ferritins; Folic Acid; Glomerular Filtration Rate; Hemoglobins; Humans; Kidney Diseases; Male; Malnutrition; Retrospective Studies; Sex Factors; Vitamin B 12

To evaluate the determinants of total plasma homocysteine levels and their relations with nutritional parameters, inflammatory status, and traditional risk factors for cardiovascular disease in renal failure patients on dialysis treatment.. The study was conducted on 70 clinically stable patients, 50 of them on hemodialysis (70% men; 55.3 ± 14.5 years) and 20 on peritoneal dialysis (50% men; 62 ± 13.7 years). Patients were analyzed in terms of biochemical parameters (serum lipids, creatinine, homocysteine [Hcy], creatine-kinase [Ck], folic acid, and vitamin B(12)), anthropometric data, markers of inflammatory status (tumor necrosis factor-alpha, C-reactive protein, interleukin-6), and adapted subjective global assessment.. The total prevalence of hyperhomocysteinemia (>15 μmol/L) was 85.7%. Plasma folic acid and plasma vitamin B(12) were within the normal range. Multiple regression analysis (r(2) = 0.20) revealed that the determinants of total Hcy were type of dialysis, creatinine, Ck, folic acid, and total cholesterol. Hcy was positively correlated with albumin and creatinine and negatively correlated with total cholesterol, high density lipoprotein cholesterol, folic acid, and vitamin B(12).. The determinants of total Hcy in the study sample were type of dialysis, creatinine, Ck, folic acid, and total cholesterol. Evidently, the small sample size might have had an effect on the statistical analyses and further studies are needed. However, Hcy in patients on dialysis treatment may not have the same effect as observed in the general population. In this respect, the association between malnutrition and inflammation may be a confounding factor in the determination of the true relationship between Hcy, nutritional status, and cardiovascular risk factors in this group.

Topics: Adult; Aged; Biomarkers; Brazil; C-Reactive Protein; Creatine Kinase; Creatinine; Female; Folic Acid; Follow-Up Studies; Homocysteine; Humans; Hyperhomocysteinemia; Inflammation; Interleukin-6; Kidney Failure, Chronic; Linear Models; Lipids; Male; Malnutrition; Middle Aged; Peritoneal Dialysis; Prevalence; Renal Dialysis; Risk Factors; Tumor Necrosis Factor-alpha; Vitamin B 12

While undernutrition and anaemia have previously been linked to poor development of children, relatively little is known about the role of B-vitamins and fatty acids on cognition. The present study aims to explore the associations between indicators of body size, fatty acid and micronutrient status on cognitive performance in 598 Indian school children aged 6-10 years. Baseline data of a clinical study were used to assess these associations by analyses of variance adjusting for age, sex, school, maternal education and cognitive tester. The Kaufman Assessment Battery for Children II was used to measure four cognitive domains, including fluid reasoning, short-term memory, retrieval ability and cognitive speediness. Scores were combined into an overall measure, named mental processing index (MPI). Body size indicators and Hb concentrations were significantly positively related to cognitive domains and MPI, such that increases of 1 sd in height-for-age and weight-for-age z-scores would each translate into a 0.09 sd increase in MPI, P = 0.0006 and 0.002, respectively. A 10 g/l increase in Hb concentrations would translate into a 0.08 sd increase in MPI, P = 0.0008. Log-transformed vitamin B12 concentrations were significantly inversely associated with short-term memory, retrieval ability and MPI (beta (95 % CI) = - 0.124 (- 0.224, - 0.023), P = 0.02). Other indicators of Fe, iodine, folate and fatty acid status were not significantly related to cognition. Our findings for body size, fatty acids and micronutrients were in agreement with previous observational studies. The inverse association of vitamin B12 with mental development was unexpected and needed further study.

Topics: Analysis of Variance; Anemia; Body Size; Child; Child Development; Cognition; Cross-Sectional Studies; Fatty Acids; Female; Hemoglobins; Humans; India; Male; Malnutrition; Micronutrients; Nutritional Status; Vitamin B 12

Anaemia in the very elderly is usually dissected to a variety of root causes. The frequency of nutritional anaemias is particularly uncertain, since there is controversy on the real prevalence of folate, vitamin B12 and iron deficiencies, as well as on their potential pathophysiological relationship with anaemia.. We retrospectively analysed results of haemoglobin, ferritin, folate and vitamin B12 measurements performed on a cohort of unselected subjects over 85 years old who were referred by general practitioners for routine diagnostic check-up to our laboratory over the past 2 years. Furthermore, glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Disease (MDRD) formula.. The overall prevalence of nutritional deficiencies was low in males (<25%) and very low in females (<15%). Significant differences between anaemic and non-anaemic subjects were observed only for GFR in both males (44+/-3 versus 67+/-3 mL/min/1.73 m(2); p=0.035) and females (42+/-3 versus 61+/-3 mL/min/1.73 m(2); p=0.019). Likewise, a significantly difference in the frequency of anaemic and non-anaemic subjects with values below the conventional thresholds of the parameters tested was observed only for GFR in both males (59 versus 14%; p<0.001) and females (61 versus 41%; p<0.001), and for ferritin in females (15 versus 5%; p<0.001). In multiple linear regression analysis haemoglobin values were significantly associated only with GFR (both in men and women).. The results of this study suggest that impaired renal function might be the major determinant of anaemia in the very elderly. Accordingly, the cost-effectiveness of screening for nutritional deficiencies in older individuals is doubtful, since it would be associated with substantial expenditure and limited diagnostic efficiency.

Topics: Aged, 80 and over; Anemia; Female; Ferritins; Folic Acid; Glomerular Filtration Rate; Hemoglobins; Humans; Kidney Diseases; Male; Malnutrition; Retrospective Studies; Sex Factors; Vitamin B 12

Impaired one-carbon metabolism is thought to be associated with the risk of neural tube defects (NTDs); however, the role of methylation in NTDs remains unclear. Long interspersed nucleotide element-1 (LINE-1) constitutes 17-25% of the human genome. LINE-1 hypomethylation correlates with global DNA methylation levels in cancerous cells, but limited information is available on LINE-1 methylation in NTDs.. We determined whether LINE-1 methylation patterns were associated with neural tube development and the possible relations between DNA methylation and key maternal metabolites involved in folate-mediated one-carbon metabolism.. Global methylation, maternal plasma folic acid, vitamin B-12, and total homocysteine (tHcy) concentrations were assessed in 48 NTD and 49 control samples by immunoassay, and LINE-1 methylation levels were evaluated by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.. Methylation levels of genomic DNA and LINE-1 decreased significantly in the neural tissue of NTD samples. The risk of NTDs increased with decreasing levels of LINE-1 methylation, with an odds ratio of 5.246 (95% CI: 1.519, 18.124; P = 0.009) for the lowest quartile (methylation level < or = 57.94%) compared with the highest quartile (methylation level > or = 60.94%). Compared with control subjects, case subjects had lower maternal plasma concentrations of vitamin B-12.. Hypomethylation of LINE-1 and genomic DNA was associated with an increased risk of NTDs. Functional insufficiency of maternal plasma vitamin B-12 was associated with NTDs, although no significant correlation could be established between maternal folic acid, vitamin B, tHcy, and LINE-1 methylation.

Topics: Adult; Base Sequence; DNA Methylation; Educational Status; Embryonic Development; Female; Genome, Human; Homocysteine; Humans; Immunoassay; Long Interspersed Nucleotide Elements; Male; Malnutrition; Molecular Sequence Data; Neural Tube Defects; Open Reading Frames; Parity; Pregnancy; Pregnancy Complications; Risk Factors; Vitamin B 12; Young Adult

Elderly people are at risk for malnutrition, and those who consume a puréed diet may be particularly at risk. A fortification procedure was developed at a long-term care (LTC) facility, and nutrient intakes and serum vitamin levels were assessed to determine whether they subsequently increased.. Fortification levels were determined using a combination of two techniques: the Dietary Reference Intakes planning formula and Health Canada's defined nutrient contribution method. For six puréed foods, triangle sensory tests were performed to determine whether fortification changed the flavour of the foods. Four fortified foods were incorporated into the daily puréed menu at an LTC facility. Nutrient intakes of 10 residents and serum vitamin B12, folate, and 25-hydroxyvitamin D levels of 11 residents were analyzed at baseline and eight weeks after the intervention.. Nutrient intakes increased after the intervention for all nutrients in the fortification mix (p0.01). 25-hydroxyvitamin D and folate levels increased after the intervention (p0.01), but serum vitamin B12 levels did not change (p>0.05).. The development of acceptable vitamin-fortified puréed foods is feasible and is an effective way to increase the micronutrient status of LTC residents. Mineral fortification requires further work to minimize flavour changes.

Topics: Aged; Folic Acid; Food, Fortified; Humans; Institutionalization; Long-Term Care; Malnutrition; Nutritional Requirements; Pilot Projects; Taste; Vitamin B 12; Vitamin D; Vitamins

Previous findings for the Texas Neural Tube Defects Project suggested that while maternal access to nutrients is adequate, bioavailability of nutrients to the fetus is compromised in NTD-affected pregnancies. Helicobacter pylori could cause nutrient loss to the fetus. Folate, B12, and ferritin are depleted in H. pylori infection; these same deficiencies are related to NTD risk.. Using H. pylori IgG ELISA Test System, we tested for H. pylori serum antibodies in participants in the population-based case-control study component of the Texas Neural Tube Defect Project conducted along the Texas-Mexico border. Case-women had pregnancies affected by NTD (anencephalus, spina bifida, encephalocele) and resided and delivered in one of the 14 Texas-Mexico border counties from 1995 through 2000. Control-women were study area residents delivering normal live births during the same period.. Of 225 case- and 378 control-women, 103 cases and 156 controls provided questionnaire and H. pylori antibody data. H. pylori seropositivity was modestly associated with NTD-affected pregnancies (OR 1.4; 95% CI: 0.8-2.4). ORs of 2.0 or greater were seen in women younger than age 25 and with less than 7 years education.. Our findings intimate that H. pylori could play a role in NTD causation in certain populations. While results did not provide compelling support for this proposal, subgroup findings prompt us to advocate an evaluation of this hypothesis in developing nations among populations with higher prevalence of H. pylori, marginal nutrient intake, and young childbearing age.

Topics: Adult; Case-Control Studies; Female; Ferritins; Folic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Malnutrition; Micronutrients; Neural Tube Defects; Pregnancy; Risk Factors; Surveys and Questionnaires; Texas; Vitamin B 12

Iron, folate, and vitamin B12 deficiencies have adverse effects on pregnancy outcome. In India, data on the concomitant prevalence of these deficiencies among pregnant women are meager.. We conducted a community-based study to assess the prevalence of deficiencies of iron, folate, and vitamin B12 among pregnant women in a rural block of Haryana State.. The study was approved by the ethics committee of the All India Institute of Medical Sciences, New Delhi. A total of 283 pregnant women were enrolled in the study. After oral informed consent had been obtained from the women, blood was drawn from the antecubital vein for estimation of the levels of serum ferritin by enzyme-linked immunosorbent assay (levels < 12 ng/ mL were considered as indicative of poor iron stores); serum folate was determined by radioimmunoassay (levels <3 ng/mL were considered as indicative of poor folate stores); and serum vitamin B12 was estimated by the microbiologic method (levels < 200 pg/mL were considered as indicative of poor vitamin B12 stores).. The results indicated that 67.7%, 26.3%, and 74.1% of the women had poor iron, folate, and vitamin B12 stores, respectively. Concomitant deficiencies of iron, folate, and vitamin B12 occurred in 16.2% of the women. We found that 59.9% of the women were consuming less than 75% of the recommended daily caloric allowance (2175 kcal), indicating an overall poor food intake. This could be one of the predominant reasons for poor iron, folate, and vitamin B12 stores among the women.. Our findings suggest that apart from iron and folate, vitamin B12 deficiencies may play an important role in causing anemia.

Topics: Adolescent; Adult; Comorbidity; Female; Folic Acid; Folic Acid Deficiency; Humans; India; Iron; Iron Deficiencies; Malnutrition; Micronutrients; Nutritional Requirements; Nutritional Status; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prevalence; Rural Population; Vitamin B 12; Vitamin B 12 Deficiency

In this article, we report the results of a case control study carried out on 290 Turkish pregnant women at 5-24 wk of gestation to determine their zinc, folic acid, and vitamin B12 levels in relation to their nutritional and socioeconomic status. The women were divided into two groups (n=145 each), depending on the stage of gestation. Group I consisted of women in the first trimester of gestation; those in the second trimester were allocated into group II. Twenty-five age-matched, healthy nonpregnant women were selected as controls. The nutritional status of the subjects was determined by means of a survey. Based on this, the women were subdivided into three subgroups: malnourished (PN), moderately nourished (MN), and well nourished (WN). Also from the survey, the socioeconomic status was classified as good (G) or bad (B). A statistically significant decrease on zinc and folic acid was observed in group I women, as their socioeconomic status worsened. In group II, zinc decreased only in the PN and MN subgroups, p<0.001. The folic acid and vitamin B12 levels did not change significantly during the second trimester of gestation in all subgroups. Regarding zinc, nutrition, or dietary habits are more relevant than socioeconomic status, but poor nutrition affects folic acid levels only during the first trimester of gestation.

Topics: Adolescent; Adult; Case-Control Studies; Data Interpretation, Statistical; Feeding Behavior; Female; Folic Acid; Humans; Malnutrition; Nutritional Status; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Social Class; Vitamin B 12; Zinc

Topics: Deficiency Diseases; Diagnostic Tests, Routine; Diet; Diet Therapy; Dumping Syndrome; Humans; Intestinal Absorption; Malnutrition; Oleic Acid; Peptic Ulcer; Postgastrectomy Syndromes; Stomach Neoplasms; Surgical Procedures, Operative; Suture Techniques; Vitamin B 12

Topics: Body Weight; Corrinoids; Humans; Malnutrition; Nutrition Disorders; Vitamin B 12

Topics: Child; Corrinoids; Dietary Supplements; Hematinics; Humans; Malnutrition; Physiological Phenomena; Vitamin B 12

Topics: Child; Corrinoids; Hematinics; Humans; Infant; Infant Nutrition Disorders; Malnutrition; Nitrogen; Vitamin B 12