vitamin-b-12 and Respiratory-Tract-Infections

Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children.. We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children.. Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally.. Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm.. A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.

Topics: Body Weight; Child Development; Diarrhea; Dietary Supplements; Energy Intake; Follow-Up Studies; Haiti; Humans; Infant; Infant Nutritional Physiological Phenomena; Iron, Dietary; Longitudinal Studies; Morbidity; Poverty Areas; Respiratory Tract Infections; Socioeconomic Factors; Urban Population; Vitamin A; Vitamin B 12; Zinc

Young children in low- and middle-income countries frequently have inadequate vitamin B-12 (cobalamin) status. Poor folate status is also common and is associated with increased diarrheal and respiratory morbidity.. The objective was to measure the effect of folic acid and/or vitamin B-12 administration on the incidence of diarrhea and acute lower respiratory tract infections.. One thousand North Indian children (6-30 mo of age) were enrolled in a randomized, double-blind, placebo-controlled trial to receive 2 times the Recommended Dietary Allowance of folic acid and/or vitamin B-12 or placebo daily for 6 mo. Children were individually randomly assigned in a 1:1:1:1 ratio in blocks of 16. Primary outcomes were the number of episodes of acute lower respiratory infections, diarrhea, and prolonged diarrhea.. Folic acid and vitamin B-12 supplementation significantly improved vitamin B-12 and folate status, respectively. Neither folic acid nor vitamin B-12 administration reduced the incidence of diarrhea or lower respiratory infections. In comparison with placebo, children treated with folic acid alone or in combination with vitamin B-12 had a significantly higher risk of persistent diarrhea (OR: 2.1; 95% CI: 1.1, 3.8).. Folic acid or vitamin B-12 supplementation did not reduce the burden of common childhood infections. In view of the increased risk of diarrhea, the safety of folic acid supplements in young children should be further assessed. This trial was registered at www.clinicaltrials.gov as NCT00717730 and at www.ctri.nic.in as CTRI/2010/091/001090.

Topics: Child, Preschool; Diarrhea; Dietary Supplements; Double-Blind Method; Female; Folic Acid; Folic Acid Deficiency; Humans; India; Infant; Male; Nutrition Policy; Odds Ratio; Respiratory Tract Infections; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex; Vitamin B Deficiency

A recent trial of vitamin B12 supplementation among Indian children 6-30 months found no effect on the incidence of diarrhea and respiratory infections. These results differ with studies in adults that showed improvement of the immune response following treatment with vitamin B12. We sought to determine how the adequacy of vitamin B12 concentrations in breast milk could act as immune modulator and protect against the incidence of diarrhea and respiratory infections of children up to 18 months in urban Tanzania.. A prospective cohort study was undertaken to determine the association of breast milk vitamin B12 concentration with the incidence of acute respiratory infection and diarrhea among infants in urban Tanzania. A random sample of 491 women enrolled in a trial of multivitamins provided milk for B12 analysis at or around 6 weeks postpartum. Of 491 women, 345 had breast milk vitamin B12 inadequacy (< 310 pmol/L). Using generalized estimating equations, we found no overall association of milk vitamin B12 concentration with incident diarrhea and acute respiratory infections in infants. Studies measuring longitudinal changes of breast milk B12 concentration over time are needed to clarify the role of breast milk vitamin B12 in childhood infections.

Topics: Acute Disease; Adolescent; Adult; Breast Feeding; Diarrhea; Female; Humans; Incidence; Infant; Lactation; Male; Milk, Human; Prospective Studies; Respiratory Tract Infections; Tanzania; Vitamin B 12; Young Adult

Topics: Child; Child, Preschool; Folic Acid; Homocysteine; Humans; Hypersensitivity; Pediatric Obesity; Respiratory Tract Infections; Vitamin B 12

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

Topics: Child, Preschool; Diarrhea; Dietary Supplements; Female; Folic Acid; Humans; India; Infant; Luminescent Measurements; Male; Odds Ratio; Pneumonia; Respiratory Tract Infections; Seasons; Social Class; Vitamin B 12; Vitamin D; Vitamin D Deficiency

The Imersland-Gräsbeck Syndrome (IGS) is a rare inherited disorder characterized by megaloblastic anemia due to a selective Vitamin B₁₂ malabsorption in association with mild proteinuria. This syndrome can be diagnosed and treated easily. Herein, we describe an infant with IGS as a rare etiology of growth retardation with diarrhea, vomiting and therapy-resistant proteinuria.

Topics: Anemia, Megaloblastic; Diarrhea, Infantile; Growth Disorders; Humans; Infant; Malabsorption Syndromes; Male; Proteinuria; Recurrence; Respiratory Tract Infections; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex; Vomiting

Vitamin deficiencies are often part of malnutrition, which predisposes to acute lower respiratory tract infections.. The objective was to measure the association between cobalamin and folate status and subsequent respiratory morbidity.. A prospective cohort study was conducted in 2482 children aged 6-30 mo nested in a zinc supplementation trial. We measured plasma concentrations of folate, cobalamin, methylmalonic acid, and total homocysteine (tHcy) and followed the children for 4 mo.. We observed 1176 episodes of acute lower respiratory tract infections. Children with folate concentrations in the lowest quartile (interquartile range: 6.4-20.0 nmol/L) had a 44% higher incidence [adjusted incidence rate ratio (IRR): 1.44; 95% CI: 1.23, 1.70] of acute lower respiratory tract infections than did children in the other 3 quartiles. For tHcy, the IRR was 1.24 (1.07, 1.40) in a comparison of those in the highest quartile with those in the other quartiles. Breastfeeding was associated with high folate concentrations and protection against subsequent respiratory tract infections. This protection was significantly and substantially reduced after adjustment for plasma folate concentrations at baseline. Compared with the children in the other 3 quartiles, the IRR for being in the lowest quartile of cobalamin was 1.13 (0.76, 1.03) and for being in the highest quartile of methylmalonic acid was 1.12 (0.96, 1.31).. Poor folate status appears to be an independent risk factor for lower respiratory tract infections in young children. This study also suggests that the protective effect of breastfeeding is partly mediated by folate provided through breast milk.

Topics: Acute Disease; Child, Preschool; Cohort Studies; Female; Folic Acid; Homocysteine; Humans; Incidence; India; Infant; Male; Methylmalonic Acid; Multivariate Analysis; Prospective Studies; Regression Analysis; Respiratory Tract Infections; Risk Factors; Vitamin B 12

Topics: Anti-Infective Agents; Blood Platelets; Child, Preschool; Erythrocyte Count; Female; FIGLU Test; Folic Acid; Folic Acid Antagonists; Hemoglobins; Histidine; Humans; Infant; Kwashiorkor; Male; Nutrition Disorders; Pyrimidines; Respiratory Tract Infections; Sulfamethoxazole; Trimethoprim; Urinary Tract Infections; Vitamin B 12

Topics: Adolescent; Adrenal Glands; Adult; Aged; Betaine; Cholangitis; Enterocolitis, Pseudomembranous; Female; Hepatitis A; Humans; Infections; Male; Middle Aged; Respiratory Tract Infections; Tissue Extracts; Urinary Tract Infections; Vitamin B 12

Topics: Adolescent; Age Factors; Body Weight; Child; Child, Preschool; Citrates; Copper; Dyspepsia; Feeding and Eating Disorders; Gastroenteritis; Humans; Infant; Infant, Newborn; Iron; Manganese; Nucleotides; Respiratory Tract Infections; Vitamin B 12

Topics: Adult; Aged; Aminopyrine; Analgesics; Female; Fever; Humans; Joint Diseases; Male; Middle Aged; Pyridoxine; Quinolines; Respiratory Tract Infections; Rheumatic Diseases; Spinal Diseases; Vitamin B 12

Topics: Humans; Respiratory Tract Infections; Virus Diseases; Vitamin B 12