Vitamin B12, folate deficiencies more prevalent in adolescents than younger kids – India study

By Hui Ling Dang

- Last updated on GMT

A new survey from India has found a higher rate of vitamin B12 and folate deficiencies in teenagers than in younger children. ©Getty Images
A new survey from India has found a higher rate of vitamin B12 and folate deficiencies in teenagers than in younger children. ©Getty Images

Related tags India Vitamin b12 deficiency Folate deficiency Children adolescents

There is a higher rate of vitamin B12 and folate deficiencies in teenagers than in younger children, according to a new survey from India.

Vitamin B12 deficiency among adolescents aged 10 to 19 was over two times higher than pre-schoolers and school-age kids.

Folate deficiency among adolescents was also more common, with the condition seen in one in three adolescents.

Deficiencies of vitamin B12 and folate are linked to metabolic disorders.

Vitamin B12 is only found in animal-based foods such as meat, poultry, fish, and dairy products, while folate is abundant in both animal and plant foods.

As plant-based diets are widely adopted among the Indian population, it could contribute to inadequate intake of these nutrients.

Although a high prevalence of B12 and folate deficiency has been reported in India, the studies were not nationally representative.

As such, the country’s Ministry of Health and Family Welfare conducted the Comprehensive National Nutrition Survey (CNNS), a cross-sectional survey involving Indian children and adolescents across 29 states and the union territory of Delhi from February 2016 to October 2018.

The total sample group, who were interviewed and had their anthropometric measurements collected, consisted of 105,243 participants — specifically, pre-schoolers (one to four years old), school-age children (five to nine years old), and adolescents (10 to 19 years old).

Among them, data on serum vitamin B12 and erythrocyte folate levels of 33,880 and 38,750 participants respectively were analysed.

Findings published in Nutrients ​showed that the prevalence of vitamin B12 deficiency was highest among adolescents at 31%, followed by school-age children (17.3%), and preschool children (13.8%).

Folate deficiency was also higher among adolescents at 35.6%, as compared to 27.6% in school-age children and 22.8% in preschool children.

In addition, although vitamin B12 and folate levels tended to decline with age in both genders, the decrease was significantly greater in adolescent boys.

“Adolescent boys had 8% higher B12 and 5% higher folate deficiency, as compared to girls of the same age group. The bigger prevalence of B12 deficiency among boys may be explained by a greater need for micronutrients to sustain rapid muscular growth during adolescence,” ​the authors wrote.  

Other key findings

There was no association found between anthropometric undernutrition and vitamin B12 and folate deficiency, except for a significantly lower prevalence of B12 deficiency among five- to nine-year-old severely stunted children and 10- to 19-year-old severely wasted children.

“Although this occurrence is counterintuitive, it could be a ramification of reduced metabolic requirements in the face of reduced growth and/or muscular activity,” ​the researchers explained.   

Besides increased growth requirements in children and adolescents, the authors indicated that chronic low intakes through predominantly vegetarian diets and poor absorption could induce the risk of nutrient deficiencies.

Furthermore, this study observed that B12 and folate deficiency was associated with 19 to 25% of anaemia prevalence.

Importance of filling deficiencies

Vitamin B12 and folate are required in various metabolic and biological functions related to DNA synthesis and child development.

These nutrients are also essential for the production of red blood cells, and the myelin sheath, an insulating layer that forms around nerves, including those in the brain and spinal cord.

Vitamin B12 and folate deficiencies occur throughout the life cycle and may result in different outcomes.

During pregnancy, they are associated with an increased risk of neural tube defects, low birth weight, intrauterine growth retardation, miscarriage, and pre-eclampsia.

In children, they can cause megaloblastic anaemia, stunting, infection, cognitive dysfunction, neurologic damage, and brain atrophy in severe cases.

“Our study bridges a critical information gap on the prevalence of B12 and FA deficiency in Indian children and adolescents and demonstrates that about a third of adolescent boys are likely to lack these nutrients.

“These findings are important to shape nutrition policy in India. More consistent use of thresholds to define FA and B12 deficiency is needed in order to assess the realistic impact it has on public health,” ​the authors concluded.

Source: Nutrients

“Prevalence of Vitamin B12 and Folate Deficiencies in Indian Children and Adolescents”

Authors: Tattari Shalini, et al

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