The Indian Journal of Nutrition and Dietetics

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Prevalence of Serum Cobalamin and Serum Folate Deficiency with Associated Risk Factors among Children Aged 0 to 19 Years in India – A Review


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1 Centre for Community Medicine, All India Institutes of Medical Sciences, New Delhi, Delhi - 110 029, India
     

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Anemia is broadly caused by nutritional and non-nutritional factors. Deficiency of cobalamin and folate are one of the causes of anemia and hence are of public health significance among 0 to 19 years old children in India. These deficiencies either alone or together may cause megaloblastic anemia, poor cognitive and motor development and stunting amongst children. To estimate the prevalence of serum cobalamin and serum folate with associated risk factors among children aged 0 to 19 years in India through various published studies. This review literature search was carried out using internet search engine namely PubMed, Google Scholar, Cochrane, Research gate using the term of cobalamin, vitamin B12, folate, children, deficiency and India from January 1st 2011 to June 30th 2021. Of the 252 research articles identified, 13 articles meeting the inclusion criteria (community based, cross sectional studies) were included and 5 articles among 0 to 5 years, 8 articles among 6 to 19 years reported the prevalence of cobalamin and folate deficiency. The prevalence of cobalamin deficiency ranged from 7 to 74% and prevalence of folate deficiency ranged from 1.5 to 40.2% among children aged 0 to 19 years. Most common associated risk factor identified was inadequacy of the diet and consumption of only vegetarian diet. Cobalamin and folate deficiency are of significant public health importance in age group 0 to 19 years in India. The deficiency varied across region and by contributing factors. Dietary diversification and promoting animal source of foods amongst children should be promoted to address cobalamin and folate deficiency.

Keywords

Cobalamin, Folate, Prevalence, Deficiency, Risk Factor, Children, Anemia
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  • Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. 2019. (2016). Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi. Comprehensive National Nutrition Survey (1.0; 315).

  • Stevens, G.A., Finucane, M.M., De-Regil, L. M., Paciorek, C.J., Flaxman, S.R., Branca, F., Peña-Rosas, J.P., Bhutta, Z.A. and Ezzati, M. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: A systematic analysis of population-representative data. The Lancet. Global Health, 2013, 1, 16-25. https://doi.org/10.1016/S2214-109X(13)70001-9.

  • Balarajan, Y., Ramakrishnan, U., Özaltin, E., Shankar, A.H. and Subramanian, S. Anaemia in low-income and middle-income countries. The Lancet, 2011, 378, 2123-2135. https://doi.org/10.1016/S0140-6736(10)62304-5

  • Bjørke-Monsen, A.L. and Ueland, P.M. Cobalamin status in children. J. Inherited Metab. Dis., 2011, 34, 111-119. https://doi.org/10.1007/s10545-010-9119-1

  • Mahmood. (n.d.). The metabolic processes of folic acid and Vitamin B12 deficiency. Retrieved May 10, 2022, from https://www.jhrr.org/article.asp?issn=2394 2010;year=2014;volume=1;issue=1;spage=5;epage=9;aulast=Mahmood

  • Pawlak, R., Parrott, S.J., Raj, S., Cullum-Dugan, D. and Lucus, D. How prevalent is vitamin B12 deficiency among vegetarians? Nutr. Rev., 2013, 71, 110-117. https://doi.org/10.1111/nure.12001

  • Goyal, S., Tiwari, K., Meena, P., Malviya, S. and Asif, Mohd. Cobalamin and folate status in malnourished children. Int. J. Contemp. Pediat., 2017, 4, 1480. https://doi.org/10.18203/2349-3291.ijcp20172690

  • Quadros, E.V. Advances in the understanding of cobalamin assimilation and metabolism. Bri. J. Haematol., 2010, 148, 195-204. https://doi.org/10.1111/j.1365-2141.2009.07937.x

  • Sivaprasad, M., Shalini, T., Balakrishna, N., Sudarshan, M., Lopamudra, P., Suryanarayana, P., Arlappa, N., Ravikumar, B.P., Radhika, M.S. and Reddy, G.B. Status of vitamin B12 and folate among the urban adult population in South India. Ann. Nutr. Metabol., 2016, 68, 94-102. https://doi.org/10.1159/000442677

  • Stover, P.J. Physiology of folate and vitamin B12 in health and disease. Nutr. Rev., 2004, 62, 3-12. https://doi.org/10.1111/j.1753-4887.2004.tb00070.x

  • Just, M. J. and Kozakiewicz, M. Depressive disorders co-existing with Addison-Biermeranemia- Case report. Neuropsy. Dis. Treat., 2015, 11, 1145-1148. https://doi.org/10.2147/NDT.S83137

  • Jani, R., Salian, N., Udipi, S., Ghugre, P., Lohia, N., Haas, J. and Boy, E. Folate status and intake of tribal Indian adolescents aged 10 to 17 years. Fd. Nutr. Bull., 2015, 36, 14-23. https://doi.org/10.1177/156482651503600102

  • Gupta, A., Kapil, U., Ramakrishnan, L., Pandey, R.M. and Yadav, C.P. Prevalence of vitamin B12 and folate deficiency in school children residing at high altitude regions in India. The Ind. J. Pediat., 2017, 84, 289-293. https://doi.org/10.1007/s12098-017-2291-7

  • Chakraborty, S., Chopra, M., Mani, K., Giri, A.K., Banerjee, P., Sahni, N.S., Siddhu, A., Tandon, N. and Bharadwaj, D. Prevalence of vitamin B12 deficiency in healthy Indian school-going adolescents from rural and urban localities and its relationship with various anthropometric indices: A cross-sectional study. J. Hum. Nutr. Diet., 2018, 31, 513-522. https://doi.org/10.1111/jhn.12541

  • Houghton, L.A., Trilok-Kumar, G., McIntosh, D., Haszard, J.J., Harper, M.J., Reid, M., Erhardt, J., Bailey, K. and Gibson, R.S. Multiple micronutrient status and predictors of anemia in young children aged 12-23 months living in New Delhi, India. PLOS ONE, 2019, 14, e0209564. https://doi.org/10.1371/journal.pone.0209564

  • Verma, S. Incidence of Vitamin B12 and folate deficiency amongst adolescents. Int. J. Contemp. Med. Res., 2017, 4, 1755 - 1757.

  • Yaikhomba, T., Poswal, L. and Goyal, S. Assessment of iron, folate and vitamin B12 status in severe acute malnutrition. The Ind. J. Pediat., 2015, 82, 511-514. https://doi.org/10.1007/s12098-014-1600-7

  • Mittal, M., Bansal, V., Jain, R. and Dabla, P.K. Perturbing satus of vitamin B12 in Indian infants and their mothers. Fd. Nutr. Bull., 2017, 38, 209-215. https://doi.org/10.1177/0379572117697535

  • Rajendra, Sudha, Sreekanthan, Vijayakumar, A., Rajendran, and Mohammed, M. Iron, vitamin B12 and folate deficiency in adolescents having nutritional anaemia. J. Evolut. Med. Dent. Sci., 2014, 3, 10626-10634.

  • Kadiyala, A., Palani, A., Rajendraprasath, S. and Venkatramanan, P. Prevalence of vitamin B12 deficiency among exclusively breast fed term infants in South India. J. Trop. Pediat., 2021, 67, 114. https://doi.org/10.1093/tropej/fmaa114

  • Kalyan G.B., Mittal, M. and Jain, R. Compromised Vitamin B12 Status of Indian Infants and Toddlers. Fd. Nutr. Bull., 2020, 41, 430-437. https://doi.org/10.1177/0379572120950886

  • Kapil, U., Toteja, G. and Bhadoria, A. Cobalamin and folate deficiencies among children in the age group of 12-59 months in India. Biomed. J., 2015, 38, 162. https://doi.org/10.4103/2319-4170.137768

  • Kapil, U. and Bhadoria, A.S. Prevalence of folate, ferritin and cobalamin deficiencies amongst adolescent in India. J. Family Med. Prim. Care., 2014, 3, 247-249. https://doi.org/10.4103/2249-4863.141619

  • Bhardwaj, A., Kumar, D., Raina, S.K., Bansal, P., Bhushan, S. and Chander, V. Rapid Assessment for coexistence of vitamin B12 and iron deficiency anemia among adolescent males and females in Northern Himalayan state of India. Anemia, 2013, 2013, 1-5. https://doi.org/10.1155/2013/959605

  • Ng’eno, B., Perrine, C., Whitehead, R., Subedi, G., Mebrahtu, S., Dahal, P. and Jefferds, M. High prevalence of vitamin B12 deficiency and no folate deficiency in young children in Nepal. Nutr., 2017, 9, 72. https://doi.org/10.3390/nu9010072

  • Stewart, C.P., Dewey, K.G., Lin, A., Pickering, A.J., Byrd, K.A., Jannat, K., Ali, S., Rao, G., Dentz, H.N., Kiprotich, M., Arnold, C.D., Arnold, B.F., Allen, L.H., Shahab-Ferdows, S., Ercumen, A., Grembi, J.A., Naser, A.M., Rahman, M., Unicomb, L. and Null, C. Effects of lipid-based nutrient supplements and infant and young child feeding counseling with or without improved Water, Sanitation and Hygiene (WASH) on anemia and micronutrient status: Results from 2 cluster-randomized trials in Kenya and Bangladesh. The Am. J. Clin. Nutr., 2019, 109, 148. https://doi.org/10.1093/ajcn/nqy239

  • Eneroth, H., elArifeen, S., Persson, L.Å., Lönnerdal, B., Hossain, M.B., Stephensen, C.B. and Ekström, E.C. Maternal multiple micronutrient supplementation has limited impact on micronutrient status of Bangladeshi infants compared with standard iron and folic acid supplementation, 2010, 140, 618-624. https://pubag.nal.usda.gov/catalog/40246?msclkid=54207659d04411eca44b4e1f14f62c90

  • Benson, J., Phillips, C., Kay, M., Webber, M.T., Ratcliff, A. J., Correa-Velez, I. and Lorimer, M. F. Low vitamin B12 levels among newly-arrived refugees from Bhutan, Iran and Afghanistan: A multicentre Australian study. PLoS ONE, 2013, 8, e57998. https://doi.org/10.1371/journal.pone.0057998

  • Hettiarachchi, M. and Liyanage, C. Coexisting micronutrient deficiencies among Sri Lankan pre-school children: A community-based study. Mat. Child Nutr., 2010, 8, 259-266. https://doi.org/10.1111/j.1740-8709.2010.00290.x


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  • Prevalence of Serum Cobalamin and Serum Folate Deficiency with Associated Risk Factors among Children Aged 0 to 19 Years in India – A Review

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Authors

Areeba Khanam
Centre for Community Medicine, All India Institutes of Medical Sciences, New Delhi, Delhi - 110 029, India
Surbhi Gupta
Centre for Community Medicine, All India Institutes of Medical Sciences, New Delhi, Delhi - 110 029, India
Neha Singh
Centre for Community Medicine, All India Institutes of Medical Sciences, New Delhi, Delhi - 110 029, India
Kashish Vohra
Centre for Community Medicine, All India Institutes of Medical Sciences, New Delhi, Delhi - 110 029, India
Kapil Yadav
Centre for Community Medicine, All India Institutes of Medical Sciences, New Delhi, Delhi - 110 029, India

Abstract


Anemia is broadly caused by nutritional and non-nutritional factors. Deficiency of cobalamin and folate are one of the causes of anemia and hence are of public health significance among 0 to 19 years old children in India. These deficiencies either alone or together may cause megaloblastic anemia, poor cognitive and motor development and stunting amongst children. To estimate the prevalence of serum cobalamin and serum folate with associated risk factors among children aged 0 to 19 years in India through various published studies. This review literature search was carried out using internet search engine namely PubMed, Google Scholar, Cochrane, Research gate using the term of cobalamin, vitamin B12, folate, children, deficiency and India from January 1st 2011 to June 30th 2021. Of the 252 research articles identified, 13 articles meeting the inclusion criteria (community based, cross sectional studies) were included and 5 articles among 0 to 5 years, 8 articles among 6 to 19 years reported the prevalence of cobalamin and folate deficiency. The prevalence of cobalamin deficiency ranged from 7 to 74% and prevalence of folate deficiency ranged from 1.5 to 40.2% among children aged 0 to 19 years. Most common associated risk factor identified was inadequacy of the diet and consumption of only vegetarian diet. Cobalamin and folate deficiency are of significant public health importance in age group 0 to 19 years in India. The deficiency varied across region and by contributing factors. Dietary diversification and promoting animal source of foods amongst children should be promoted to address cobalamin and folate deficiency.

Keywords


Cobalamin, Folate, Prevalence, Deficiency, Risk Factor, Children, Anemia

References