Vitamin B12 Deficiency Prevalent in Colombian Children
As a follow-up on our post a couple of years ago “Why Is Widespread Vitamin B12 Deficiency in Developing Countries Being Ignored?”, a new study reports on vitamin B12 deficiency in Colombian children aged 5 to 11 years.
Colombia, located in the north western part of South America, currently has a 30% poverty rate, which is a large decline since poverty levels were at 50% in 2002. While expectations are that the current economic climate, including a stable food supply and a growing economy, will further reduce poverty in the coming years, around 14 million people still live in poverty and are at nutritional risk. The poverty rate is still above the average for South America, and income inequality is considerable: development in different parts of the country has not been even and there are certain regions with considerably higher levels of poverty. This economically heterogeneous environment can lead to differences in the prevalence of micronutrient deficiency. In impoverished regions, vitamin B12 deficiency levels can be high as the main source of vitamin B12 from the diet, animal foods, tend to be the most expensive to purchase or produce.
Ramírez-Vélez and co-workers used cross-sectional data from a nationally representative sample of almost 7000 Colombian children aged 5 to 12 years, who participated in the Encuesta Nacional de Situación Nutricional en Colombia (ENSIN). The authors found that 3% of Colombian children have vitamin B12 deficiency (defined as serum vitamin B12 <200 pg/ml), and 18% had marginal deficiency (serum B12 <300 pg/ml). It seems that older children (those aged over 9, or particularly children aged 11 years), have a higher risk of deficiency.
Some regional differences were found: children living in the east, west and south were more likely to have deficiency, and living in the west of the country was identified most strongly with risk of deficiency. According to information from the World Bank, these regions are the most impoverished and have failed to keep pace with the economic and social developments in other parts of the country. Interestingly, ethnic groups, socio-economic and urbanity levels were not associated with deficiency in this study, although Villamor and associates found in 2008 that poverty and low intakes of animal products were associated with lower vitamin B12 levels in Colombia’s capital Bogota.
The authors note that vitamin B12 status is better than averages for South America, however there is considerable room for improvement. Strategies for improving vitamin B12 status include improving access to animal products, including meat, eggs and dairy, to all sectors of the population, or fortification of a staple food with vitamin B12. For example, a milk intervention was effective in improving the vitamin B12 status of deficient young adults (Naik). Flour fortification could be an effective strategy to improve the vitamin B12 status of the entire population, given that over 20% of children are deficient or are at risk of deficiency (Allen).
Ramírez-Vélez, Robinson et al. Vitamin B12 Concentration and Association with Socio-demographic Factors in Colombian Children: Findings From the 2010 National Nutrition Survey (ENSIN). Nutrition. Published online 21 September 2014 http://dx.doi.org/10.1016/j.nut.2015.08.019
Allen LH, Rosenberg IH, Oakley GP, Omenn GS. Considering the case for vitamin B12 fortification of flour. Food Nutr Bull. 2010 Mar;31(1 Suppl):S36-46. http://www.ncbi.nlm.nih.gov/pubmed/20629351
Allen LH. Folate and vitamin B12 status in the Americas. Nutr Rev. 2004 Jun;62(6 Pt 2):S29-33; discussion S34. http://www.ncbi.nlm.nih.gov/pubmed/15298445
Brito A, Mujica-Coopman MF, López de Romaña D, Cori H, Allen LH. Folate and Vitamin B12 Status in Latin America and the Caribbean: An Update. Food Nutr Bull. 2015 Jun;36 Suppl 2:S109-18. http://www.ncbi.nlm.nih.gov/pubmed/26125196
Naik S, Bhide V, Babhulkar A, Mahalle N, Parab S, Thakre R, Kulkarni M. Daily milk intake improves vitamin B-12 status in young vegetarian Indians: an intervention trial. Nutr J. 2013 Oct 9;12:136. doi: 10.1186/1475-2891-12-136. http://www.ncbi.nlm.nih.gov/pubmed/24107225
Villamor E, Mora-Plazas M, Forero Y, Lopez-Arana S, Baylin A. Vitamin B-12 status is associated with socioeconomic level and adherence to an animal food dietary pattern in Colombian school children. J Nutr. 2008 Jul;138(7):1391-8. http://www.ncbi.nlm.nih.gov/pubmed/18567766
World Bank Group. Colombia: Systematic Country Diagnostic. Report number 97878. http://www-wds.worldbank.org/