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Open Access 01-12-2019 | Vitamin B12 Deficiency | Research article

Effects of dietary intervention on vitamin B₁₂ status and cognitive level of 18-month-old toddlers in high-poverty areas: a cluster-randomized controlled trial

Authors: Xiaoyang Sheng, Junli Wang, Feng Li, Fengxiu Ouyang, Jingqiu Ma

Published in: BMC Pediatrics | Issue 1/2019

Abstract

Background

The local diet in high-poverty areas in China is mainly vegetarian, and children may be more vulnerable to vitamin B₁₂ deficiency.

Objective

The aims of this study were to explore the vitamin B₁₂ status of toddlers living in high-poverty areas of China and to observe the effects of different complementary foods on the vitamin B₁₂ status and cognitive level of these toddlers.

Methods

The study was nested within a cluster-randomized controlled trial implemented in 60 administrative villages (clusters) of Xichou County in which infants aged 6 months old were randomized to receive 50 g/d of pork (meat group), an equi-caloric fortified cereal supplement (fortified cereal group) or local cereal supplement (local cereal group) for one year. At 18 months, a subsample of the 180 toddlers (60 from each group) was randomly tested for serum vitamin B₁₂ and total homocysteine (tHcy) levels, and their neurodevelopment was evaluated.

Results

The median serum concentrations of vitamin B₁₂ and tHcy were 360.0 pg/mL and 8.2 μmol/L, respectively, in children aged 18 months. Serum vitamin B₁₂ concentrations less than 300 pg/mL were found in 62 (34.4%) children, and concentrations less than 200 pg/mL were found in 30 (16.7%) children. The median vitamin B₁₂ concentration was significantly different among the three groups (P < 0.001). The highest vitamin B₁₂ level was demonstrated in the fortified cereal group (509.5 pg/mL), followed by the meat group (338.0 pg/mL) and the local cereal group (241.0 pg/mL). Vitamin B₁₂ concentration was positively correlated with the cognitive score (P < 0.001) and the fine motor score (P = 0.023) of the Bayley Scales of Infant Development, 3rd Edition (BSID III) screening test. Compared to the local cereal group, children in the meat group had higher cognitive scores (P < 0.05).

Conclusion

In poor rural areas of China, vitamin B₁₂ deficiency in toddlers was common due to low dietary vitamin B₁₂ intake. Fortified cereal and meat could help improve the vitamin B₁₂ status of children and might improve their cognitive levels.

Trial registration

The larger trial in which this study was nested was registered at clinical trials.gov as NCT00726102. It was registered on July 31, 2008.

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Title: Effects of dietary intervention on vitamin B12 status and cognitive level of 18-month-old toddlers in high-poverty areas: a cluster-randomized controlled trial
Authors: Xiaoyang Sheng
Junli Wang
Feng Li
Fengxiu Ouyang
Jingqiu Ma
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Vitamin B12 Deficiency
Published in: BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-019-1716-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effects of dietary intervention on vitamin B₁₂ status and cognitive level of 18-month-old toddlers in high-poverty areas: a cluster-randomized controlled trial

Abstract

Background

Objective

Methods

Results

Conclusion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

Trial registration

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