Ingrid Kvestad1, Mari Hysing1, Merina Shrestha2, Manjeswori Ulak2, Andrew L Thorne-Lyman3,4,5, Sigrun Henjum6, Per M Ueland7,8, Øyvind Midttun9, Wafaie Fawzi5, Ram K Chandyo2, Prakash S Shrestha2, Tor A Strand10,11. 1. Regional Center for Child and Youth Mental Health and Child Welfare, West, Uni Research Health, Bergen, Norway. 2. Department of Child Health, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. 3. Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. 4. WorldFish, Penang, Malaysia. 5. Departments of Global Health and Population, Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA. 6. College of Applied Sciences, Oslo and Akershus University, Oslo, Norway. 7. Department of Clinical Science and. 8. Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway. 9. Bevital AS, Bergen, Norway; and. 10. Center for Intervention Studies in Maternal and Child Health, University of Bergen, Bergen, Norway; tor.strand@uib.no. 11. Division for Research, Innlandet Hospital Trust, Lillehammer, Norway.
Abstract
Background: Poor vitamin B-12 (cobalamin) status is widespread in South Asia. Insufficient vitamin B-12 status has been linked to poor neurodevelopment in young children.Objective: We measured the associations between vitamin B-12 status in infancy (2-12 mo) and the development and cognitive functioning in Nepalese children 5 y later.Design: Vitamin B-12 status was assessed in infancy with the use of plasma cobalamin, total homocysteine (tHcy), and methylmalonic acid (MMA). At 5 y of age, we measured development with the use of the Ages and Stages Questionnaire, 3rd edition (ASQ-3), and cognitive functioning by using the Developmental Neuropsychological Assessment, 2nd edition (NEPSY II), in 320 children. In regression models, we estimated the associations between vitamin B-12 status, including a combined indicator of vitamin B-12 status (3cB12) and scores on the ASQ-3 and NEPSY II subtests. Results: All markers of vitamin B-12 status with the exception of plasma cobalamin were significantly associated with the total ASQ-3 scores in the multiple regression models. A 1-unit increase in the 3cB12 score was associated with an increase in the total ASQ-3 score of 4.88 (95% CI: 2.09, 7.68; P = 0.001). Increases in both plasma tHcy and MMA (indicating poorer status) were associated with a decrease in scores on the NEPSY II affect recognition and geometric puzzle subtests. Each unit increment in 3cB12 scores was associated with increases of 0.82 (95% CI: 0.49, 1.14; P < 0.0005), 0.59 (95% CI: 0.10, 1.09; P = 0.020), and 0.24 (95% CI: 0.02, 0.47; P = 0.035) in the affect recognition, geometric puzzle, and block construction scores, respectively.Conclusions: Vitamin B-12 status in infancy is associated with development and performance on social perception tasks and visuospatial abilities at 5 y of age. The long-term effects of poor vitamin B-12 status in infancy need further investigation in randomized controlled trials.
Background: Poor vitamin B-12 (cobalamin) status is widespread in South Asia. Insufficient vitamin B-12 status has been linked to poor neurodevelopment in young children.Objective: We measured the associations between vitamin B-12 status in infancy (2-12 mo) and the development and cognitive functioning in Nepalese children 5 y later.Design: Vitamin B-12 status was assessed in infancy with the use of plasma cobalamin, total homocysteine (tHcy), and methylmalonic acid (MMA). At 5 y of age, we measured development with the use of the Ages and Stages Questionnaire, 3rd edition (ASQ-3), and cognitive functioning by using the Developmental Neuropsychological Assessment, 2nd edition (NEPSY II), in 320 children. In regression models, we estimated the associations between vitamin B-12 status, including a combined indicator of vitamin B-12 status (3cB12) and scores on the ASQ-3 and NEPSY II subtests. Results: All markers of vitamin B-12 status with the exception of plasma cobalamin were significantly associated with the total ASQ-3 scores in the multiple regression models. A 1-unit increase in the 3cB12 score was associated with an increase in the total ASQ-3 score of 4.88 (95% CI: 2.09, 7.68; P = 0.001). Increases in both plasma tHcy and MMA (indicating poorer status) were associated with a decrease in scores on the NEPSY II affect recognition and geometric puzzle subtests. Each unit increment in 3cB12 scores was associated with increases of 0.82 (95% CI: 0.49, 1.14; P < 0.0005), 0.59 (95% CI: 0.10, 1.09; P = 0.020), and 0.24 (95% CI: 0.02, 0.47; P = 0.035) in the affect recognition, geometric puzzle, and block construction scores, respectively.Conclusions: Vitamin B-12 status in infancy is associated with development and performance on social perception tasks and visuospatial abilities at 5 y of age. The long-term effects of poor vitamin B-12 status in infancy need further investigation in randomized controlled trials.
Authors: Jun S Lai; M Na'im Mohamad Ayob; Shirong Cai; Phaik Ling Quah; Peter D Gluckman; Lynette P Shek; Fabian Yap; Kok Hian Tan; Yap Seng Chong; Keith M Godfrey; Michael J Meaney; Birit F P Broekman; Anne Rifkin-Graboi; Mary F F Chong Journal: Br J Nutr Date: 2019-04-02 Impact factor: 3.718
Authors: Susan Thomas; Tinku Thomas; Ronald J Bosch; Asha Ramthal; David C Bellinger; Anura V Kurpad; Christopher P Duggan; Krishnamachari Srinivasan Journal: Matern Child Health J Date: 2019-02
Authors: Ram K Chandyo; Manjeswori Ulak; Ingrid Kvestad; Merina Shrestha; Suman Ranjitkar; Sudha Basnet; Mari Hysing; Laxman Shrestha; Tor A Strand Journal: BMJ Open Date: 2017-08-29 Impact factor: 2.692
Authors: Brita Askeland Winje; Ingrid Kvestad; Srinivasan Krishnamachari; Karim Manji; Sunita Taneja; David C Bellinger; Nita Bhandari; Shruti Bisht; Anne Marie Darling; Christopher P Duggan; Wafaie Fawzi; Mari Hysing; Tivendra Kumar; Anura V Kurpad; Christopher R Sudfeld; Erling Svensen; Susan Thomas; Tor A Strand Journal: BMJ Open Date: 2018-02-22 Impact factor: 2.692