Vitamin B-12, folate, iron, and vitamin A concentrations in rural Indian children are associated with continued breastfeeding, complementary diet, and maternal nutrition  

Oleh:

Pasricha, Sant-Rayn ; Shet, Arun S ; Black, James F. ; Sudarshan, H.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The American Journal of Clinical Nutrition vol. 94 no. 05 (Nov. 2011), page 1358-1370 .
Topik: PUBLIC HEALTH; Nutritional epidemiology; Vitamin B-12; Young Children in Rural South Asia; Vitamin A

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Perpustakaan FK Nomor Panggil: A07.K.2011.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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The American Journal of Clinical NutritionSkip to main page content HOME CURRENT ISSUE EMAIL ALERTS ARCHIVES SUBSCRIPTIONS SEARCH FOR ARTICLES CUSTOM PUBLICATION FAQ Search AJCN Submit Advanced Search Expand+ The American Journal of Clinical Nutritionwww.ajcn.org First published September 14, 2011, doi: 10.3945/?ajcn.111.018580 Am J Clin Nutr November 2011 vol. 94 no. 5 1358-1370 © 2011 American Society for Nutrition Vitamin B-12, folate, iron, and vitamin A concentrations in rural Indian children are associated with continued breastfeeding, complementary diet, and maternal nutrition1,2,3,4 Sant-Rayn Pasricha, Arun S Shet, James F Black, H Sudarshan, NS Prashanth, and Beverley-Ann Biggs + Author Affiliations 1From the Hematology Research Unit, Division of Molecular Medicine, St Johns National Academy of Health Sciences, Bangalore, India (S-RP and ASS); The Nossal Institute for Global Health (S-RP and JFB) and Department of Medicine, Royal Melbourne Hospital, Faculty of Medicine, Dentistry and Health Sciences (S-RP and BA-B), University of Melbourne, Parkville, Australia; The Karuna Trust, Bangalore, Karnataka, India (NSP and HS); the Institute of Public Health, Bangalore, Karnataka, India (NSP); and the Division of Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden (ASS). + Author Notes ?2 The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. ?3 Supported by the Allen Foundation and the Fred P Archer Charitable Trust and a Melbourne Research Scholarship (University of Melbourne; to S-RP). ?4 Address correspondence to B-A Biggs, Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia. E-mail: babiggs@unimelb.edu.au. Abstract Background: Determinants of vitamin B-12, folate, iron, and vitamin A concentrations in young children in rural south Asia are poorly understood. These micronutrients are crucial for the production of hemoglobin and have other important physiologic functions. Objective: We sought to develop explanatory models for concentrations of vitamin B-12, folate, ferritin, and retinol binding protein (RBP) in children aged between 1 and 2 y in rural Karnataka, India. Design: We performed a cross-sectional study in 12–23-mo-old toddlers who lived in 2 rural districts of Karnataka, India. For each child, data concerning dietary, food-security, and sociodemographic and maternal factors were obtained, and serum vitamin B-12, folate, ferritin, and RBP were measured. Multiple regression and structural equation modeling were applied to determine associations with micronutrient concentrations. Results: Of 396 sampled children, 254 children (65.6%) had at least one micronutrient deficiency. With the use of multiple regression, continued breastfeeding was independently associated with the concentration of each micronutrient [(log) vitamin B-12: standardized coefficient of -0.30 (P < 0.001); folate: standardized coefficient of +0.20 (P < 0.001); (log) ferritin: standardized coefficient of -0.18 (P = 0.004); (log) RBP: standardized coefficient of-0.21 (P < 0.001)]. Children who continued to breastfeed received less nutrition from complementary foods and belonged to poorer families with higher food insecurity. A structural equation model for children's vitamin B-12 concentrations was developed that highlighted the interrelation between wealth, continued breastfeeding, complementary diet, and vitamin B-12 concentrations in children. Conclusions: Micronutrient deficiencies are common in this population. Rural Indian children between 1 and 2 y of age who continue to breastfeed should be especially targeted during micronutrient-supplementation programs.

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