Prevalence and Predictors of Vitamin D Deficiency and Insufficiency among Pregnant Rural Women in Bangladesh

Although adequate vitamin D status during pregnancy is essential for maternal health and to prevent adverse pregnancy outcomes, limited data exist on vitamin D status and associated risk factors in pregnant rural Bangladeshi women. This study determined the prevalence of vitamin D deficiency and insufficiency, and identified associated risk factors, among these women. A total of 515 pregnant women from rural Bangladesh, gestational age ≤ 20 weeks, participated in this cross-sectional study. A separate logistic regression analysis was applied to determine the risk factors of vitamin D deficiency and insufficiency. Overall, 17.3% of the pregnant women had vitamin D deficiency [serum 25(OH)D concentration <30.0 nmol/L], and 47.2% had vitamin D insufficiency [serum 25(OH)D concentration between 30–<50 nmol/L]. The risk of vitamin D insufficiency was significantly higher among nulliparous pregnant women (OR: 2.72; 95% CI: 1.75–4.23), those in their first trimester (OR: 2.68; 95% CI: 1.39–5.19), anaemic women (OR: 1.53; 95% CI: 0.99–2.35; p = 0.056) and women whose husbands are farmers (OR: 2.06; 95% CI: 1.22–3.50). The risk of vitamin deficiency was significantly higher among younger pregnant women (<25 years; OR: 2.12; 95% CI: 1.06–4.21), nulliparous women (OR: 2.65; 95% CI: 1.34–5.25), women in their first trimester (OR: 2.55; 95% CI: 1.12–5.79) and those with sub-optimal vitamin A status (OR: 2.30; 95% CI: 1.28–4.11). In conclusion, hypovitaminosis D is highly prevalent among pregnant rural Bangladeshi women. Parity and gestational age are the common risk factors of vitamin D deficiency and insufficiency. A husband’s occupation and anaemia status might be important predictors of vitamin D insufficiency, while younger age and sub-optimal vitamin A status are risk factors for vitamin D deficiency in this population.     

Influences of Vitamin B12 Supplementation on Cognition and Homocysteine in Patients with Vitamin B12 Deficiency and Cognitive Impairment

Vitamin B₁₂ deficiency is associated with cognitive impairment, hyperhomocysteinemia, and hippocampal atrophy. However, the recovery of cognition with vitamin B₁₂ supplementation remains controversial. Of the 1716 patients who visited our outpatient clinic for dementia, 83 had vitamin B₁₂ deficiency. Among these, 39 patients (mean age, 80.1 ± 8.2 years) had undergone Mini-Mental State Examination (MMSE) and laboratory tests for vitamin B₁₂, homocysteine (Hcy), and folic acid levels. The hippocampal volume was estimated using the z-score of the MRI-voxel-based specific regional analysis system for Alzheimer’s disease. This is multi-center, open-label, single-arm study. All the 39 patients were administered vitamin B₁₂ and underwent reassessment to measure the retested for MMSE and Hcy after 21−133 days (median = 56 days, interquartile range (IQR) = 43–79 days). After vitamin B₁₂ supplementation, the mean MMSE score improved significantly from 20.5 ± 6.4 to 22.9 ± 5.5 (p < 0.001). Hcy level decreased significantly from 22.9 ± 16.9 nmol/mL to 11.5 ± 3.9 nmol/mL (p < 0.001). Significant correlation was detected between the extent of change in MMSE scores and baseline Hcy values. The degree of MMSE score was not correlated with hippocampal atrophy assessed by the z-score. While several other factors should be considered, vitamin B₁₂ supplementation resulted in improved cognitive function, at least in the short term, in patients with vitamin B₁₂ deficiency.     

Evaluation of vitamin B6 intake and status of 20- to 64-year-old Koreans

BACKGROUND/OBJECTIVES

Recent research regarding vitamin B₆ status including biochemical index is limited. Thus, this study estimated intakes and major food sources of vitamin B₆; determined plasma pyridoxal 5''-phosphate (PLP); and assessed vitamin B₆ status of Korean adults.

MATERIALS/METHODS

Three consecutive 24-h diet recalls and fasting blood samples were collected from healthy 20- to 64-year-old adults (n = 254) living in the Seoul metropolitan area, cities of Kwangju and Gumi, Korea. Vitamin B₆ intake and plasma PLP were analyzed by gender and by vitamin B₆ supplementation. Pearson''s correlation coefficient was used to determine associations of vitamin B₆ intake and plasma PLP.

RESULTS

The mean dietary and total (dietary plus supplemental) vitamin B₆ intake was 1.94 ± 0.64 and 2.41 ± 1.45 mg/day, respectively. Median (50th percentile) dietary intake of men and women was 2.062 and 1.706 mg/day. Foods from plant sources provided 70.61% of dietary vitamin B₆ intake. Only 6.3% of subjects consumed total vitamin B₆ less than Estimated Average Requirements. Plasma PLP concentration of all subjects was 40.03 ± 23.71 nmol/L. The concentration of users of vitamin B₆ supplements was significantly higher than that of nonusers (P < 0.001). Approximately 16% of Korean adults had PLP levels < 20 nmol/L, indicating a biochemical deficiency of vitamin B₆, while 19.7% had marginal vitamin B₆ status. Plasma PLP concentration showed positive correlation with total vitamin B₆ intake (r = 0.40984, P < 0.0001).

CONCLUSIONS

In this study, vitamin B₆ intake of Korean adults was generally adequate. However, one-third of subjects had vitamin B₆ deficiency or marginal status. Therefore, in some adults in Korea, consumption of vitamin B₆-rich food sources should be encouraged.     

Dietary Intake Adequacy and Food Sources of Nutrients Involved in the Methionine-Methylation Cycle in Women of Childbearing Age from the ANIBES Spanish Population

Growing evidence confirms choline as a critical perinatal nutrient. However, intake levels of choline and betaine among the Spanish fertile population remain unknown. Given their role in one-carbon metabolism with potential epigenetic effects, the aim of the present study was to evaluate the dietary intakes, their adequacy to existing guidelines and the main food sources together with other micronutrients involved in the methylation-methionine cycle (vitamin B₆, folates and vitamin B₁₂) in women of childbearing age. The ANIBES study, a cross-sectional study of a representative sample of women of childbearing age (18–45 years, n = 641) resident in Spain, was used. The sample was divided into younger women (18–30 years, n = 251) and older women (31–45 years, n = 390). Dietary intake was assessed by a three-day dietary record by using a tablet device. Total median intakes for the total sample were 303.9 mg/d for choline; 122.6 mg/d for betaine; 1.3 mg/d for vitamin B₆; 140.8 μg/d for folates, and 3.8 μg/d for vitamin B₁₂. The older subgroup showed significantly higher choline (p < 0.05), betaine (p < 0.001) and folates (p < 0.05) intakes than younger women. Main food sources for the whole sample were meat and meat products for choline (28.3%), vitamin B₆ (25.7%) and vitamin B₁₂ (22.8%); cereals and derivatives (79.9%) for betaine; vegetables (20.0%) for folates. Overall intake adequacy was only observed for vitamin B₁₂, with a very limited number of participants showing adequate intakes for all the other micronutrients. These results illustrate there is a relevant need to raise awareness about optimizing the status of the methionine cycle-related vitamins and cofactors in this potentially vulnerable population.     

Biological Variability and Impact of Oral Contraceptives on Vitamins B6, B12 and Folate Status in Women of Reproductive Age

Vitamins B₆, B₁₂ and folate play crucial metabolic roles especially during the reproductive years for women. There is limited reporting of within-subject variability of these vitamins. This study aimed to determine the within and between subject variability in serum vitamins B₆, B₁₂, folate and erythrocyte folate concentrations in young women; identify factors that contribute to variability; and determine dietary intakes and sources of these vitamins. Data were obtained from the control group of a trial aimed at investigating the effect of iron on the nutritional status of young women (age 25.2 ± 4.2 year; BMI 21.9 ± 2.2 kg/m²). The coefficients of variability within-subject (CV_I) and between-subject (CV_G) for serum vitamins B₆, B₁₂ and folate, and erythrocyte folate were calculated. Food frequency questionnaires provided dietary data. CV_I and CV_G were in the range 16.1%–25.7% and 31.7%–62.2%, respectively. Oral contraceptive pill (OCP) use was associated (P = 0.042) with lower serum vitamin B₁₂ concentrations. Initial values were 172 ± 16 pmol/L and 318 ± 51 pmol/L for OCP and non-OCP users, respectively; with differences maintained at four time points over 12 weeks. BMI, age, physical activity, alcohol intake and haematological variables did not affect serum or erythrocyte vitamin concentrations. Vitamin B₁₂ intakes were derived from traditional and unexpected sources including commercial energy drinks. Young women using OCP had significantly lower serum vitamin B₁₂ concentrations. This should be considered in clinical decision making and requires further investigation.     

Effects of dietary supplementation of high-dose folic acid on biomarkers of methylating reaction in vitamin B12-deficient rats

Folate is generally considered as a safe water-soluble vitamin for supplementation. However, we do not have enough information to confirm the potential effects and safety of folate supplementation and the interaction with vitamin B₁₂ deficiency. It has been hypothesized that a greater methyl group supply could lead to compensation for vitamin B₁₂ deficiency. On this basis, the present study was conducted to examine the effects of high-dose folic acid (FA) supplementation on biomarkers involved in the methionine cycle in vitamin B₁₂-deficient rats. Sprague-Dawley rats were fed diets containing either 0 or 100 µg (daily dietary requirement) vitamin B₁₂/kg diet with either 2 mg (daily dietary requirement) or 100 mg FA/kg diet for six weeks. Vitamin B₁₂-deficiency resulted in increased plasma homocysteine (p<0.01), which was normalized by dietary supplementation of high-dose FA (p<0.01). However, FA supplementation and vitamin B₁₂ deficiency did not alter hepatic and brain S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) concentrations and hepatic DNA methylation. These results indicated that supplementation of high-dose FA improved homocysteinemia in vitamin B₁₂-deficiency but did not change SAM and SAH, the main biomarkers of methylating reaction.     

Plasma Vitamin B12 and Folate Alter the Association of Blood Lead and Cadmium and Total Urinary Arsenic Levels with Chronic Kidney Disease in a Taiwanese Population

Heavy metals causing chronic nephrotoxicity may play a key role in the pathogenesis of chronic kidney disease (CKD). This study hypothesized that plasma folate and vitamin B₁₂ would modify the association of CKD with total urinary arsenic and blood lead and cadmium levels. We recruited 220 patients with CKD who had an estimated glomerular filtration rate of <60 mL/min/1.73 m² for ≥3 consecutive months and 438 sex- and age-matched controls. We performed inductively coupled plasma mass spectrometry to measure blood cadmium and lead levels. The urinary arsenic level was determined using a high-performance liquid chromatography–hydride generator–atomic absorption spectrometry. Plasma vitamin B₁₂ and folate levels were measured through the SimulTRAC-SNB radioassay. Compared with patients with plasma vitamin B₁₂ ≤ 6.27 pg/mL, the odds ratio (OR) and 95% confidence interval of CKD for patients with plasma vitamin B₁₂ > 9.54 pg/mL was 2.02 (1.15–3.55). However, no association was observed between plasma folate concentration and CKD. A high level of plasma vitamin B₁₂ combined with high levels of blood lead and cadmium level and total urinary arsenic tended to increase the OR of CKD in a dose-response manner, but the interactions were nonsignificant. This is the first study to demonstrate that patients with high plasma vitamin B₁₂ level exhibit increased OR of CKD related to high levels of blood cadmium and lead and total urinary arsenic.     

Micronutrient Status in Female University Students: Iron,Zinc, Copper,Selenium, Vitamin B12 and Folate

Young women are at an increased risk of micronutrient deficiencies, particularly due to higher micronutrient requirements during childbearing years and multiple food group avoidances. The objective of this study was to investigate biomarkers of particular micronutrients in apparently healthy young women. Female students (n = 308; age range 18–35 year; Body Mass Index 21.5 ± 2.8 kg/m²; mean ± SD) were recruited to participate in a cross-sectional study. Blood samples were obtained from participants in the fasted state and analysed for biomarkers of iron status, vitamin B₁₂, folate, homocysteine, selenium, zinc, and copper. The results show iron deficiency anaemia, unspecified anaemia, and hypoferritinemia in 3%, 7% and 33.9% of participants, respectively. Low vitamin B₁₂ concentrations (<120 pmol/L) were found in 11.3% of participants, while 4.7% showed sub-clinical deficiency based on serum methylmalonic acid concentrations >0.34 μmol/L. Folate concentrations below the reference range were observed in 1.7% (serum) or 1% (erythrocytes) of participants, and 99.7% of the participant had erythrocyte-folate concentrations >300 nmol/L. Serum zinc concentrations <10.7 μmol/L were observed in 2% of participants. Serum copper and selenium concentrations were below the reference range in 23% and 11% of participants, respectively. Micronutrient deficiencies including iron and vitamin B₁₂, and apparent excess of folate are present in educated Australian female students of childbearing age, including those studying nutrition. The effects of dietary behaviours and food choices on markers of micronutrient status require further investigation.     

待产女性血清维生素B12和叶酸水平的流行病学特征

目的 分析陕西省待产女性维生素B₁₂和叶酸水平及两者间关系的流行病学特征。方法 资料来源于2014年1月至2016年12月在6所三甲医院待产的健康孕妇,产前采集血样以测定维生素B₁₂和叶酸水平。采用分位数回归模型分析待产女性维生素B₁₂和叶酸水平间的关系。结果 共纳入1 277名待产女性,其血清维生素B₁₂的中位数为164.7 pg/ml,缺乏率为69.6%,血清叶酸的中位数为7.6 ng/ml,缺乏率为12.1%,单纯缺乏维生素B₁₂者占58.4%,单纯缺乏叶酸者占0.9%。农村待产女性维生素B₁₂和叶酸水平低于城市女性,维生素B₁₂和叶酸水平随年龄的增长而呈不同幅度增加,<25岁者维生素B₁₂和叶酸水平明显较低。叶酸缺乏者的维生素B₁₂水平比非缺乏者平均低37.62 pg/ml,分位数回归模型显示,在不同的维生素B₁₂分位点上,叶酸缺乏者的维生素B₁₂水平明显低于不缺乏者,且这种差异随着维生素B₁₂水平的升高而增大。结论 陕西省待产女性维生素B₁₂和叶酸缺乏症仍普遍存在,在妇幼保健实践中,叶酸增补的同时可能需重视维生素B₁₂补充。加大健康教育力度,重点提高农村和年轻女性对营养素补充重要性的认识,从而改善其维生素B₁₂和叶酸水平。     

Associations between Plasma Folate and Vitamin B12, Blood Lead,and Bone Mineral Density among Adults and Elderly Who Received a Health Examination

This study hypothesized that plasma folate and vitamin B₁₂ levels modified the association between blood lead and cadmium and total urinary arsenic levels and bone loss. A total of 447 study subjects who received a physical examination at the Wanfang Hospital Medical Center were recruited. Bone loss was defined as a calcaneus bone mineral density T-score less than −1. Blood cadmium and lead concentrations were measured by ICP-MS. Urinary arsenic species were determined using HPLC-HG-AAS. A SimulTRAC-SNB radioassay was used to measure plasma folate, vitamin B₁₂, and homocysteine levels. Total urinary arsenic and blood lead concentration were positively correlated with the odds ratio (OR) for bone loss in a dose–response manner. The OR and 95% confidence interval (CI) for bone loss in participants with blood lead concentrations > 56.14 versus ≤33.82 μg/dL were 1.82 and 1.10–3.01. No correlation between plasma folate and vitamin B₁₂ levels alone and bone loss was observed. However, this study is the first observational study to find that blood lead concentrations tend to increase the OR of bone loss in a low plasma folate and plasma vitamin B₁₂ group with multivariate ORs (95% CI) of 2.44 (0.85–6.96).     

Established and Suspected Biomarkers of Cardiovascular Disease (CVD) Risk in Pre-Menopausal Lebanese Women

Cardiovascular disease (CVD) is known to be caused by both environmental and non-environmental factors and the contribution of these factors seems to vary among different populations. Major nutritional biomarkers of CVD in 290 Lebanese pre-menopausal women were assessed. Diabetes, folate, and vitamin B₁₂ deficiencies were rare (below 0.5%) among the subjects. Abnormalities in lipid profile were more common, in which 16.7% of subjects had low HDL-cholesterol. Vitamin B₆ deficiency was also present at 14.5%. Low levels of HDL (established biomarker) and vitamin B₆ (suspected biomarker) seem to be the major nutritional abnormalities in Lebanese females of childbearing age.     

Dietary source of vitamin B12 intake and vitamin B12 status in female elderly Koreans aged 85 and older living in rural area

Recently, we found and analyzed vitamin B₁₂ in some Korean traditional plant foods which had not reported, yet. This study was to investigate vitamin B₁₂ intake and its dietary sources and the vitamin B₁₂ status in the very old elderly Koreans. We measured serum vitamin B₁₂ level and estimated the amounts of vitamin B₁₂ intake from different dietary sources in female elderly Koreans aged 85 and over who had consumed a relatively low animal traditional diet for the whole life. The average age of the subjects (n = 127) was 98.0 years (85-108 years). The assessment on energy and nutrient intake involved a one-day 24-hour recall, and serum vitamin B₁₂ concentration was measured by radioimmunoassay. Overall diet pattern was not different between the 85-99 yr-old group and centenarians, except centenarians were taking more dairy product. The average ratio of plant food to animal food consumption was 87.5:12.5 in weight. The average vitamin B₁₂ intake of our subjects was 3.2 µg/day, and 52.7% of subjects consumed under estimated average requirement, 2.0 µg/day. On dietary source, 67.3% of dietary vitamin B₁₂ was from meat, eggs and fishes and 30.6% was from plant foods, such as soybean-fermented foods, seaweeds, and kimchi. The average serum vitamin B₁₂ concentration was 450.5 pg/mL, and low serum vitamin B₁₂ (< 200 pg/mL) was found in 9.6% of subjects. Dietary vitamin B₁₂ intake was significantly lower in subjects with low serum vitamin B₁₂ (0.79 µg/day) than those with normal serum vitamin B₁₂ (3.47 µg/day). There were no significant difference in vitamin B₁₂ intake and its dietary sources and serum vitamin B₁₂ level between the 85-99 yr-old group and centenarians. In conclusion, several plant-origin foods including seaweed, soybean-fermented foods, and kimchi, may contribute significantly to good vitamin B₁₂ status in very old elderly Koreans.     

Evaluation of vitamin B12 status in Egypt IV: Food consumption patterns among lactating mothers and their impact on the intake of the vitamin

The adequacy of vitamin B₁₂ intake was assessed among 62 lactating mothers in the 2–32 weeks of lactation by an interactive 24-h recall and an open-ended food frequency questionnaire. Double portions of the foods consumed were sampled and assayed microbiologically for its vitamin B₁₂ content. Based on the food item and its respective vitamin B₁₂ content, combined with the usual portion size in grams and the frequency of consumption, a rapid calculator of approximate dietary vitamin B₁₂ intake was developed. The estimated vitamin B₁₂ intake averaged 4.17±0.74?µg/d. Only 25.8% of the lactating mothers had adequate vitamin B₁₂ intake (>2.5?µg vitamin B₁₂ daily). Three quarter of the studied population were consuming vitamin B₁₂<2.5?µg/d. Out of those, 50% had estimated daily intake <2.0?µg/d. This percentage prevalence confirms the additional burden on the lactating mothers to satisfy the daily vitamin B₁₂ requirement for its breast-fed baby.     

High Prevalence of Vitamin D Deficiency in Pregnant Korean Women: The First Trimester and the Winter Season as Risk Factors for Vitamin D Deficiency

We investigated the vitamin D status of Korean women during pregnancy and assessed the effects of vitamin D deficiency on two pregnancy outcomes; preterm births and the births of small for gestational age. We measured the serum 25-hydroxyvitamin D levels in 220 pregnant Korean women who were recruited prospectively and compared these levels with those of 500 healthy non-pregnant women. We analyzed vitamin D status according to patient demographics, season, and obstetrical characteristics; moreover, we also assessed pregnancy outcomes. The overall prevalence of vitamin D deficiency(<20 ng/mL) in pregnant women and healthy non-pregnant women was 77.3% and 79.2%; respectively; and the prevalence of severe vitamin D deficiency (<10 ng/mL) was 28.6% and 7.2%; respectively (p < 0.05). Vitamin D deficiency was more prevalent in the winter (100%) than in the summer (45.5%) in pregnant Korean women. A higher risk of vitamin D deficiency was observed in the first trimester than in the third trimester (adjusted OR 4.3; p < 0.05). No significant association was observed between vitamin D deficiency and any of the pregnancy outcomes examined. Further research focusing on the long-term consequences of vitamin D deficiency during pregnancy in Korean women is warranted.     

BOOKS RECEIVED

The purpose of this study was to determine whether institutionalized older individuals taking proton pump inhibitors (PPI) for more than 12 months were more likely to have vitamin B₁₂ deficiency than individuals not taking PPI, and whether cyanocobalamin nasal spray would improve their vitamin B₁₂ status. Participants were long-term care residents aged 60–89 years. PPI users (n = 17) were treated with cyanocobalamin nasal spray for 8 weeks; non-PPI users (n = 19) were not treated but were followed for the same time duration. Serum samples from all subjects were analyzed for vitamin B₁₂ and serum methylmalonic acid (sMMA) at baseline and the end of the 8-week treatment. There was a significant difference in mean vitamin B₁₂, sMMA, and frequency of deficiency between control and intervention groups at baseline. After treatment, there was an increase (p = 0.012) in serum vitamin B₁₂ concentration, and a decrease (p = 0.004) in frequency of deficiency in PPI users. Thus, we found that institutionalized older individuals on PPI for more than 12 months may be more likely to be vitamin B₁₂ deficient than non-PPI users. Additionally, treatment of PPI users with cyanocobalamin nasal spray for 8 weeks could improve vitamin B₁₂ status.     

Vitamin B12-Containing Plant Food Sources for Vegetarians

The usual dietary sources of Vitamin B₁₂ are animal-derived foods, although a few plant-based foods contain substantial amounts of Vitamin B₁₂. To prevent Vitamin B₁₂ deficiency in high-risk populations such as vegetarians, it is necessary to identify plant-derived foods that contain high levels of Vitamin B₁₂. A survey of naturally occurring plant-derived food sources with high Vitamin B₁₂ contents suggested that dried purple laver (nori) is the most suitable Vitamin B₁₂ source presently available for vegetarians. Furthermore, dried purple laver also contains high levels of other nutrients that are lacking in vegetarian diets, such as iron and n-3 polyunsaturated fatty acids. Dried purple laver is a natural plant product and it is suitable for most people in various vegetarian groups.     

The Influence of Maternal Vitamin D Supplementation in Pregnancies Associated with Preeclampsia: A Case-Control Study

Preeclampsia is a pregnancy-specific illness that is hypothesized to occur due to vitamin D deficiency during pregnancy. Therefore, vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being. The present study follows a case-control analysis that aims to determine the effect of vitamin D supplements on reducing the probability of recurrent preeclampsia. We identified 59 patients for the control group without vitamin D supplementation during pregnancy, while 139 patients were included in the cases group of pregnant women with a history of preeclampsia who confirmed taking daily vitamin D supplements in either 2000 UI or 4000 UI until the 36th week of pregnancy. There were 61 (80.3%) patients with a normal serum vitamin D level measured at 32 weeks in the pregnant women who took a daily dose of 4000 UI vitamin D and 43 (68.3%) in those who took a 2000 UI dose of vitamin D, compared to just 32 (54.2%) in those who did not take vitamin D at all. Regarding the blood pressure of pregnant women measured at 32 weeks, it was observed that 20.3% were hypertensive in the no supplementation group, compared to only 11.1% and 6.6% in those who were taking vitamin D during pregnancy (p-value = 0.049). Serum vitamin D levels at 32 weeks were measured at an average value of 23.9 ng/mL, compared with 28.4 ng/mL in the group taking a 2000 UI daily dose and 33.6 in those who supplemented with 4000 UI daily (p-value < 0.001). Proteinuria was identified more often in the group at risk for preeclampsia who did not take vitamin D supplements, while systolic blood pressure (p-value = 0.036) as well as diastolic blood pressure (p-value = 0.012), were all identified to have significantly higher values in the pregnant women with a history of preeclampsia that did not take vitamin D during the current pregnancy. The significant risk factors for preeclampsia development in pregnant patients at risk are: insufficient vitamin D serum levels (<20 ng/mL), OR = 2.52; no vitamin D supplementation, OR = 1.46; more than two pregnancies, OR = 1.89; gestational diabetes mellitus, OR = 1.66; and cardiovascular comorbidities, OR = 2.18. These findings imply that vitamin D has a role in the preservation of placental function and, therefore, in the prevention of the development of late preeclampsia. Pregnant mothers who supplemented their diets with vitamin D were protected against preeclampsia recurrence. Vitamin D supplementation during pregnancy may aid in the prevention of gestational hypertension and preeclampsia.     

High frequency of maternal vitamin B12 deficiency as an important cause of infantile vitamin B12 deficiency in Sanliurfa province of Turkey

Summary Background Vitamin B₁₂ deficiency in infancy may cause failure to thrive, severe neurological disorders and megaloblastic pancytopenia. It is well known that infants born with deficient vitamin B₁₂ storage have increased the risk of vitamin B₁₂ deficiency. Vitamin B₁₂ deficiency is more prevalent in infancy in Sanliurfa province (at the southeast region of Turkey). Aim of the study The aim of this study was to determine the frequencies of vitamin B₁₂, folic acid and iron deficiencies in pregnants and their babies at birth and to what extend the mothers’ deficiency becomes effective on babies’ deficiencies. Methods The study groups were constituted by 180 pregnant women and their single and term babies. Venous blood samples of pregnants were obtained 1–3 h before delivery and babies’ cord bloods were collected at birth. Vitamin B₁₂ and folic acid levels were measured with electro chemiluminiscence method; serum iron and iron binding capacities were measured by colorimetric method and complete blood counts were performed by automatic blood counter. Results Mean vitamin B₁₂ levels in maternal and cord blood serum were 130 ± 61.7 pg/ml and 207 ± 141 pg/ml; mean folic acid levels were 8.91 ± 6.46 ng/ml and 17.8 ± 11.8 ng/ml; mean serum iron levels were 56.9 ± 37.5 μg/dl and 147 ± 43.2 μg/dl; and mean transferrin saturations were 11.8 ± 8% and 65.6 ± 24%, respectively. There were vitamin B₁₂ deficiency (<160 pg/ml) in 72% of the mothers and 41% of the babies, and severe deficiency (<120 pg/ml) in 48% of the mothers and 23% of the babies. Folic acid deficiency was found in 12% of the mothers, but was not found in the babies. There were iron deficiency in 62% of the mothers and 1% of the babies. There were statistically significant correlation between maternal and cord blood serum vitamin B₁₂ levels (r = 0.395, P < 0.001) and folic acid levels (r = 0.227, P = 0.017), while there were no correlation between maternal and cord blood iron levels and transferrin saturations. Conclusion The study results showed that vitamin B₁₂ deficiency is prevalent in pregnants in this region and that 41% of infants have born with deficient vitamin B₁₂ storages. Therefore, prophylactic use of vitamin B₁₂ by pregnant women in Sanliurfa and other poor communities could have considerable benefits to prevent vitamin B₁₂ deficiency and its complications in infants.     

Vitamin and Mineral Deficiencies Are Highly Prevalent in Newly Diagnosed Celiac Disease Patients

Malabsorption, weight loss and vitamin/mineral-deficiencies characterize classical celiac disease (CD). This study aimed to assess the nutritional and vitamin/mineral status of current “early diagnosed” untreated adult CD-patients in the Netherlands. Newly diagnosed adult CD-patients were included (n = 80, 42.8 ± 15.1 years) and a comparable sample of 24 healthy Dutch subjects was added to compare vitamin concentrations. Nutritional status and serum concentrations of folic acid, vitamin A, B₆, B₁₂, and (25-hydroxy) D, zinc, haemoglobin (Hb) and ferritin were determined (before prescribing gluten free diet). Almost all CD-patients (87%) had at least one value below the lower limit of reference. Specifically, for vitamin A, 7.5% of patients showed deficient levels, for vitamin B₆ 14.5%, folic acid 20%, and vitamin B₁₂ 19%. Likewise, zinc deficiency was observed in 67% of the CD-patients, 46% had decreased iron storage, and 32% had anaemia. Overall, 17% were malnourished (>10% undesired weight loss), 22% of the women were underweight (Body Mass Index (BMI) < 18.5), and 29% of the patients were overweight (BMI > 25). Vitamin deficiencies were barely seen in healthy controls, with the exception of vitamin B₁₂. Vitamin/mineral deficiencies were counter-intuitively not associated with a (higher) grade of histological intestinal damage or (impaired) nutritional status. In conclusion, vitamin/mineral deficiencies are still common in newly “early diagnosed” CD-patients, even though the prevalence of obesity at initial diagnosis is rising. Extensive nutritional assessments seem warranted to guide nutritional advices and follow-up in CD treatment.     

The effects of exercise training and acute exercise duration on plasma folate and vitamin B12

BACKGROUND/OBJECTIVES

Energy production and the rebuilding and repair of muscle tissue by physical activity require folate and vitamin B₁₂ as a cofactor. Thus, this study investigated the effects of regular moderate exercise training and durations of acute aerobic exercise on plasma folate and vitamin B₁₂ concentrations in moderate exercise trained rats.

MATERIALS/METHODS

Fifty rats underwent non-exercise training (NT, n = 25) and regular exercise training (ET, n = 25) for 5 weeks. The ET group performed moderate exercise on a treadmill for 30 min/day, 5 days/week. At the end of week 5, each group was subdivided into 4 groups: non-exercise and 3 exercise groups. The non-exercise group (E0) was sacrificed without exercising and the 3 exercise groups were sacrificed immediately after exercising on a treadmill for 0.5 h (E0.5), 1 h (E1), and 2 h (E2). Blood samples were collected and plasma folate and vitamin B₁₂ were analyzed.

RESULTS

After exercise training, plasma folate level was significantly lower and vitamin B₁₂ concentration was significantly higher in the ET group compared with the NT group (P < 0.05). No significant associations were observed between plasma folate and vitamin B₁₂ concentrations. In both the NT and ET groups, plasma folate and vitamin B₁₂ were not significantly changed by increasing duration of aerobic exercise. Plasma folate concentration of E0.5 was significantly lower in the ET group compared with that in the NT group. Significantly higher vitamin B₁₂ concentrations were observed in the E0 and E0.5 groups of the ET group compared to those of the NT group.

CONCLUSION

Regular moderate exercise training decreased plasma folate and increased plasma vitamin B₁₂ levels. However, no significant changes in plasma folate and vitamin B₁₂ concentrations were observed by increasing duration of acute aerobic exercise.