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Nutrients 2018, 10(5), 639; https://doi.org/10.3390/nu10050639

Cobalamin and Folate Status among Breastfed Infants in Bhaktapur, Nepal

1
Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway
2
Department of Community Medicine, Kathmandu Medical College, P.O. Box 21266, Sinamangal, Kathmandu, Nepal
3
Department of Child Health, Institute of Medicine, P.O. Box 1524, Kathmandu, Nepal
4
Regional Center for Child and Youth Mental Health and Child Welfare, West, Uni Research Health, P.O. Box 7810, 5020 Bergen, Norway
5
Department of Clinical Science, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway
6
Innlandet Hospital Trust, P.O. Box 990, 2629 Lillehammer, Norway
7
Lillehammer University College, P.O. Box 952, 2604 Lillehammer, Norway
*
Author to whom correspondence should be addressed.
Received: 21 February 2018 / Revised: 28 April 2018 / Accepted: 16 May 2018 / Published: 18 May 2018
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Abstract

Cobalamin and folate are crucial micronutrients during infancy and they are required for growth and cognitive development. Due to the monotonous and predominantly vegetarian-based complementary feeding and poor maternal micronutrient status, infants from low- and middle-income countries are susceptible to cobalamin deficiency. However, data on plasma cobalamin and folate and the functional markers methylmalonic acid and total homocysteine from breastfed infants in Nepal are still needed. We collected plasma samples from 316 6–11-month-old breastfed infants with a length-for-age of less than minus one z-score and analyzed blood for plasma folate, cobalamin, methylmalonic acid and total homocysteine concentrations. Cobalamin deficiency (plasma cobalamin <148 pmol/L) was found among 11%, whereas 24% of the infants had plasma cobalamin concentrations between 148–221 pmol/L. Elevated total homocysteine (>10 µmol/L) and methylmalonic acid (>0.28 µmol/L) indicating functional cobalamin deficiency were found among 53% and 75% of the infants, respectively. Based on a combined indicator of cobalamin status, 58% were found to have low cobalamin status. However, folate deficiency (<10 nmol/L) was not found as the lowest value of plasma folate was 20.7 nmol/L. It is important to examine the extent to which poor cobalamin status during infancy has immediate or long-term consequences. View Full-Text
Keywords: cobalamin; folate; infants; combined B12; methylmalonic acid; homocysteine and Nepal cobalamin; folate; infants; combined B12; methylmalonic acid; homocysteine and Nepal
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Chandyo, R.K.; Ulak, M.; Kvestad, I.; Hysing, M.; Shrestha, M.; Ranjitkar, S.; Ulvik, A.; Ueland, P.M.; Shrestha, L.; Strand, T.A. Cobalamin and Folate Status among Breastfed Infants in Bhaktapur, Nepal. Nutrients 2018, 10, 639.

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