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Open AccessArticle

Vitamin Status among Breastfed Infants in Bhaktapur, Nepal

Department of Child Health, Institute of Medicine, Tribhuvan University, Maharajgunj, P.O. Box 1524, Kathmandu 44600, Nepal
Centre for International Health, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway
Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
World Fish, Malaysia, GPO 10670, Bayan Lepas, Penang 11960, Malaysia
Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, 0130 Oslo, Norway
Section for Pharmacology, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
Bevital AS, c/o Helse Bergen, Jonas Lies veg 87, 5020 Bergen, Norway
Department of Epidemiology and Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
Innlandet Hospital Trust, 2629 Lillehammer, Norway
Author to whom correspondence should be addressed.
Nutrients 2016, 8(3), 149;
Received: 18 November 2015 / Revised: 17 February 2016 / Accepted: 3 March 2016 / Published: 8 March 2016
Vitamin deficiencies are known to be common among infants residing in low- and middle-income countries but relatively few studies have assessed several biochemical parameters simultaneously. The objective of the study was to describe the status of vitamins (A, D, E, B6, B12 and folate) in breastfed infants. We measured the plasma concentrations of trans retinol, 25 hydroxy vitamin D, α-tocopherol, pyridoxal 5′-phosphate, cobalamin, folate, methylmalonic acid, homocysteine, hemoglobin and C-reactive protein from 467 randomly selected infants. One in five (22%) was deficient in at least one vitamin. Mean (SD) plasma folate concentration was 73 (35) nmol/L, and no infant in the sample was folate deficient. Vitamin B6 deficiency and vitamin B12 deficiency was found in 22% and 17% of the infants, respectively. Elevated plasma methylmalonic acid or total homocysteine concentration was found in 82% and 62% of infants, respectively. Fifteen percent of infants were vitamin A deficient and 65% were marginally deficient in vitamin A. Fewer than 5% of infants had low plasma vitamin D concentration or vitamin E concentration (α-tocopherol <9.3 µmol/L). Our results illustrate the importance of continued supplementation campaigns and support the expansion of food fortification and dietary diversification programs that target children and women in Nepal. View Full-Text
Keywords: vitamins; infant; Nepal; methylmalonic acid; homocysteine vitamins; infant; Nepal; methylmalonic acid; homocysteine
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Ulak, M.; Chandyo, R.K.; Thorne-Lyman, A.L.; Henjum, S.; Ueland, P.M.; Midttun, Ø.; Shrestha, P.S.; Fawzi, W.W.; Graybill, L.; Strand, T.A. Vitamin Status among Breastfed Infants in Bhaktapur, Nepal. Nutrients 2016, 8, 149.

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