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Title:   Author  item
                                            ANAYA-LOYOLA, MIRIAM - Autonomous University Of Querétaroitem
                                            BRITO, ALEX - University Of Californiaitem
                                            VILLALPANDO, SALVADOR - National Institute Of Public Health (INSP)item
                                            Allen, Lindsay

                                                         - *A*
  Submitted to: International Journal for Vitamin and Nutrition Research
                                    Publication Type: Peer Reviewed Journal
                                    Publication Acceptance Date: 9/15/2018
                                    Publication  Date: 4/16/2019
                                    Citation: Anaya-Loyola, M., Brito, A., Villalpando, S., Allen, L.H. 2019. Prevalence of low serum vitamin B12 in Mexican children and women: results from the first National Nutrition Survey (1999) as a basis for interventions and progress. International Journal for Vitamin and Nutrition Research. https://doi.org/10.1024/0300-9831/a000579.DOI: https://doi.org/10.1024/0300-9831/a000579                                                              
                                Interpretive Summary: The purpose of this study was to analyze vitamin B12 in serum samples from the a nationally representative sample of population groups included in the 1999 Mexican National Nutrition survey, and determine the prevalence of low and marginal values and predictors of low values. Prevalence in 1999 was compared to that for children in 2006 and 2009 as a basis for planning interventions and measuring progress. Participants were 488 children age 10 to 59 months, 390 schoolers age 5 to 11 years, and 464 women age 12 to 49 years. The combined prevalence of low (<200 pg/mL) and marginal (200-300 pg/mL) concentrations was 25.6% and 21.0%, in children and women respectively. Adolescent girls had the lowest serum B12 concentrations, averaging 325±307 pg/mL. The prevalence of low serum B12 in pregnant women was 40%, based on a lower cut point (<135 pg/mL) for pregnancy. Residents of rural areas and the South, and the poorest socioeconomic status groups, had lower serum B12. Low values were also more common in illiterate participants and indigenous women. Children and women who met dietary recommendations for B12 intake had higher serum B12 than those who did not. In the population overall, 46% of participants had an intake below their Estimated Average Requirement, and dietary B12 intake of both women and children was correlated with serum B12 (r=0.18, p<0.0001 and r=0.11, p<0.05). We conclude that there was a high prevalence of vitamin B12 inadequacy in 1999, explained by a low intake of the vitamin by less privileged population groups. Subsequent surveys in 2006 and 2012 surveys suggest a substantial improvement in vitamin B12 status of children but data were not collected on adolescents and adult women.
                                Technical Abstract: The purpose of this study was to analyze vitamin B12 in serum samples from the a nationally representative sample of population groups included in the 1999 Mexican National Nutrition survey, and determine the prevalence of low and marginal values and predictors of low values. The study’s unique features are the representative nature of the sample, inclusion of a wide range of ages, and availability of data useful for determining risk factors for poor vitamin B12 status. Prevalence of low serum B12 concentrations in 1999 was compared to published data for children in 2006 and 2009 as a basis for planning interventions and measuring progress. Participants were 488 children age 10 to 59 months, 390 schoolers age 5 to 11 years, and 464 women age 12 to 49 years. The combined prevalence of low (<200 pg/mL) and marginal (200-300 pg/mL) concentrations was 25.6% and 21.0%, in children and women respectively. Adolescent girls had the lowest serum B12 concentrations, averaging 325±307 pg/mL. The prevalence of low serum B12 in pregnant women was 40%, based on a lower cut point (<135 pg/mL) for pregnancy. Residents of rural areas and the South, and the poorest socioeconomic status groups, had lower serum B12. Low values were also more common in illiterate participants and indigenous women. Children and women who met dietary recommendations for vitamin B12 intake had higher serum B12 than those who did not. In the population overall, 46% of participants had an intake below their Estimated Average Requirement, and dietary B12 intake of both women and children was correlated with serum B12 (r=0.18, p<0.0001 and r=0.11, p<0.05). We conclude that there was a high prevalence of vitamin B12 inadequacy in 1999, explained by a low intake of the vitamin by less privileged population groups. Subsequent surveys in 2006 and 2012 surveys suggest a substantial improvement in vitamin B12 status of children, likely due to national nutrition programs, but data were not collected on adolescents and adult women.


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