Diarrhea and Novel Dietary Factors Emerge as Predictors of Serum Vitamin B 12 in Panamanian Children

Abstract

Background

The role of gastrointestinal infection as a factor determining vitamin B₁₂ status in populations with low intake of animal-source foods is unclear.

Objective

To determine dietary adequacy and serum concentrations of vitamin B₁₂ in an extremely impoverished indigenous population of Panamanian children aged ₁₂ to 60 months, and to identify predictors of both dietary and serum vitamin B₁₂.

Methods

A previous community-based survey provided the usual dietary intake and personal, household, and infection (Ascaris and diarrheal disease) information for 209 weaned children. Serum vitamin B₁₂ was assayed using electrochemiluminescence for 65 of these children. Children with adequate or inadequate dietary vitamin B₁₂ intake were compared, and predictors of dietary and serum vitamin B₁₂ were identified using step-wise regression analyses of one index child per household.

Results

Dietary vitamin B₁₂ intake was inadequate in 43% of children; these children were poorer, had less frequent diarrhea, and obtained a higher percentage of their energy from carbohydrate than children with adequate intake. Energy intake positively predicted dietary vitamin B₁₂ intake. In contrast, serum vitamin B₁₂ concentrations were normal in all but 3% of the children. Serum vitamin B₁₂ was positively associated with weekly servings of fruit, corn-based food, and ñame (a traditional starchy food), but not with animal-source foods. Finally, serum vitamin B₁₂ was not associated with Ascaris intensity but was lowered with increasing frequency of diarrhea.

Conclusions

Although inadequate dietary intake of vitamin B₁₂ was common, most serum values were normal. Nevertheless, diarrheal disease emerged as a negative predictor of serum vitamin B₁₂ concentration.