Prevalence and Indicators of Vitamin B12 Insufficiency among Young Women of Childbearing Age

Vitamin B12 insufficiency is a global health issue among women of childbearing age, yet few studies have investigated its prevalence and risk factors among healthy Middle Eastern populations. This cross-sectional study included 346 Saudi women aged 19–30 years and enrolled at King Saud University, Riyadh, Saudi Arabia. A series of questionnaires were administered to record the study participants’ sociodemographic status, medical history, dietary intake, and physical activity. Participants’ anthropometric data were also recorded and their fasting blood samples were analyzed. The rate of vitamin B12 insufficiency (≤220 pmol/L) was approximately 6% among the study participants. After adjusting for confounding factors, it was observed that the risk factors for vitamin B12 insufficiency included daily sitting time ≥ 7 h, low income (<10,000 Saudi riyal) and increasing age. The recommended dietary allowance of vitamin B12 (>2.4 mcg/day) has been shown to confer reasonable protection against vitamin B12 insufficiency. These study findings highlight that a combination of increased physical activity and dietary vitamin B12 intake above the current recommended dietary allowance may help improve the serum vitamin B12 levels of young women of childbearing age, especially those with a low socioeconomic status. Timely detection and protection against vitamin B12 insufficiency in this subpopulation are important to prevent maternal and fetal health risks.

[1]  Anil Kumar,et al.  Vitamin B12 Deficiency (Cobalamin) , 2019 .

[2]  L. Allen,et al.  Biomarkers of Nutrition for Development (BOND): Vitamin B-12 Review. , 2018, The Journal of nutrition.

[3]  A. Al-Asmari,et al.  The association of metformin use with vitamin B12 deficiency and peripheral neuropathy in Saudi individuals with type 2 diabetes mellitus , 2018, PloS one.

[4]  B. Almutairi,et al.  Eating disorders and associated risk factors among Imam Abdulrahman bin Faisal university preparatory year female students in Kingdom of Saudi Arabia , 2018, Saudi medical journal.

[5]  M. Tonelli,et al.  A systematic review of the vitamin B12, folate and homocysteine triad across body mass index , 2018, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[6]  A. Steptoe,et al.  A cut-off of daily sedentary time and all-cause mortality in adults: a meta-regression analysis involving more than 1 million participants , 2018, BMC Medicine.

[7]  L. Ahmad,et al.  Prevalence of disordered eating attitudes among adolescent girls in Arar City, Kingdom of Saudi Arabia , 2018, Health psychology research.

[8]  N. Al-Daghri,et al.  Vitamin D Deficiency Prevalence and Predictors in Early Pregnancy among Arab Women , 2018, Nutrients.

[9]  B. Venn,et al.  Vitamin B12 Status of Various Ethnic Groups Living in New Zealand: An Analysis of the Adult Nutrition Survey 2008/2009 , 2018, Nutrients.

[10]  M. Hagströmer,et al.  Accelerometer-measured sedentary time and physical activity-A 15 year follow-up of mortality in a Swedish population-based cohort. , 2017, Journal of science and medicine in sport.

[11]  A. Fayed,et al.  Demographic profile and pregnancy outcomes of adolescents and older mothers in Saudi Arabia: analysis from Riyadh Mother (RAHMA) and Baby cohort study , 2017, BMJ Open.

[12]  Michael A. Via,et al.  Nutritional and Micronutrient Care of Bariatric Surgery Patients: Current Evidence Update , 2017, Current Obesity Reports.

[13]  C. M. Hansen,et al.  Nutrition Assessment of B-Vitamins in Highly Active and Sedentary Women , 2017, Nutrients.

[14]  S. Alkahtani Convergent validity: agreement between accelerometry and the Global Physical Activity Questionnaire in college-age Saudi men , 2016, BMC Research Notes.

[15]  A. Adaikalakoteswari,et al.  Vitamin B12 status in women of childbearing age in the UK and its relationship with national nutrient intake guidelines: results from two National Diet and Nutrition Surveys , 2016, BMJ Open.

[16]  R. Bhopal,et al.  Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis. , 2016, The American journal of clinical nutrition.

[17]  V. Plummer,et al.  What Women Have to Say about Giving Birth in Saudi Arabia , 2016 .

[18]  J. H. Hwang,et al.  The effects of exercise training and acute exercise duration on plasma folate and vitamin B12 , 2016, Nutrition research and practice.

[19]  G. Bray,et al.  Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study. , 2016, The Journal of clinical endocrinology and metabolism.

[20]  L. Allen,et al.  Regional, Socioeconomic, and Dietary Risk Factors for Vitamin B-12 Deficiency Differ from Those for Folate Deficiency in Cameroonian Women and Children. , 2015, The Journal of nutrition.

[21]  C. Edwards,et al.  Validation of a food frequency questionnaire specific for salt intake in Saudi Arabian adults using urinary biomarker and repeated multiple pass 24-hour dietary recall , 2015, Proceedings of the Nutrition Society.

[22]  T. Quay,et al.  High prevalence of suboptimal vitamin B12 status in young adult women of South Asian and European ethnicity. , 2015, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[23]  B. Shields,et al.  Lower Circulating B12 Is Associated with Higher Obesity and Insulin Resistance during Pregnancy in a Non-Diabetic White British Population , 2015, PloS one.

[24]  M. González-Gross,et al.  A review of the cut-off points for the diagnosis of vitamin B12 deficiency in the general population , 2015, Clinical chemistry and laboratory medicine.

[25]  Sevgi Özkan,et al.  Premarital screening of 466 Mediterranean women for serum ferritin, vitamin B12, and folate concentrations. , 2015, Turkish journal of medical sciences.

[26]  C. W. Wong,et al.  Vitamin B12 deficiency in the elderly: is it worth screening? , 2015, Hong Kong medical journal = Xianggang yi xue za zhi.

[27]  P. Finglas,et al.  McCance and Widdowson's The Composition of Foods Seventh Summary Edition and updated Composition of Foods Integrated Dataset , 2015 .

[28]  V. Mohan,et al.  Vitamin B12 deficiency is associated with adverse lipid profile in Europeans and Indians with type 2 diabetes , 2014, Cardiovascular Diabetology.

[29]  Alyssa A. Gamaldo,et al.  Serum Nutritional Biomarkers and Their Associations with Sleep among US Adults in Recent National Surveys , 2014, PloS one.

[30]  Y. Khader,et al.  Vitamin B12 Deficiency in Jordan: A Population-Based Study , 2014, Annals of Nutrition and Metabolism.

[31]  A. Bitton,et al.  Vitamin B12 Deficiency in Inflammatory Bowel Disease: Prevalence, Risk Factors, Evaluation, and Management , 2014, Inflammatory bowel diseases.

[32]  M. González-Gross,et al.  Algorithm for the early diagnosis of vitamin B12 deficiency in elderly people. , 2013, Nutricion hospitalaria.

[33]  S. Wilhelm,et al.  Perils and pitfalls of long-term effects of proton pump inhibitors , 2013, Expert review of clinical pharmacology.

[34]  E. Rush,et al.  Screening for inadequate dietary vitamin B-12 intake in South Asian women using a nutrient-specific, semi-quantitative food frequency questionnaire. , 2013, Asia Pacific journal of clinical nutrition.

[35]  J. Danesh,et al.  Homocysteine and Coronary Heart Disease: Meta-analysis of MTHFR Case-Control Studies, Avoiding Publication Bias , 2012, PLoS medicine.

[36]  L. Finer,et al.  Unintended pregnancy in the United States: incidence and disparities, 2006. , 2011, Contraception.

[37]  S. Khatry,et al.  Low maternal vitamin B-12 status is associated with offspring insulin resistance regardless of antenatal micronutrient supplementation in rural Nepal. , 2011, The Journal of nutrition.

[38]  M. Cogswell,et al.  Monitoring of vitamin B-12 nutritional status in the United States by using plasma methylmalonic acid and serum vitamin B-12. , 2011, The American journal of clinical nutrition.

[39]  S. Vollset,et al.  Dietary sources of vitamin B-12 and their association with plasma vitamin B-12 concentrations in the general population: the Hordaland Homocysteine Study. , 2009, The American journal of clinical nutrition.

[40]  J. Troendle,et al.  Maternal Vitamin B12 Status and Risk of Neural Tube Defects in a Population With High Neural Tube Defect Prevalence and No Folic Acid Fortification , 2009, Pediatrics.

[41]  Z. Abdollahi,et al.  Folate, Vitamin B12 and Homocysteine Status in Women of Childbearing Age: Baseline Data of Folic Acid Wheat Flour Fortification in Iran , 2008, Annals of Nutrition and Metabolism.

[42]  S. Vollset,et al.  Coffee consumption and circulating B-vitamins in healthy middle-aged men and women. , 2008, Clinical chemistry.

[43]  B. de Benoist Conclusions of a WHO Technical Consultation on Folate and Vitamin B12 Deficiencies , 2008, Food and nutrition bulletin.

[44]  A. Chetrit,et al.  Physical activity is inversely associated with total homocysteine levels, independent of C677T MTHFR genotype and plasma B vitamins , 2007, AGE.

[45]  M. Abdel-Fattah,et al.  DETERMINANTS OF BIRTH SPACING AMONG SAUDI WOMEN , 2007, Journal of family & community medicine.

[46]  P. Ueland,et al.  Longitudinal study of the effect of pregnancy on maternal and fetal cobalamin status in healthy women and their offspring. , 2007, The Journal of nutrition.

[47]  W. Fawzi,et al.  Low maternal vitamin B12 status is associated with intrauterine growth retardation in urban South Indians , 2006, European Journal of Clinical Nutrition.

[48]  P. Jacques,et al.  Relation between homocysteine and B-vitamin status indicators and bone mineral density in older Americans. , 2005, Bone.

[49]  R. Obeid,et al.  Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians. , 2003, The American journal of clinical nutrition.

[50]  J. Pacala Vitamin B12 deficiency. , 1993, The Journal of family practice.

[51]  N. Alyousefi,et al.  Factors Influencing Saudi Mothers Success in Exclusive Breastfeeding for the First Six Months of Infant Life: A Cross-Sectional Observational Study , 2017 .

[52]  V. Patel,et al.  Vitamin B 12 Status among Pregnant Women in the UK and Its Association with Obesity and Gestational Diabetes , 2016 .

[53]  E. Nexo,et al.  A daily intake of approximately 6 microg vitamin B-12 appears to saturate all the vitamin B-12-related variables in Danish postmenopausal women. , 2006, The American journal of clinical nutrition.

[54]  E. Nexo,et al.  Diagnosis and treatment of vitamin B12 deficiency--an update. , 2006, Haematologica.