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Vitamin B-12 Deficiency in Children Is Associated with Grade Repetition and School Absenteeism, Independent of Folate, Iron, Zinc, or Vitamin A Status Biomarkers.
J Nutr. 2015 Jul; 145(7):1541-8.JN

Abstract

BACKGROUND

Micronutrients are essential to neurocognitive development; yet their role in educational outcomes is unclear.

OBJECTIVE

We examined the associations of micronutrient status biomarkers with the risk of grade repetition and rates of school absenteeism in a cohort of school children.

METHODS

We recruited 3156 children aged 5-12 y from public schools in Bogota, Colombia. Circulating ferritin, hemoglobin, zinc, vitamin A, and vitamin B-12; erythrocyte folate; and mean corpuscular volume (MCV) were measured in blood samples obtained at the beginning of the year. Absenteeism was recorded weekly during the school year, and grade repetition was determined the next year. Risk ratios for grade repetition and rate ratios for absenteeism were estimated by categories of micronutrient status indicators with use of Poisson regression, adjusting for potential confounders.

RESULTS

The risk of grade repetition was 4.9%, and the absenteeism rate was 3.8 d per child-year of observation. Vitamin B-12 deficiency (<148 pmol/L) was associated with an adjusted 2.36-fold greater risk of grade repetition (95% CI: 1.03, 5.41; P = 0.04) compared with plasma concentrations ≥148 pmol/L. Other micronutrients were not related to grade repetition. Vitamin B-12 deficiency was also associated with school absenteeism rates. Compared with children with plasma vitamin B-12 concentrations ≥148 pmol/L, vitamin B-12-deficient children had a 1.89-times higher adjusted rate (95% CI: 1.53, 2.34; P < 0.0001). Anemia was related to a 72% higher rate (95% CI: 48%, 99%; P < 0.0001), whereas every 5-fL difference in MCV was associated with a 7% lower adjusted rate (95% CI: 4%, 10%; P < 0.0001).

CONCLUSIONS

Vitamin B-12 deficiency was associated with risk of grade repetition and school absenteeism rates in school children from Bogota, Colombia. The effects of correcting vitamin B-12 deficiency on educational outcomes and neurocognitive development of school children need to be determined in intervention studies.

Authors+Show Affiliations

Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI; and.Foundation for Research in Nutrition and Health (FINUSAD), Bogota, Colombia.Foundation for Research in Nutrition and Health (FINUSAD), Bogota, Colombia.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI; and villamor@umich.edu.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25972530

Citation

Duong, Minh-Cam, et al. "Vitamin B-12 Deficiency in Children Is Associated With Grade Repetition and School Absenteeism, Independent of Folate, Iron, Zinc, or Vitamin a Status Biomarkers." The Journal of Nutrition, vol. 145, no. 7, 2015, pp. 1541-8.
Duong MC, Mora-Plazas M, Marín C, et al. Vitamin B-12 Deficiency in Children Is Associated with Grade Repetition and School Absenteeism, Independent of Folate, Iron, Zinc, or Vitamin A Status Biomarkers. J Nutr. 2015;145(7):1541-8.
Duong, M. C., Mora-Plazas, M., Marín, C., & Villamor, E. (2015). Vitamin B-12 Deficiency in Children Is Associated with Grade Repetition and School Absenteeism, Independent of Folate, Iron, Zinc, or Vitamin A Status Biomarkers. The Journal of Nutrition, 145(7), 1541-8. https://doi.org/10.3945/jn.115.211391
Duong MC, et al. Vitamin B-12 Deficiency in Children Is Associated With Grade Repetition and School Absenteeism, Independent of Folate, Iron, Zinc, or Vitamin a Status Biomarkers. J Nutr. 2015;145(7):1541-8. PubMed PMID: 25972530.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin B-12 Deficiency in Children Is Associated with Grade Repetition and School Absenteeism, Independent of Folate, Iron, Zinc, or Vitamin A Status Biomarkers. AU - Duong,Minh-Cam, AU - Mora-Plazas,Mercedes, AU - Marín,Constanza, AU - Villamor,Eduardo, Y1 - 2015/05/13/ PY - 2015/01/29/received PY - 2015/04/21/accepted PY - 2015/5/15/entrez PY - 2015/5/15/pubmed PY - 2015/9/15/medline KW - folate KW - grade repetition KW - iron KW - school absenteeism KW - school children KW - vitamin B-12 SP - 1541 EP - 8 JF - The Journal of nutrition JO - J. Nutr. VL - 145 IS - 7 N2 - BACKGROUND: Micronutrients are essential to neurocognitive development; yet their role in educational outcomes is unclear. OBJECTIVE: We examined the associations of micronutrient status biomarkers with the risk of grade repetition and rates of school absenteeism in a cohort of school children. METHODS: We recruited 3156 children aged 5-12 y from public schools in Bogota, Colombia. Circulating ferritin, hemoglobin, zinc, vitamin A, and vitamin B-12; erythrocyte folate; and mean corpuscular volume (MCV) were measured in blood samples obtained at the beginning of the year. Absenteeism was recorded weekly during the school year, and grade repetition was determined the next year. Risk ratios for grade repetition and rate ratios for absenteeism were estimated by categories of micronutrient status indicators with use of Poisson regression, adjusting for potential confounders. RESULTS: The risk of grade repetition was 4.9%, and the absenteeism rate was 3.8 d per child-year of observation. Vitamin B-12 deficiency (<148 pmol/L) was associated with an adjusted 2.36-fold greater risk of grade repetition (95% CI: 1.03, 5.41; P = 0.04) compared with plasma concentrations ≥148 pmol/L. Other micronutrients were not related to grade repetition. Vitamin B-12 deficiency was also associated with school absenteeism rates. Compared with children with plasma vitamin B-12 concentrations ≥148 pmol/L, vitamin B-12-deficient children had a 1.89-times higher adjusted rate (95% CI: 1.53, 2.34; P < 0.0001). Anemia was related to a 72% higher rate (95% CI: 48%, 99%; P < 0.0001), whereas every 5-fL difference in MCV was associated with a 7% lower adjusted rate (95% CI: 4%, 10%; P < 0.0001). CONCLUSIONS: Vitamin B-12 deficiency was associated with risk of grade repetition and school absenteeism rates in school children from Bogota, Colombia. The effects of correcting vitamin B-12 deficiency on educational outcomes and neurocognitive development of school children need to be determined in intervention studies. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/25972530/Vitamin_B_12_Deficiency_in_Children_Is_Associated_with_Grade_Repetition_and_School_Absenteeism_Independent_of_Folate_Iron_Zinc_or_Vitamin_A_Status_Biomarkers_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.3945/jn.115.211391 DB - PRIME DP - Unbound Medicine ER -