Vitamin B12: An Intergenerational Story

Area of Science:

• Nutritional Science
• Maternal and Child Health
• Developmental Origins of Health and Disease (DOHaD)

Background:

• Vitamin B12, essential for human metabolism, is synthesized by microbes and primarily obtained from animal-sourced foods.
• Dietary insufficiency, often linked to cultural and economic factors like vegetarianism, is the leading cause of vitamin B12 deficiency globally.
• Subclinical vitamin B12 deficiency is prevalent in India, particularly among vegetarian populations.

Purpose of the Study:

• To investigate the life-course evolution of vitamin B12 deficiency in a birth cohort.
• To explore the association between maternal vitamin B12 status and fetal growth and infant metabolic health.
• To evaluate the efficacy of adolescent vitamin B12 supplementation for primordial prevention of adverse health outcomes in offspring.

Main Methods:

• Long-term serial follow-up of a birth cohort (Pune Maternal Nutrition Study) to track vitamin B12 status.
• Analysis of factors contributing to vitamin B12 deficiency, including genetics, maternal transfer, environment, and diet.
• A supplementation trial (Pune Rural Intervention in the Young Adolescent) assessing the impact of adolescent vitamin B12 intake on maternal and infant outcomes.

Main Results:

• Identified multiple contributors to vitamin B12 deficiency, including genetics, maternal transfer, family environment, growth, and low milk consumption.
• Established a novel association between low maternal vitamin B12 and fetal growth restriction.
• Observed increased risk factors for diabetes in infants born to mothers with low vitamin B12 status.
• Demonstrated adequate absorption and metabolic improvements with small-dose vitamin B12 supplementation in a pilot study.

Conclusions:

• Vitamin B12 deficiency has complex origins influenced by various life-course factors.
• Maternal vitamin B12 status is critical for fetal development and has long-term implications for infant health, including diabetes risk.
• Adolescent vitamin B12 supplementation may serve as a strategy for primordial prevention, impacting the developmental origins of health and disease.