Ravindra M Vora, Meryl J Alappattu, Apoorva D Zarkar, Mayur S Soni, Santosh J Karmarkar, Aśok C Antony
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Because tea-the second most common beverage worldwide (after water)-is consumed by most Indians every day, and appeared an ideal vehicle for fortification with folate and vitamin B<sub>12</sub>, we determined if daily consumption of vitamin-fortified tea for 2 months could benefit young women of childbearing-age in Sangli, India.</p><p><strong>Methods: </strong>Women (average age=20±2 SD) used teabags spiked with therapeutic doses of 1 mg folate plus <i>either</i> 0.1 mg vitamin B<sub>12</sub> (Group-1, n=<i>19</i>) <i>or</i> 0.5 mg vitamin B<sub>12</sub> (Group-2, n=<i>19</i>), or mock-fortified teabags (Group-0, n=<i>5</i>) to prepare a cup of tea every day for 2 months, following which their pre-intervention and post-intervention serum vitamin and haemoglobin concentrations were compared.</p><p><strong>Results: </strong>Most women had baseline anaemia with low-normal serum folate and below-normal serum vitamin B<sub>12</sub> levels. After 2 months, women in both Group-1 and Group-2 exhibited significant increases in mean differences in pre-intervention versus post-intervention serum folate levels of 8.37 ng/mL (95% CIs 5.69 to 11.04, p<0.05) and 6.69 ng/mL (95% CI 3.93 to 9.44, p<0.05), respectively; however, Group-0 experienced an insignificant rise of 1.26 ng/mL (95% CI -4.08 to 0.16). In addition, over one-half and two-thirds of women in Group-1 and Group-2, respectively, exhibited increases in serum vitamin B<sub>12</sub> levels over 300 pg/mL. There was also a significant post-interventional increase in the mean haemoglobin concentration in Group-1 of 1.45 g/dL (95% CI 0.64 to 2.26, p=0.002) and Group-2 of 0.79 g/dL (95% CI 0.11 to 1.42, p=0.027), which reflected a bona fide clinical response.</p><p><strong>Conclusion: </strong>Tea is an outstanding scalable vehicle for fortification with folate and vitamin B<sub>12</sub> in India, and has potential to help eliminate haematological and neurological complications arising from inadequate dietary consumption or absorption of folate and vitamin B<sub>12</sub>.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2021-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000209","citationCount":"8","resultStr":"{\"title\":\"Potential for elimination of folate and vitamin B<sub>12</sub> deficiency in India using vitamin-fortified tea: a preliminary study.\",\"authors\":\"Ravindra M Vora, Meryl J Alappattu, Apoorva D Zarkar, Mayur S Soni, Santosh J Karmarkar, Aśok C Antony\",\"doi\":\"10.1136/bmjnph-2020-000209\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The majority of Indian women have a poor dietary folate and vitamin B<sub>12</sub> intake resulting in their chronically low vitamin status, which contributes to anaemia and the high incidence of folate-responsive neural-tube defects (NTDs) in India. Although many countries have successfully deployed centrally-processed folate-fortified flour for prevention of NTDs, inherent logistical problems preclude widespread implementation of this strategy in India. Because tea-the second most common beverage worldwide (after water)-is consumed by most Indians every day, and appeared an ideal vehicle for fortification with folate and vitamin B<sub>12</sub>, we determined if daily consumption of vitamin-fortified tea for 2 months could benefit young women of childbearing-age in Sangli, India.</p><p><strong>Methods: </strong>Women (average age=20±2 SD) used teabags spiked with therapeutic doses of 1 mg folate plus <i>either</i> 0.1 mg vitamin B<sub>12</sub> (Group-1, n=<i>19</i>) <i>or</i> 0.5 mg vitamin B<sub>12</sub> (Group-2, n=<i>19</i>), or mock-fortified teabags (Group-0, n=<i>5</i>) to prepare a cup of tea every day for 2 months, following which their pre-intervention and post-intervention serum vitamin and haemoglobin concentrations were compared.</p><p><strong>Results: </strong>Most women had baseline anaemia with low-normal serum folate and below-normal serum vitamin B<sub>12</sub> levels. After 2 months, women in both Group-1 and Group-2 exhibited significant increases in mean differences in pre-intervention versus post-intervention serum folate levels of 8.37 ng/mL (95% CIs 5.69 to 11.04, p<0.05) and 6.69 ng/mL (95% CI 3.93 to 9.44, p<0.05), respectively; however, Group-0 experienced an insignificant rise of 1.26 ng/mL (95% CI -4.08 to 0.16). In addition, over one-half and two-thirds of women in Group-1 and Group-2, respectively, exhibited increases in serum vitamin B<sub>12</sub> levels over 300 pg/mL. 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引用次数: 8
摘要
导语:大多数印度妇女饮食中叶酸和维生素B12摄入不足,导致她们的维生素水平长期偏低,这导致了贫血和叶酸反应性神经管缺陷(NTDs)在印度的高发病率。尽管许多国家已经成功地部署了中央加工的叶酸强化面粉来预防被忽视的热带病,但固有的后勤问题阻碍了这一战略在印度的广泛实施。茶是世界上第二大最常见的饮料(仅次于水),是大多数印度人每天饮用的饮料,似乎是补充叶酸和维生素B12的理想载体,因此我们确定了每天饮用维生素强化茶2个月是否对印度Sangli的育龄年轻女性有益。方法:女性(平均年龄=20±2 SD)使用添加治疗剂量1mg叶酸加0.1 mg维生素B12(1组,n=19)或0.5 mg维生素B12(2组,n=19)或模拟强化茶包(0组,n=5)的茶包,每天准备一杯茶,持续2个月,之后比较干预前和干预后血清维生素和血红蛋白浓度。结果:大多数妇女基线贫血与低正常血清叶酸和低于正常血清维生素B12水平。2个月后,1组和2组的女性在干预前和干预后血清叶酸水平的平均差异显著增加,达到8.37 ng/mL (95% ci 5.69至11.04,p12水平超过300 pg/mL)。干预后,组1平均血红蛋白浓度显著升高,为1.45 g/dL (95% CI 0.64 ~ 2.26, p=0.002),组2平均血红蛋白浓度为0.79 g/dL (95% CI 0.11 ~ 1.42, p=0.027),反映了真实的临床反应。结论:在印度,茶是叶酸和维生素B12强化的一种出色的可扩展工具,并有可能帮助消除因饮食摄入或吸收叶酸和维生素B12不足而引起的血液学和神经系统并发症。
Potential for elimination of folate and vitamin B12 deficiency in India using vitamin-fortified tea: a preliminary study.
Introduction: The majority of Indian women have a poor dietary folate and vitamin B12 intake resulting in their chronically low vitamin status, which contributes to anaemia and the high incidence of folate-responsive neural-tube defects (NTDs) in India. Although many countries have successfully deployed centrally-processed folate-fortified flour for prevention of NTDs, inherent logistical problems preclude widespread implementation of this strategy in India. Because tea-the second most common beverage worldwide (after water)-is consumed by most Indians every day, and appeared an ideal vehicle for fortification with folate and vitamin B12, we determined if daily consumption of vitamin-fortified tea for 2 months could benefit young women of childbearing-age in Sangli, India.
Methods: Women (average age=20±2 SD) used teabags spiked with therapeutic doses of 1 mg folate plus either 0.1 mg vitamin B12 (Group-1, n=19) or 0.5 mg vitamin B12 (Group-2, n=19), or mock-fortified teabags (Group-0, n=5) to prepare a cup of tea every day for 2 months, following which their pre-intervention and post-intervention serum vitamin and haemoglobin concentrations were compared.
Results: Most women had baseline anaemia with low-normal serum folate and below-normal serum vitamin B12 levels. After 2 months, women in both Group-1 and Group-2 exhibited significant increases in mean differences in pre-intervention versus post-intervention serum folate levels of 8.37 ng/mL (95% CIs 5.69 to 11.04, p<0.05) and 6.69 ng/mL (95% CI 3.93 to 9.44, p<0.05), respectively; however, Group-0 experienced an insignificant rise of 1.26 ng/mL (95% CI -4.08 to 0.16). In addition, over one-half and two-thirds of women in Group-1 and Group-2, respectively, exhibited increases in serum vitamin B12 levels over 300 pg/mL. There was also a significant post-interventional increase in the mean haemoglobin concentration in Group-1 of 1.45 g/dL (95% CI 0.64 to 2.26, p=0.002) and Group-2 of 0.79 g/dL (95% CI 0.11 to 1.42, p=0.027), which reflected a bona fide clinical response.
Conclusion: Tea is an outstanding scalable vehicle for fortification with folate and vitamin B12 in India, and has potential to help eliminate haematological and neurological complications arising from inadequate dietary consumption or absorption of folate and vitamin B12.