Swaminathan Sumathi, Thomas Tinku, Kurpad Anura V
aDivision of Nutrition, St John's Research Institute bDivision of Epidemiology and Biostatistics, St John's Research Institute cDepartment of Physiology, St John's Medical College, and Division of Nutrition, St John's Research Institute, Bangalore, India.
Curr Opin Clin Nutr Metab Care. 2015 May;18(3):295-306. doi: 10.1097/MCO.0000000000000166.
This review examines the effect of B vitamins on women and child health from recent evidence available.
Findings were related to functional outcomes. In terms of foetal growth, although supplementation with B12 increased B12 status of nonpregnant and pregnant women and infants, maternal plasma homocysteine, which is related to multiple deficiencies of vitamin B12, B6, riboflavin or folate, has been shown to be associated with lower birth size rather than solely plasma B12. However, an experimental study with thiamine supplementation showed improvement in status in thiamine-deficient mothers and breast milk concentration, but not in infant status. Given the multiple aetiology of anaemia, the use of multiple micronutrient fortification has expectedly shown a reduction in anaemia prevalence in women. Furthermore, these micronutrients can interact with each other: high maternal folate intakes coupled with low B12 intakes were associated with a higher risk of delivering a small-for-gestational age infant. A high maternal plasma folate was also associated with insulin resistance in children aged 9.5 and 13.5 years.
Interventions with B vitamins were found to be efficacious in improving the status in women and children. In multiple micronutrient supplementation programmes, the optimum composition of the supplement needs to be determined. The deleterious effect of high folate intakes with low B12 intakes needs to be explored further.
本综述依据近期可得证据,探讨B族维生素对妇女和儿童健康的影响。
研究结果与功能结局相关。在胎儿生长方面,尽管补充维生素B12可提高未孕及孕期妇女和婴儿的维生素B12水平,但与维生素B12、B6、核黄素或叶酸多种缺乏相关的母体血浆同型半胱氨酸,已被证明与出生体重较低有关,而非仅与血浆维生素B12有关。然而,一项补充硫胺素的实验研究显示,硫胺素缺乏的母亲其状态及母乳中硫胺素浓度有所改善,但婴儿状态未改善。鉴于贫血病因多样,多种微量营养素强化措施预期可降低妇女贫血患病率。此外,这些微量营养素之间可能相互作用:母体叶酸摄入量高而维生素B12摄入量低与分娩小于胎龄儿的风险较高有关。母体血浆叶酸水平高还与9.5岁和13.5岁儿童的胰岛素抵抗有关。
发现补充B族维生素对改善妇女和儿童状态有效。在多种微量营养素补充方案中,需要确定补充剂的最佳成分。高叶酸摄入量与低维生素B12摄入量的有害影响需进一步探究。