Newer Paradigms in vit B12 Research
A SNEHA- Diabetes Unit, KEM Hospital, Pune Meeting
Feb 2-4th, Lagoona Resort, Lonavala, India
There is a renewed interest in the nutritional biology of vitamins B12 and folate as a result of two new developments:
| a. |
a very high prevalence of vitamin B12 deficiency has been demonstrated in a number of populations, notably in India but also in many countries in Latin America, and |
| b. |
demonstration that these vitamins may be important in many physiological and pathological processes hitherto unsuspected: fetal programming (body composition and insulin resistance), neurocognitive development, immune function, bone development, etc. |
In addition to the conventional role for these two vitamins in hematopoiesis, neurological function, methylation pathways and nucleic acid synthesis, there is a growing recognition that they control epigenetic regulation of genes and may have profound effect on cellular functions and disease production.
A recent consultation by the World Health Organization and studies in India have demonstrated widespread low vitamin B12 status in all age groups starting in early infancy. Deficiency is most prevalent in vegetarians and those with a low intake of animal source foods (>50% of the Indian population). Studies in Pune and Bangalore have shown that low maternal vitamin b12 status predisposes to fetal intrauterine growth restriction, and follow up studies in Pune have linked this to the development of subsequent adiposity and insulin resistance. Higher folate status may worsen the situation. Pune studies have also highlighted an association between socio-economic development (better education and hygiene) and the development of vitamin B12 deficiency, exaggerating the imbalance between the two vitamins. There is a need to know if folic acid fortification would be safe in this situation. The implications of these findings are obvious for the developing countries who are undergoing transition and are facing a burgeoning epidemic of the so called metabolic syndrome
These exciting new developments have necessitated a meeting of people with interest in these two vitamins to plan an international research agenda based on current information and new directions.
1) current knowledge on the role of vitamin b12 and folate in metabolism and cellular function,
2) global prevalence and causes of deficiency
3) role in developmental programming ( pregnancy and lactation )
4) affections in the elderly
5) epigenetics and genetics, immune function / inflammation as a mechanism explaining adverse consequences of b12 deficiency
6) rational supplementation policies including novel nutritional sources,
8) future research: plan of studies and interventions and write proposals to obtain funding for carrying them out. This will be a planning meeting for the collaborating research team. A major issue to discuss will be the need to evaluate potentially harmful effects of folic acid fortification without including vit B12.