Obese Children and Adolescents: A Risk Group for Low Vitamin B12 Concentration | Adolescent Medicine | JAMA Pediatrics | JAMA Network
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September 2006

Obese Children and Adolescents: A Risk Group for Low Vitamin B12 Concentration

Author Affiliations

Author Affiliations: Pediatric Endocrinology and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel (Dr Pinhas-Hamiel, Ms Doron-Panush, and Dr Reichman); Pediatric Endocrinology and Metabolism Unit, Schneider Children's Medical Center, Petah Tikva, Israel (Ms Doron-Panush and Dr Shatilin); Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer (Drs Reichman and Geva-Lerner); Food and Nutrition Administration and Department of Epidemiology and Preventive Medicine, Ministry of Health, Jerusalem, Israel (Dr Nitzan-Kaluski); and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Dr Pinhas-Hamiel, Ms Doron-Panush, and Drs Reichman, Nitzan-Kaluski, Shalitin, and Geva-Lerner).

Arch Pediatr Adolesc Med. 2006;160(9):933-936. doi:10.1001/archpedi.160.9.933

Objective  To assess whether overweight children and adolescents are at an increased risk for vitamin B12 deficiency.

Design  Prospective descriptive study.

Setting  Two pediatric endocrine centers in Israel.

Participants  Three hundred ninety-two children and adolescents were divided into 2 groups as follows: the normal-weight group had body mass indexes, calculated as weight in kilograms divided by height in meters squared, under the 95th percentile (<1.645 standard deviation scores; n = 228); the obese group had body mass indexes equal to or above the 95th percentile (≥1.645 standard deviation scores; n = 164).

Intervention  We measured vitamin B12 concentrations. Low serum B12 was defined as a B12 concentration less than 246 pg/mL, and vitamin B12 deficiency was defined as a concentration below 211 pg/mL.

Main Outcome Measure  Vitamin B12 concentrations corrected for body mass index standard deviation scores, age, and sex.

Results  Median concentration of serum B12 in normal- weight children was 530 pg/mL and in obese children, 400 pg/mL (P<.001). Low B12 concentrations were noted in 10.4% of the obese children compared with only 2.2% of the normal weight group (P<.001). Vitamin B12 deficiency was noted in 12 children, 8 (4.9%) of the obese subjects and 4 (1.8%) of the normal weight group (P = .08). After we adjusted for age and sex, obesity was associated with a 4.3-fold risk for low serum B12, and each unit increase in body mass index standard deviation score resulted in an increased risk of 1.24 (95% confidence interval, 0.99-1.56).

Conclusions  Obesity in children and adolescents was associated with an increased risk of low vitamin B12 concentration. We recommend that dietary assessment of obese children should include an estimation of vitamin B12 intake. The possibility of vitamin B12 deficiency in addition to other micronutrient deficiencies should be considered in obese children.