Folate and cobalamin status in relation to diet in healthy 2-y-old children

Background: Limited data exist on sources of folate and cobalamin in the toddler diet. Objective: We examined the influence of diet on folate and cobalamin status in healthy toddlers in an unfortified population. Design: Dietary intake was assessed in 178 children, aged 24 mo, by using 7-d food records and related to serum folate and cobalamin status in 155 children. Results: Median (25th-75th percentile) daily intakes of folate and cobalamin were 87 mu g (74-104 mu g) and 3.1 mu g (2.4-3.8 mu g), respectively. Thirty-five percent of subjects had a folate intake below the Norwegian recommendations (80 mu g folate/d), but only 5.8% of subjects had low serum folate concentrations (, 10 nmol/L). All children reached the recommended cobalamin intake (0.8 mu g cobalamin/d). Median (25th-75th percentile) serum concentrations were as follows: folate, 19 nmol/L (14-24 nmol/L); cobalamin, 410 pmol/L (334-521 pmol/L); holotranscobalamin, 94 pmol/L (67-121 pmol/L); holohaptocorrin, 315 pmol/L (241-409 pmol/L); methylmalonic acid, 0.16 mu mol/L (0.13-0.20 mu mol/L); and total homocysteine, 5.0 mu mol/L (4.2-5.7 mu mol/L). Folate intake correlated with serum folate concentrations (rho = 0.25, P < 0.01), and cobalamin intake correlated with serum holotranscobalamin concentrations (rho = 0.21, P < 0.05). In multivariate models, serum folate concentrations were significantly positively associated with the consumption of fruit and berries and grain products; however, this was not the case with dairy products, which was the food group that contributed most to folate intake. Cobalamin status was associated with dairy products (cobalamin and holotranscobalamin), cobalamin supplements (cobalamin and holohaptocorrin), and liver pate (holotranscobalamin). Conclusions: In this unfortified toddler population, folate status was associated with intakes of fruit and berries and grain products. Cobalamin status was associated with intakes of dairy, liver pate, and supplements. In the assessment of vitamin sources, vitamin availability must be considered. Am J Clin Nutr 2011;93:727-35.