No Long-Term Cognitive Benefit of B12/Folate Supplementation in Early Childhood

By Reuters Staff

February 06, 2020

NEW YORK (Reuters Health) - Vitamin B12 and/or folic acid supplementation for six months in preschoolers does not improve cognitive function by age 6 to 9 years, according to new research from India.

Vitamin B12 and folate are important for normal brain development, and suboptimal status has been linked to poor neurodevelopment. Evidence from randomized trials suggests a benefit of vitamin B12 supplementation in susceptible populations.

However, results of the first follow-up study in which the long-term effects of vitamin B12 and/or folic acid supplementation in early childhood on later cognitive function are measured suggest no persistent long-term cognitive benefit, Dr. Sunita Taneja of the Center for Health Research and Development, New Delhi, and colleagues report in Pediatrics.

In the original trial, 1,000 children were recruited at age 6 to 30 months from families of low- to middle-socioeconomic class living in New Delhi. The children were randomly assigned to placebo or 1.8 mcg/day vitamin B12, 150 mg folic acid, or both daily for six months.

Cognitive assessments obtained in 791 of the children when they were between 6 and 9 years old showed no differences between the intervention groups and the placebo group on scores of the main cognitive outcomes (Wechsler Intelligence Scale for Children, Fourth Edition India; Crichton Verbal Scale; and subtests of the NEPSY-II).

"The change in infant biomarker status after supplementation resulted in an expected metabolic response and improved growth and neurodevelopment immediately after supplementation," the researchers report.

Yet, despite previous findings of a beneficial short-term effect of B-vitamin supplementation on early child development, they did not find a long-term benefit on the cognitive outcomes in the full sample or in predefined subgroups when the children were 6 to 9 years old, they say.

The "improved status in early childhood did not lead to a change in cognition in early school age, when cognitive measures are considered more stable than in early childhood. The public health relevance of vitamin B12 and folic acid administration in early childhood to improve long-term cognitive function is accordingly questionable," they write.

One limitation of the study was that the timing and length of the supplementation may not have been ideal to detect long-term differences in cognition.

The study had no commercial funding and the authors have no relevant disclosures.

Dr. Taneja did not respond to a request for comment by press time.

SOURCE: Pediatrics, online February 4, 2020.