# The COMIDITA study: urban Latino toddlers, diet intake and developmental outcomes

> **NIH NIH R21** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $243,000

## Abstract

Children of recently immigrated Latinos are at increased risk for exposure to multiple social and environmental
factors that also contribute to inadequate nutrient intake, disadvantaging their development. Folate, a key
methyl donor critical for DNA synthesis, methylation, and neurodevelopment, can be ingested as naturally
occurring food folate or as synthetic folic acid (FA), present in fortified grains and vitamin supplements. Cost
and convenience lead to a predominance of fortified foods in accessible staples for poor Latino immigrants.
In rodent pups, a post-natal diet of insufficient folate impairs normal neurodevelopment, while diets with excess
FA impair short term memory and behavior. In adult humans, excess FA intake exacerbates memory loss and
detrimental cognitive effects of vitamin B12 deficiency. Data examining toddler folate intake and cognition are
limited. A 2015 National Toxicology Program (NTP) expert panel identified study of cognitive impact of high FA
intake during toddlerhood as a priority. The prevalence of neurocognitive and behavior problems in low-income
toddlers paired with concerns from rodent diet data suggest the need to better account for dietary intake in
poor toddlers, including examining high FA intake from fortified foods. Data on diet and folate biomarkers in US
Latino toddlers are sparse. Our analysis of NHANES data suggests risk for consuming insufficient folate (below
the Estimated Average Requirement) and also risk for ingesting excess FA (above the tolerable Upper Limit for
age) are both significantly increased in toddlers of Spanish preference Latinos, though few take supplements.
Latino toddlers may be susceptible to low folate or high FA intake because of highly prevalent polymorphisms
that exacerbate the impact of low folate (MTHFR; rs1801133) or high FA (DHFR; rs70991108) intake. In our
ongoing pilot of 2 year olds (N=55) documenting diet and neurodevelopment in Columbia’s Early Head Start,
most mothers are immigrants from central Mexico who maintain pre-migration dietary habits when feeding their
US born toddlers, while including foods provided by government assistance. We have collected toddler blood
samples, data on food insecurity, migration, acculturation, home cognitive stimulation, repeated 24 hour diet
recalls and neurodevelopmental assessments. We hypothesize toddlers may over-consume fortified grains
such as boxed cereal, bread, and traditional foods made with fortified corn flour. At 24 months, 25% of toddlers
have high plasma folate, while 24 month diet intake of synthetic FA increases with crowded living conditions
and correlates inversely with executive function and behavior assessed at ages 30 and 36 months suggesting
a potential negative association with FA consistent with rodent data. We propose to expand on our innovative
pilot, addressing an NTP identified priority, examining diet and neurodevelopment in 145 toddlers (adding 90
new recruits to the existing 55), followed longitudinal...

## Key facts

- **NIH application ID:** 9901573
- **Project number:** 5R21MD013622-02
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Manuela A Orjuela
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $243,000
- **Award type:** 5
- **Project period:** 2019-04-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9901573

## Citation

> US National Institutes of Health, RePORTER application 9901573, The COMIDITA study: urban Latino toddlers, diet intake and developmental outcomes (5R21MD013622-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9901573. Licensed CC0.

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