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Vegetarians and B12

Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians.

Herrmann W, Schorr H, Obeid R, Geisel J.

Central Laboratory, Department of Clinical Chemistry, Saarland University Hospital, Homburg, Germany. kchwher@uniklinik-saarland.de

BACKGROUND: Vegetarians have a lower intake of vitamin B-12 than do omnivores. Early and reliable diagnosis of vitamin B-12 deficiency is very important.

OBJECTIVE: The objective was to investigate vitamin B-12 status in vegetarians and nonvegetarians.

DESIGN: The study cohort included 66 lactovegetarians or lactoovovegetarians (LV-LOV group), 29 vegans, and 79 omnivores. Total vitamin B-12, methylmalonic acid, holotranscobalamin II, and total homocysteine concentrations were assayed in serum.

RESULTS: Of the 3 groups, the vegans had the lowest vitamin B-12 status. In subjects who did not consume vitamins, low holotranscobalamin II (< 35 pmol/L) was found in 11% of the omnivores, 77% of the LV-LOV group, and 92% of the vegans.

Elevated methylmalonic acid (> 271 nmol/L) was found in 5% of the omnivores, 68% of the LV-LOV group, and 83% of the vegans. Hyperhomocysteinemia (> 12 micromol/L) was present in 16% of the omnivores, 38% of the LV-LOV group, and 67% of the vegans.

The correlation between holotranscobalamin II and vitamin B-12 was weak in the low serum vitamin B-12 range (r = 0.403) and strong in the high serum vitamin B-12 range (r = 0.769). Holotranscobalamin II concentration was the main determinant of total homocysteine concentration in the vegetarians (beta = -0.237, P < 0.001).

Vitamin B-12 deficiency led to hyperhomocysteinemia that was not probable in the upper folate range (> 42.0 nmol/L).

CONCLUSIONS: Vegan subjects and, to a lesser degree, subjects in the LV-LOV group had metabolic features indicating vitamin B-12 deficiency that led to a substantial increase in total homocysteine concentrations.

Vitamin B-12 status should be monitored in vegetarians. Health aspects of vegetarianism should be considered in the light of possible damaging effects arising from vitamin B-12 deficiency and hyperhomocysteinemia.

Am J Clin Nutr. 2003 Jul;78(1):3-6.

Ann's NOTE: While vegans and others might need to supplement Vit B12, it seems likely that people who eat a standard 'Western' diet of fried foods, VERY few fruits/vegetables, lots of salt, sugar and soda, are much less healthy. (Higher risk of heart disease, cancer, hypertension, diabetes, etc.)


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Br J Cancer, 1/04
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