A systematic review and meta‐analysis of functional vitamin B12 status among adult vegans.

The dietary intake of vitamin B12 among unsupplemented vegans is notably lower compared to both vegetarians and omnivores. Prolonged low intakes of vitamin B12, such as seen in those adhering to a vegan diet, lead to physiological deficiency of vitamin B12 and an elevated risk of B12‐related morbidi...

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Publicado en:Nutrition Bulletin Vol. 49; no. 4; pp. 463 - 480
Autores principales: Niklewicz, Ali, Hannibal, Luciana, Warren, Martin, Ahmadi, Kourosh R.
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2024
      vid: 49
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/nbu.12712
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        atl: A systematic review and meta‐analysis of functional vitamin B12 status among adult vegans.
      aug:
        au:
          Niklewicz, Ali
          Hannibal, Luciana
          Warren, Martin
          Ahmadi, Kourosh R.
        affil: Department of Nutritional Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
      sug:
        subj:
          Biological Markers Blood
          Vitamin B12 Deficiency Risk Factors
          Risk Assessment
          Food Intake
          Vitamin B12 Blood
          Acids, Acyclic Blood
          Homocysteine Blood
          Vegetarianism
          Human
          Systematic Review
          Meta Analysis
          PubMed
          Vitamin B12 Therapeutic Use
          Dietary Supplementation
          Checklists
          Data Analysis Software
          Descriptive Statistics
          Childbearing Age
          Germany
          Funding Source
      ab: The dietary intake of vitamin B12 among unsupplemented vegans is notably lower compared to both vegetarians and omnivores. Prolonged low intakes of vitamin B12, such as seen in those adhering to a vegan diet, lead to physiological deficiency of vitamin B12 and an elevated risk of B12‐related morbidity. However, while serum B12 serves as a conventional biomarker for assessing B12 status, its utility is limited given its sensitivity and specificity in ascribing physiological deficiency of B12 and the functional vitamin B12 status of those adhering to vegan diets is unclear. We conducted a systematic review and meta‐analysis using data based on the full panel of biomarkers of vitamin B12 status to test whether adherence to a vegan diet is associated with an elevated risk of functional vitamin B12 deficiency compared to vegetarian or omnivorous diets. In addition, subgroup analysis was carried out to look at the effect of vitamin B12 supplement use on B12 status among vegans. Our search identified 4002 records, of which 19 studies met the inclusion criteria for the systematic review and 17 studies were taken forward for the meta‐analysis. Meta‐analysis results revealed significantly lower serum B12, pmol/ (−0.72 [−1.26, −0.18]; p = 0.01) and elevated total homocysteine, μmol/L (tHcy) (0.57 [0.26, 0.89]; p < 0.001) concentrations, alongside elevated methylmalonic acid, nmol/L (MMA) (0.28 [−0.01, 0.57]; p = 0.06) and lower holotranscobalamin, pmol/ (HoloTC) (−0.42 [−0.91, 0.07]; p = 0.09) levels among vegan adults compared to omnivores, indicating increased functional B12 deficiency in addition to low vitamin B12 status in vegan adults. There were no differences between vegans and vegetarians in HoloTC (0.04 [−0.28, 0.35]; p = 0.814) or MMA (−0.05 [−0.29, 0.20]; p = 0.708), but differences were found in serum B12 (−0.25 [−0.40, −0.10]; p = 0.001) and for tHcy (0.24 [0.09, 0.39]; p = 0.002) concentrations. Subgroup analyses indicated that the use of vitamin B12 supplements among vegans contributes to significant improvements in all biomarker concentrations compared to their unsupplemented counterparts. Our findings underscore the need for improved strategies to redress poor vitamin B12 status with appropriate B12 supplementation use among those adhering to vegetarian and vegan diets.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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