Abstract
The EAT-Lancet commission recently suggested that transformation to healthy diets by 2050 will require a reduction of at least 50% in consumption of foods such as red meat and sugar, and a doubling in the global consumption of fruits, vegetables, nuts, and legumes. A diet rich in plant-based foods and with fewer animal source foods confers both improved health and environmental benefits. Notably, the risk of vitamin B12 deficiency increases when consuming a diet low in animal products. Humans are dependent on animal foods such as dairy products, meat, fish and eggs. Vitamin B12 deficiency is common worldwide, especially in populations with low consumption of animal foods because of low socioeconomic status, ethical reasons, or because of their lifestyle (i.e., vegans). According to the European Food Safety Authoroty, the recommended adequate intake of vitamin B12 is 4.0 μg/d for adults, and vitamin B12 requirements are higher during pregnancy and lactation. Infants and children from deficient mothers and elderly people are at risk for vitamin B12 deficiency. Diagnosis of vitamin B12 deficiency is hampered by low specificity of available biomarkers, and there is no consensus yet regarding the optimal definition of low vitamin B12 status. In general, a combination of at least two biomarkers is recommended. Therefore, this review presents an overview of vitamin B12 biochemistry and its biomarkers. We further summarize current recommendations of vitamin B12 intake, and evidence on the associations of vitamin B12 intake from different nutrient-dense animal foods with vitamin B12 status markers. Finally, potential consequences of low vitamin B12 status on different health outcomes for pregnant women, infants and elderly are presented.
Highlights
This study studied individual animal food groups, and fully adjusted differences in plasma vitamin B12 for low vs high consumers were significant only for meat, but not for dairy, fish, cows liver, and eggs [32]
We further summarize current recommendations of vitamin B12 intake, and evidence on the associations of vitamin B12 intake from different nutrient-dense animal foods with vitamin B12 status markers
Adolescents who had received a macrobiotic diet until 6 y of age and had switched a diet containing animal products (n = 73) still had significantly lower vitamin B12 concentrations and higher concentrations methylmalonic acid (MMA), but comparable total homocysteine (Hcy) concentrations, as compared to their agematched controls who consumed an omnivorous diet from birth onwards. These results suggest that switching from a macrobiotic diet to moderate consumption of animal food products is inadequate to restore vitamin B12 status among children with a low vitamin B12 in early childhood [30]
Summary
This study studied individual animal food groups, and fully adjusted differences in plasma vitamin B12 for low vs high consumers were significant only for meat, but not for dairy, fish, cows liver, and eggs [32]. One study among pregnant women (n = 1266) was identified that addressed the association of vitamin B12 intake from dairy, meat, (shell)fish, and eggs with circulating levels of vitamin B12 biomarkers, and presence of vitamin B12 deficiency in week 34–36 of pregnancy.
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