Vitamin B12 status, dietary protein intake and proton pump inhibitor use in geriatric rehabilitation subjects

Abstract

AbstractAim: To compare the dietary intake and nutritional status of users and non‐users of proton pump inhibitor medications.Methods: Cross‐sectional study of subacute rehabilitation inpatients. Forty‐nine patients (nine men and 40 women) without dementia fulfilled the study criteria. Information was collected on admission and included medical history, duration of proton pump inhibitor medication use, nutritional status and cognitive scores. Dietary data were collected by food frequency questionnaire and blood samples were analysed for vitamin B12, homocysteine and methylmalonic acid concentrations.Results: Age was 80.4 ± 7.7 (mean ± SD) years and body mass index was 26 ± 6.7 kg/m2. Twenty‐one (of 49) subjects had subclinical vitamin B12 deficiency, which was defined as serum vitamin B12 <148 pmol/L or 148–258 pmol/L and methylmalonic acid >0.30 µmol/L or tHcy >13 µmol/L (women) and >15 µmol/L (men). Subjects were stratified according to proton pump inhibitor use and vitamin B12 status. The presence of subclinical deficiency was similar between the groups (χ2‐test P= 0.17). Proton pump inhibitor users had higher dietary protein and calcium intakes (but not supplement calcium intakes) compared with non‐users (93 vs 81 g/day, P= 0.002 and 968 vs 742 mg/day, P= 0.038, respectively).Conclusions: Subjects using proton pump inhibitor medications did not have lower vitamin B12 status, but had higher dietary protein intakes suggesting higher intakes of meats, eggs and dairy foods may reduce the risk of developing vitamin B12 deficiency whilst taking proton pump inhibitor medications.