Official websites use. Share sensitive information only on official, secure websites. Corresponding author: Sigrun Henjum, email shenjum oslomet. Plant-based diets may increase the risk of vitamin B 12 deficiency due to limited intake of animal-source foods, while dietary folate increases when adhering to plant-based diets. In this cross-sectional study, we evaluated the B 12 and folate status of Norwegian vegans and vegetarians using dietary B 12 intake, B 12 and folic acid supplement use, and biomarkers serum B 12 B 12plasma total homocysteine tHcyplasma methylmalonic acid MMA and serum folate. Vegans n and vegetarians n 90 completed a h dietary recall and a FFQ and provided a non-fasting blood sample. Predictors of higher serum B 12 concentrations were average daily supplement use and older age. Folate concentrations were adequate, indicating adequate folate intake in Norwegian vegans and vegetarians. Key words: Vitamin B 12Folate, Homocysteine, Methylmalonic acid, Vegans, Vegetarians, B 12 dietary intake. Vitamin B 12 B 12 is naturally present only in animal-source foods, and people who follow a plant-based diet and do not consume sufficient quantities of foods fortified with B 12 or take supplements will be at risk of B 12 deficiency 4. Fruits, vegetables, berries oslo escort girls c date norge grains are foods rich in folate 5. B 12 and folate are linked via the methyl group transfer from N 5 -methyltetrahydrofolate to B 12and deficiencies can lead to megaloblastic anaemia and hyperhomocysteinemia, a risk factor for atherosclerosis 6. Since B 12 is essential for DNA and RNA synthesis, erythropoiesis and the production of neurotransmitters 7low B 12 status can cause neurological damage due to an inhibition of the formation of the myelin sheath among other potential causes 4. Folate is essential for physiological processes, such as synthesis of nucleic acids and low folate status may cause cognitive and neurological symptoms. B 12 status can be assessed oslo escort girls c date norge several biomarkers, such as B 12 concentrations, total homocysteine tHcy and methylmalonic acid MMA. However, tHcy also increases with low folate status 8. Folate status can be assessed by evaluating serum folate and tHcy. Causes of B 12 deficiency can be divided into four main types: inadequate intake from food, malabsorption, chemical inactivation by nitrous oxide or genetic disorders 9. In high-income populations, B 12 deficiency is more often diagnosed as a cause of low absorption due to pernicious anaemia, an autoimmune condition where intrinsic factor production is inadequate 9. Loss of intrinsic factor also occurs with ageing. Deficiency is also more common in people who consume limited amounts of animal-source foods, such as vegans, vegetarians and the elderly 4. In low- and middle-income countries, B 12 deficiency can be relatively common due to lack of income to purchase animal-source foods or because of religious or cultural dietary preferences 9. Previous research in populations consuming a mixed diet reported that serum B 12 concentrations are on average lower in older individuals 10but few studies have included older vegans and vegetarians. According to national dietary surveys, healthy adults in Sweden and Norway have inadequate folate intakes. Three out of four women and one out of two men have been found to have intakes below the recommended intake in Norway 11 — Vegans and vegetarians have higher intakes of fruits and vegetables than the general population, likely resulting in a higher folate status in these groups. Worldwide, fortification of flour with folic acid is common, in USA folic acid fortification of all cereal grain product flour was implemented in ; however in Norway, flour with folic acid fortification is not available. In addition, a flexitarian diet, reducing the intake of meat, milk, eggs and fish in favour of plant-based alternatives, is becoming increasingly popular The measured biomarkers were further used to calculate the recently proposed B 12 status indicator, cB 12 In this study, participants, vegans and 90 vegetarians, from the Oslo area, were included 57 men and women, age range18—60 years. Due to few pescatarians n 35and no difference in B 12 status between vegetarians and pescatarians, the two groups were merged. Participants were mainly recruited through social media, using convenience sampling method. The snowball effect was further used to recruit participants through existing participants. Participants answered an electronic questionnaire, which consisted of two parts. The answers were converted into daily amounts and adjusted for portion size to obtain B 12 intake. Type, amount, brand and frequency of supplements used were also assessed for both B 12 and folic acid. The use of B 12 injections was assessed based on whether they ever had taken B 12 injections and time since last injection months. The questionnaire was designed based on a previously validated questionnaire in a study of lactating women and iodine status Changes were made to adapt to vegans and vegetarian diets and relevant lifestyle factors, including several plant-based alternatives such as legumes, plant-based milk and other non-dairy products oats, rice, soya, almond and coconutor vegan cheese and meat substitutes soya products, tofu and tempeh. Energy drink intake was also evaluated, due to high B 12 doses in some of the brands. Dietary folate intake was not calculated due to insufficient details on folate sources e. The h recall was completed for B 12 intakes on the same day as the non-fasting blood sample was collected. Types and quantities grams and decilitres of food and drinks, and brand or manufacturer were assessed. To calculate the h oslo escort girls c date norge, reported food items were multiplied by B 12 concentrations in each specific food item available in the Norwegian Food Composition Table in 5. For combined food items, the mean values for each food item were used e.
It was translated with technical assistance and editorially reviewed before publication. Norwegian primary care research institutions have the ambition, capacity and competence to access patient data [ 9 ] and to conduct randomized clinical trials RCTs [ 10—14 ] in spite of logistic barriers. The current funding allows the recruitment of 90 practices all over Norway. Man hört und liest sie immer häufiger. Jeg e Supplemental Table 2 shows the percentage of participants with B 12 , tHcy and MMA concentrations n below the respective cut-offs.
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