Doctor says vegetarians develop vitamin B12 deficiency regardless of wealth, age, where they live or type of vegetarian diet

This paper was published in Nutrition Reviews 2013 Feb;71(2):110-7

 

Study title and authors:

How prevalent is vitamin B(12) deficiency among vegetarians?

Pawlak R, Parrott SJ, Raj S, Cullum-Dugan D, Lucus D.

Department of Nutrition Science, East Carolina University, Greenville, NC 27858, USA. pawlakr@ecu.edu

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/23356638

The aim of this paper, headed by Dr Roman Pawlak from the Department of Nutrition Science at East Carolina University, was to review the scientific literature to assess the rate of vitamin B12 deficiency among vegetarians and vegans. The review found 18 studies that assessed vitamin B12 deficiency rates.

The review found:
(a) 62% of vegetarian pregnant women were vitamin B12 deficient.
(b) Between 25-86% of vegetarian children were vitamin B12 deficient.
(c) Between 21-41% of vegetarian adolescents were vitamin B12 deficient.
(d) Between 11-90% of elderly vegetarians were vitamin B12 deficient.
(e) Higher rates of deficiency were reported among vegans compared with vegetarians.
(f) Higher rates of deficiency were reported among individuals who had adhered to a vegetarian diet since birth compared with those who had adopted such a diet later in life.

Dr Pawlak concluded: "The main finding of this review is that vegetarians develop B12 depletion or deficiency regardless of demographic characteristics, place of residency, age, or type of vegetarian diet".

Low vitamin B12 levels implicated in the development of diabetes

This study can be accessed in the Public Library of Science 2011;6(11):e26747

Study title and authors:

Status of B-vitamins and homocysteine in diabetic retinopathy: association with vitamin-B12 deficiency and hyperhomocysteinemia.

Satyanarayana A, Balakrishna N, Pitla S, Reddy PY, Mudili S, Lopamudra P, Suryanarayana P, Viswanath K, Ayyagari R, Reddy GB.

Biochemistry, National Institute of Nutrition, Hyderabad, India.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22069468

Diabetic retinopathy is retinopathy (damage to the retina) caused by complications of diabetes, which can eventually lead to blindness. Many studies have indicated an association between high levels of homocysteine (a non-protein amino acid) and diabetic retinopathy.

This study investigated the relationship of B-vitamins and homocysteine in diabetes and diabetic retinopathy. The study measured values of Vitamins B6, B9 and B12 and included 300 people with type two diabetes of which 200 had retinopathy and 100 did not. A further 100 healthy subjects were also included for analysis.

Other clinical measurements were also measured in the study, and it was revealed:
(i) Those with diabetes had 123% higher blood sugar levels than the healthy subjects.
(ii) Those with diabetes had 83% higher HbA1C levels than the healthy subjects.
(iii) Those with diabetes had 19% higher insulin levels than the healthy subjects.
(iv) Those with diabetes had 25% higher triglyceride levels than the healthy subjects.
(v) Those with diabetes had 18% lower (HDL) high density lipoprotein cholesterol levels than the healthy subjects.

Regarding the relationship of B-vitamins and homocysteine in diabetes and diabetic retinopathy the study found:
(a) Homocysteine levels were higher in those with diabetes, (particularly in those with diabetic retinopathy), compared to the healthy subjects.
(b) Vitamin B6, B9 and B12 levels were lower in those with diabetes, (particularly vitamin B12), compared to the healthy subjects. (Vitamin B12 was also significantly lower in those with diabetic retinopathy compared to those with just diabetes).

The results of the study show that deficiencies of vitamins B6, B9 and B12 are associated with high homocysteine levels and the development of diabetes. Low levels of vitamin B12 were significantly associated with the incidence of diabetes and the development of diabetic retinopathy.

The best sources of vitamin B6 are: Tuna, beef liver, chicken liver, pork chops, salmon, halibut, beef and turkey.

Good sources of vitamin B9 include: Calf's liver, beef liver, other organ meats and chicken giblet's.

Vitamin B12 can only be found in foods of animal origin, the richest sources are: Oyster's, mussel's, clam's, beef liver, trout, salmon, beef, pork, egg and chicken.

Vegetarians have a higher risk of heart disease compared to omnivores

This post includes a synopsis of a study published in the Journal of the American College of Cardiology 2005; 46:1957-1958

Study title and authors:
Vascular Dysfunction in Chinese Vegetarians: An Apparent Paradox?
Timothy Kwok, MD, Ping Chook, MD, Lucia Tam, MPh, Mu Qiao, PhD, Jean L.F. Woo, MD, David S. Celermajer, PhD and Kam S. Woo, MD, FACC*
* Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong SAR (Email: ramsangwoo@cuhk.edu.hk).

This study can be accessed at: http://content.onlinejacc.org/cgi/content/full/46/10/1957

The study investigated the following heart disease risk factors in 49 vegetarians and 49 omnivores:

(i) Carotid intima-media thickness (a measurment of the combined thicknesses of the intimal and medial layers of the carotid artery walls - so the greater the carotid intima-media thickness, the greater the risk of heart disease).
(ii) Flow-mediated dilation of brachial artery (a measurement of blood flow in the brachial artery - the less the flow the greater the risk of heart disease).
(iii) Vitamin B12 levels.
(iv) Homocysteine levels.
(v) Blood pressure.

The study found:
(a) Vegetarians had significantly greater carotid intima-media thickness than omnivores.
(b) Vegetarians had less flow-mediated dilation of the brachial artery than omnivores.
(c) Vegetarians had lower vitamin B12 levels than omnivores.
(d) Vegetarians had higher homocysteine levels than omnivores.
(e) Vegetarians had higher blood pressure than omnivores.
(f) Vegetarians ate less protein, less saturated fat and less cholesterol than omnivores.

To conclude: Vegetarians have a higher risk of heart disease compared to omnivores.



Vegan diets may lead to malnutrition and growth retardation in infants

This post includes a synopsis of a study published in Pediatrics 1982 Oct;70(4):582-6 and a recipe for slow cooked rabbit.

Study title and authors:
Totally vegetarian diets and infant nutrition.

Books:

Shinwell ED, Gorodischer R.

Department of Pediatrics "A," Soroka University Hospital, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/6812012

The paper reports on the harmful effects of a vegan diet in infants.

Shinwell found that:
(a) 25 infants from the vegan community who were seen at the hospital showed evidence of protein-calorie malnutrition, iron- and vitamin B12-deficient anemia, rickets, zinc deficiency, and multiple recurrent infections.
(b) Evidence of growth retardation was also found in 47 infants seen at the local mother-child health (well-baby) clinic.
(c) Samples of breast milk showed low levels of carbohydrate, protein and fat.
(d) The main constituent of the infants' diet after the age of 3 months (a "soya milk" prepared at the community's central kitchen) was extremely dilute with a very low calorific value.

To conclude: A vegan diet may lead to malnutrition and growth retardation in infants.

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Recipe of the day

Slow Cooked Rabbit

Ingredients:

Food Mall: Rabbit

• 2 whole rabbits, cut into serving pieces

• sea salt
• pepper
• 8 oz tomato sauce
• 15 oz diced tomatoes
• 1 med onion, chopped
• 2 cloves garlic, chopped
• 1/2 t rosemary
• 1/2 t thyme
• crushed red pepper
• 1 lb carrots
• 1 cup dry white wine

Instructions:
Brown rabbit pieces in large skillet. Salt and pepper the rabbit to taste. Place the rabbit in a crock pot. Mix the rest of the ingredients together and pour over rabbit, stirring to coat. Cover and cook on low for 6- 8 hours.

Slow Cooked Rabbit

Vegans have a high risk of developing clinical symptoms related to vitamin B12 deficiency

Published in the European Journal of Clinical Nutrition (2010) 64, 933–939; doi:10.1038/ejcn.2010.142;

Serum concentrations of vitamin B12 and folate in British male omnivores, vegetarians and vegans: results from a cross-sectional analysis of the EPIC-Oxford cohort study
A M J Gilsing1, F L Crowe1, Z Lloyd-Wright2, T A B Sanders2, P N Appleby1, N E Allen1 and T J Key1
1Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
2Nutritional Sciences Research Division, King's College London, London, UK

This study can be accessed at: http://www.nature.com/ejcn/journal/v64/n9/abs/ejcn2010142a.html

The results of the study showed vitamin B12 was highest among omnivores (281 pmol/l), intermediate among vegetarians (182 pmol/l) and lowest among vegans (122 pmol/l).

Half of the vegans were categorized as vitamin B12 deficient and would be expected to have a higher risk of developing clinical symptoms related to vitamin B12 deficiency.

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Mother's who have vegetarian diets may cause lethargy and failure to thrive in their babies.

This post includes a summary of a paper published in Clinical Pediatrics Vol. 25, No. 4, 219-221 (1986) and a recipe for pot roast brisket.

Books:

Study title and author:

Nutritional Vitamin B12 Deficiency in a Breast-fed Infant of a Vegan-diet Mother
Ronald Sklar, MD
Department of Pediatrics, School of Medicine and the Doernbecher Memorial Hospital for Children, Oregon Health Sciences University, Portland, Oregon

This paper can be accessed at: http://cpj.sagepub.com/cgi/content/abstract/25/4/219

A 7-month-old male presented with lethargy and failure to thrive. The child was exclusively breast-fed from birth by a mother who was a strict vegetarian. Laboratory data revealed the child was vitamin B12 deficient and had anemia.

The study emphasized the need for the mother to have an adequact diet during pregnancy and after birth.

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Recipe of the day

Pot Roast Brisket

 

Ingredients:

Food Mall: Brisket

1 x 1.3kg/3lb beef brisket
Salt and freshly milled black pepper

30ml/2tbsp butter
50g/2oz chorizo sausage, chopped

2 garlic cloves, peeled and finely chopped

2 red onions, peeled and chopped

1 small pumpkin or butternut squash, peeled, deseeded and roughly chopped

200ml/7floz good, hot beef stock

1 x 400g can chopped tomatoes

2 bay leaves

30ml/2tbsp freshly chopped thyme leaves

Method:

1.Place the meat on a chopping board and season.

2.Heat the butter in a large non-stick frying pan and brown the joint all over with the chorizo. Transfer to a large plate.

3.In the same frying pan add the remaining ingredients and cook over a moderate heat for 3-4 minutes.

4.Spoon into the slow cooker and place the joint and chorizo on top.

5.Turn the slow cooker to HIGH and cook for 4-6 hours or LOW for 8-10 hours, or according to your manufacturers’ handbook.

6.Remove the meat from the cooker, slice and serve.

Pot Roast Brisket



Eat more animal-source foods to boost your vitamin B12

This post contains a summary of a paper published in the American Journal of Clinical Nutrition Vol. 89, No. 2, 693S-696S, February 2009 and a recipe for liver and onions.

Books:

Study title and author:

How common is vitamin B-12 deficiency?

Lindsay H Allen

From the US Department of Agriculture, ARS Western Human Nutrition Research Center, University of California, Davis, Davis, CA.

This paper can be accessed at: http://www.ajcn.org/cgi/content/abstract/89/2/693S
 
Allen revealed: "Inadequate intake, due to low consumption of animal-source foods, is the main cause of low serum vitamin B-12 in younger adults and likely the main cause in poor populations worldwide".

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Recipe of the day

Liver and onions

Ingredients

Food Mall: Bacon

450g lamb's liver

1 tbsp olive oil
25g butter
4 smoked streaky bacon rashers, chopped
2 onions, thinly sliced
chopped tomatoes
175ml beef stock
1 tbsp tomato purée
1/4 tsp dried mixed herbs
salt and freshly ground
black pepper

Preparation method:
1. Heat half the oil and half the butter in a saucepan over a low heat, add the onions and gently cook them for 10 minutes until soft and just starting to turn golden.

2. Meanwhile, rinse the liver, then pat dry with kitchen paper. If it is not already sliced, cut into thin slices. Season with salt and pepper.

3. Add the tomatoes, the stock, tomato purée and herbs to the onions and bring to the boil. Reduce the heat, cover and leave to cook on a gentle simmer, stirring occasionally.

4. Meanwhile, heat the remaining oil and butter in a large frying pan over a moderate heat until sizzling. Add the liver and bacon and fry for 3–4 minutes on each side until the liver is just cooked and the bacon is lightly browned and crispy. Do not cook for too long or the liver will become tough.

5. Remove the liver and bacon from the pan using a draining spoon and put onto warm serving plates, with the bacon scattered over the top of the liver. Spoon the onion and tomato sauce on the side, then sprinkle with parsley. Serve immediately.



Multiple Nutritional Deficiencies in Infants From a Strict Vegetarian Community

Published in Am J Dis Child. 1979;133(2):141-144.

Multiple Nutritional Deficiencies in Infants From a Strict Vegetarian Community
Ehud Zmora, MD; Rafael Gorodischer, MD; Jacob Bar-Ziv, MD

This study can be accessed at: http://archpedi.highwire.org/cgi/content/abstract/133/2/141
 
Severe nutritional deficiencies developed in four infants from a vegan community. All of the infants had profound protein-caloric malnutrition, severe rickets, osteoporosis, and vitamin B12 and other deficiencies. One infant died.

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Vegan children have a subnornual rate of growth

The post features a summary of a paper published in the American Journal of Clinical Nutrition Vol 3 No 5 and a method of flash freezing steaks and beef patties.

Study title and authors:
Human Dietary Deficiency of Vitamin B12*

Bgj FRANK WOKES, PH.D.,t .J. BADENOCH, M.D.,ı AND H. M. SINCLAIR, M.D.1

Books:

* Presented at the Third International Congress of Nutrition. Amsterdam, The Netherlands (September 13-17. 1954)

Ovaltine Research Laboratories. King’s Langley, England.
ı Radcliffe Infirmary, Oxford, England.
ı Laboratory of Human Nutrition. University of Oxford, England.

This paper can be accessed at: http://www.ajcn.org/cgi/reprint/3/5/375.pdf
 
As well as a vitamin B12 deficiency the study pinpointed that vegans suffer from a lack of calcium and vitamin D. Data on British vegan children indicated a subnornual rate of growth.

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Recipe of the day

Flash Freeze Method for Steaks and Beef Patties

Food Mall: Steaks

Let your cooked meat rest on a cutting board to room temperature. Cut in half to roughly 8 ounces or a little less or you can freeze them whole it won't make a difference.

Then line a cutting board that will fit in your freezer. You may use a tray, plate or whatever you have. The trick is to use wax paper. You could use parchment.

Then simply put it carefully in the freezer and let it freeze over night. Then place the frozen goodies in a zip-lock storage bag and the meat is ready for action on a moments notice.

The next day take out the frozen goodies. They look dry, but they are moist and delicious the next time you eat them with no freezer taste at all.

Place these Life Saving Goodies in a Zip-Lock bag and store them back in the freezer for future use.

Flash Frozen Steaks



A mother's vegetarian diet cause severe aneamia and brain damage in her child

This post includes a summary of a paper published in the Journal of Pediatric Hematology/Oncology April 2004 - Volume 26 - Issue 4 - pp 270-271 and a recipe for easy skillet rosemary chicken.

Study title and authors:

Books:

Severe Vitamin B12 Deficiency in an Infant Associated With a Maternal Deficiency and a Strict Vegetarian Diet

Weiss, Rachel MD; Fogelman, Yacov MD; Bennett, Michael MBBS, FRCP, FRCPath

This paper can be accessed at: http://journals.lww.com/jpho-online/Abstract/2004/04000/Severe_Vitamin_B12_Deficiency_in_an_Infant.13.aspx
 
A 6-month-old infant had severe anemia and brain damage due to vitamin B12 deficiency. The cause of the vitamin deficiency was a maternal dietary deficiency because of a strict vegetarian diet.

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Recipe of the day

Easy Skillet Rosemary Chicken

Ingredients:

Food Mall: Chicken

2 pounds of skin on chicken pieces

2 tablespoons coconut oil
4 rosemary sprigs
1 yellow onion, sliced into rings and halved
5-6 garlic cloves, smashed flat and cut into small pieces
Juice from ½ a lemon
½ cup chicken broth
Sea salt and black pepper to taste

Instructions:
In a large skillet, heat the coconut oil over medium high heat. Make sure the oil is nice and hot!! Season both sides of the chicken pieces with the salt and pepper. Place the chicken into your hot pan skin side down and sear for five minutes or until the skin is golden brown. Using tongs, turn the chicken over and add on top of the chicken the garlic, onions, and rosemary sprigs. Squeeze in the lemon and pour in the chicken broth, cover and turn down to medium low heat. Cook for another 15-20 minutes or until the chicken is tender.

Easy Skillet Rosemary Chicken