RESUMEN
Plant-based diets are increasingly popular worldwide. A well-planned plant-based diet lowers the risk of cardiovascular disease, type 2 diabetes and certain cancers. In contrast, a poorly planned plant-based diet increases the risk of certain micronutrient deficiencies, chiefly, vitamin B12 (B12). Because B12 is not present in plants or in unfortified plant-based foodstuffs, the safest way to prevent its deficiency in plant-based diets is to take an oral B12 supplement. Studies determining the dose and frequency of B12 to be taken by healthy individuals on a plant-based diet to support an adequate B12 status are scarce. Here, we summarize the natural sources, metabolic requirements, biomarker findings with and without supplementation with B12, and current recommendations to help prevent vitamin B12 deficiency in healthy individuals adhering or transitioning to plant-based diets. This review focuses on the prevention of vitamin B12 deficiency in healthy individuals adhering to plant-based diets. The information covered in this review does not apply to individuals suffering from autoimmune-based malabsorption of vitamin B12 resulting from pernicious anemia due to atrophic gastritis, other acquired causes of B12 malabsorption or to those with genetic disorders that impair vitamin B12 absorption, transport and utilization.
Plain language titleVitamin B12 in Plant-Based DietsPlain language summaryPlant-based diets are increasingly popular worldwide. Because vitamin B12 is not found in plants, individuals must acquire the micronutrient by consuming fortified foods or by taking an oral vitamin B12 supplement. We review B12 sources, required daily intake, and use of B12 supplements among those on plant-based diets. The safest way to prevent B12 deficiency in individuals adhering to plant-based diets is by using an oral B12 supplement.
Asunto(s)
Dieta a Base de Plantas , Suplementos Dietéticos , Deficiencia de Vitamina B 12 , Vitamina B 12 , Humanos , Dieta a Base de Plantas/efectos adversos , Estado Nutricional , Vitamina B 12/administración & dosificación , Deficiencia de Vitamina B 12/etiología , Deficiencia de Vitamina B 12/prevención & controlRESUMEN
Vitamin B12 (also known as cobalamin) is an essential water-soluble vitamin that plays a pivotal role for several physiologic functions during one's lifespan. Only certain microorganisms are able to synthetize B12, thus humans obtain cobalamin exclusively from their diet, specifically from animal-derived foods. Specific sub-group populations are at risk of vitamin B12 subclinical deficiency due to different factors including poor intake of animal source foods and age-dependent decrease in the capacity of intestinal B12 uptake. Consumption of animal products produces some negative health issues and negatively impacts sustainability while a plant-based diet increases the risk of B12 deficiency. Taking a cue from the aforementioned considerations, this narrative review aims to summarize facts about B12 deficiency and the burden of inadequate dietary intake in elderly population, as well as to discuss sustainable approaches to vitamin B12 deficiency in aging population.
Asunto(s)
Dieta , Deficiencia de Vitamina B 12/prevención & control , Vitamina B 12 , Anciano , Animales , Bacterias , Biofortificación , Biomarcadores , Alimentos Fortificados , Humanos , Micronutrientes/deficiencia , Deficiencia de Vitamina B 12/epidemiologíaAsunto(s)
COVID-19/epidemiología , Enfermedades Carenciales/prevención & control , Suplementos Dietéticos , Medicina Basada en la Evidencia , Oligoelementos/uso terapéutico , Vitaminas/uso terapéutico , Deficiencia de Ácido Ascórbico/epidemiología , Deficiencia de Ácido Ascórbico/inmunología , Deficiencia de Ácido Ascórbico/prevención & control , Deficiencia de Ácido Ascórbico/terapia , COVID-19/inmunología , COVID-19/prevención & control , COVID-19/terapia , Enfermedades Carenciales/epidemiología , Enfermedades Carenciales/inmunología , Enfermedades Carenciales/terapia , Humanos , Deficiencia de Magnesio/epidemiología , Deficiencia de Magnesio/inmunología , Deficiencia de Magnesio/prevención & control , Deficiencia de Magnesio/terapia , Micronutrientes/uso terapéutico , Factores de Riesgo , SARS-CoV-2 , Suiza , Resultado del Tratamiento , Deficiencia de Vitamina B 12/epidemiología , Deficiencia de Vitamina B 12/inmunología , Deficiencia de Vitamina B 12/prevención & control , Deficiencia de Vitamina B 12/terapia , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/inmunología , Deficiencia de Vitamina D/prevención & control , Deficiencia de Vitamina D/terapia , Zinc/deficienciaRESUMEN
PURPOSE: Although bariatric surgery can facilitate weight loss and improve many diseases, it impairs the absorption of many vitamins and micronutrients. Vitamin B12 is important for these patients and should be controlled and supplemented postoperatively. The aim of this paper is to compare serum vitamin B12 levels in two forms of supplementation (oral vs. intramuscular) for 6 months after gastric bypass. METHODS: In a prospective controlled cohort study, people with obesity patients undergoing gastric bypass received vitamin B12 supplementation either orally or intramuscularly. The patients were followed for 6 months, receiving serial doses of vitamin B12 and methylmalonic acid assessment at 6 months. RESULTS: A total of 53 patients were divided into two homogeneous groups: an oral group (n=24) and an intramuscular group (n=29). Serum vitamin B12 was measured preoperatively and postoperatively at 1, 2, 3, and 6 months. Serum methylmalonic acid was measured at 6 months. At each point, the serum vitamin B12 level remained within reference values in both groups, although it was higher in the oral group (p<0.001). Methylmalonic acid also remained within reference values in both groups, with no significant differences. CONCLUSION: Despite the anatomical and functional alterations that impair vitamin B12 absorption after gastric bypass, oral vitamin B12 supplementation was as effective as intramuscular in this population.
Asunto(s)
Derivación Gástrica , Obesidad Mórbida , Deficiencia de Vitamina B 12 , Vitamina B 12/uso terapéutico , Suplementos Dietéticos , Humanos , Obesidad Mórbida/cirugía , Estudios Prospectivos , Deficiencia de Vitamina B 12/prevención & controlRESUMEN
BACKGROUND: Patients with morbid obesity have a high risk of deficits in micronutrients, after bariatric surgery. The reasons why systematic use of multivitamin and trace element supplements cannot prevent all deficits are complex and should deserve more attention. Little is known about the influence of micronutrient deficits at surgery. AIM: This present study aimed to explore the deficit in vitamin B12 vs other micronutrients during the follow-up of a French cohort of cases with bariatric surgery under systematic multivitamin/trace elements supplementation and to determine whether it was influenced by clinical, metabolic characteristics at surgery. METHODS: We prospectively enrolled obese patients with bariatric surgery (laparoscopic gastric bypass or laparoscopic sleeve gastrectomy) between 2013 and 2018 (OBESEPI/ALDEPI Cohort, NCT02663388). They received a daily multivitamin/micronutrients supplement. Follow-up data at 4 visits, 2, 12, 18 and 24 months after surgery, were collected. RESULTS: The highest rate of deficits was observed at visit 1 for vitamin D (35.7%), iron (21.9%) and folate (10.2%). Except B12, the deficits of all micronutrients decreased in later visits. In contrast, cases with vitamin B12 deficit decreased from 13.5% at surgery to 2.0% at visit 1, and increased in later visits, with a maximum of 12.0% at visit 3. Vitamin B12 concentration at surgery was the single predictor of B12 deficit at visit 3. It was also associated with age, and APRI score, an index of nonalcoholic fatty liver disease (NAFLD), in multivariate analysis. CONCLUSIONS: The failure of systematic supplementation with multivitamin/trace elements tablets to prevent specific deficits illustrates the need for adapted specific supplementations, in some cases. The worsening of B12 deficit rate in the 18-24 months follow-up depends in part to low B12 at time of surgery. A special consideration should be devoted to this subset of patients. The cohort study was registered at clinicaltrials.gov as NCT02663388.
Asunto(s)
Cirugía Bariátrica/efectos adversos , Obesidad Mórbida/sangre , Complicaciones Posoperatorias/etiología , Deficiencia de Vitamina B 12/etiología , Vitamina B 12/sangre , Adulto , Cirugía Bariátrica/métodos , Suplementos Dietéticos , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Micronutrientes/sangre , Micronutrientes/deficiencia , Persona de Mediana Edad , Estado Nutricional , Obesidad Mórbida/complicaciones , Obesidad Mórbida/cirugía , Complicaciones Posoperatorias/prevención & control , Periodo Posoperatorio , Valor Predictivo de las Pruebas , Periodo Preoperatorio , Estudios Prospectivos , Factores de Riesgo , Deficiencia de Vitamina B 12/prevención & controlRESUMEN
BACKGROUND: Vitamin B12 deficiency is common and affects cell division and differentiation, erythropoiesis, and the central nervous system. Several observational studies have demonstrated associations between biomarkers of vitamin B12 status with growth, neurodevelopment, and anemia. The objective of this study was to measure the effects of daily supplementation of vitamin B12 for 1 year on neurodevelopment, growth, and hemoglobin concentration in infants at risk of deficiency. METHODS AND FINDINGS: This is a community-based, individually randomized, double-blind placebo-controlled trial conducted in low- to middle-income neighborhoods in Bhaktapur, Nepal. We enrolled 600 marginally stunted, 6- to 11-month-old infants between April 2015 and February 2017. Children were randomized in a 1:1 ratio to 2 µg of vitamin B12, corresponding to approximately 2 to 3 recommended daily allowances (RDAs) or a placebo daily for 12 months. Both groups were also given 15 other vitamins and minerals at around 1 RDA. The primary outcomes were neurodevelopment measured by the Bayley Scales of Infant and Toddler Development 3rd ed. (Bayley-III), attained growth, and hemoglobin concentration. Secondary outcomes included the metabolic response measured by plasma total homocysteine (tHcy) and methylmalonic acid (MMA). A total of 16 children (2.7%) in the vitamin B12 group and 10 children (1.7%) in the placebo group were lost to follow-up. Of note, 94% of the scheduled daily doses of vitamin B12 or placebo were reported to have been consumed (in part or completely). In this study, we observed that there were no effects of the intervention on the Bayley-III scores, growth, or hemoglobin concentration. Children in both groups grew on an average 12.5 cm (SD: 1.8), and the mean difference was 0.20 cm (95% confidence interval (CI): -0.23 to 0.63, P = 0.354). Furthermore, at the end of the study, the mean difference in hemoglobin concentration was 0.02 g/dL (95% CI: -1.33 to 1.37, P = 0.978), and the difference in the cognitive scaled scores was 0.16 (95% CI: -0.54 to 0.87, P = 0.648). The tHcy and MMA concentrations were 23% (95% CI: 17 to 30, P < 0.001) and 30% (95% CI: 15 to 46, P < 0.001) higher in the placebo group than in the vitamin B12 group, respectively. We observed 43 adverse events in 36 children, and these events were not associated with the intervention. In addition, 20 in the vitamin B12 group and 16 in the placebo group were hospitalized during the supplementation period. Important limitations of the study are that the strict inclusion criteria could limit the external validity and that the period of vitamin B12 supplementation might not have covered a critical window for infant growth or brain development. CONCLUSIONS: In this study, we observed that vitamin B12 supplementation in young children at risk of vitamin B12 deficiency resulted in an improved metabolic response but did not affect neurodevelopment, growth, or hemoglobin concentration. Our results do not support widespread vitamin B12 supplementation in marginalized infants from low-income countries. TRIAL REGISTRATION: ClinicalTrials.gov NCT02272842 Universal Trial Number: U1111-1161-5187 (September 8, 2014) Trial Protocol: Original trial protocol: PMID: 28431557 (reference [18]; study protocols and plan of analysis included as Supporting information).
Asunto(s)
Desarrollo Infantil , Suplementos Dietéticos , Sistema Nervioso/efectos de los fármacos , Deficiencia de Vitamina B 12/prevención & control , Vitamina B 12/administración & dosificación , Factores de Edad , Biomarcadores/sangre , Suplementos Dietéticos/efectos adversos , Método Doble Ciego , Femenino , Hemoglobinas/metabolismo , Humanos , Lactante , Masculino , Nepal , Sistema Nervioso/crecimiento & desarrollo , Ingesta Diaria Recomendada , Factores de Tiempo , Resultado del Tratamiento , Vitamina B 12/efectos adversos , Deficiencia de Vitamina B 12/diagnóstico , Deficiencia de Vitamina B 12/fisiopatologíaRESUMEN
INTRODUCCIÓN: Se ha observado un aumento en la popularidad de las dietas vegetarianas, en especial en la población adolescente y adulto joven. Estas dietas se presentan como saludables y balanceadas pero las recomendaciones son controversiales en cuanto a los potenciales déficit nutricionales. OBJETIVO: Identificar la frecuencia y tipos de dieta vegetariana utilizada, su motivación y fuentes de información. PACIENTES Y MÉTODO: Estudio transversal y analítico en universitarios de primer año de la Pontificia Universidad Católica de Chile (PUC). Se realizó una encuesta vía online obteniendo información demográfica y caracterización de dietas de aquellos que se consideraban vegetarianos. Las variables fueron analizadas mediante el software IDM SPSS Statistics® y en planilla Excel® de forma cuantitativa. RESULTADOS: 152 alumnos respondieron la encuesta (15,2% del total), siendo el 49,4% de estos vegetariano. El 32,4% inició este patrón alimentario entre los 12-18 años; sus motivaciones más frecuentes fueron las medio ambientalistas (91,9%) y animalistas (72,9%). El 52,9% de los vegetarianos reciben suplementación de vitamina b 12 pero solo un 15,9% reportó presentar este déficit. El 75,7% obtiene información relacionada acerca de las dietas vegetarianas a través de medios digitales. CONCLUSIÓN: Se encontró un alto porcentaje de estudiantes vegetarianos en las encuestas contestadas, lo que hace necesario que los profesionales de salud estén capacitados en esta área para asegurar una adecuada educación nutricional, suplementación si es necesario, y seguimiento.
INTRODUCTION: There has been an increase in the popularity of vegetarian diets, especially among adolescents and young adults. These diets seem to be healthy and balanced, but the recommendations are contro versial regarding potential nutritional deficits. OBJECTIVE: To identify the frequency and types of ve getarian diet used, their motivation, and sources of information. PATIENTS AND METHOD: Cross-sec tional analytical study in freshmen students from the Pontifical Catholic University of Chile (PUC). Through an online survey, we collected demographic information and diet characterization of those who considered themselves as vegetarians. Variables were analyzed using IDM SPSS Statistics® soft ware and in Excel® spreadsheet in a quantitative way. RESULTS: 152 students answered the survey (15.2% of the sample) and, out of these, 49.4% were vegetarian. 32.4% started this eating pattern bet ween the ages 12 and 18 and among their most frequent motivations were environmentalists (91.9%) and animalists (72.9%). 52.9% of vegetarians take vitamin B 12 supplementation but only 15.9% reported having this deficiency. 75.7% obtain information related to vegetarian diets through digital media. CONCLUSION: In the surveys answered, we found a high percentage of vegetarian students, the refore, health professionals need to be trained in this area to assure adequate nutritional education, supplementation if necessary, and follow-up.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Dieta Vegetariana/psicología , Dieta Vegetariana/estadística & datos numéricos , Conductas Relacionadas con la Salud , Estudiantes/psicología , Universidades , Dieta Vegetariana/efectos adversos , Dieta Vegetariana/métodos , Vitamina B 12/uso terapéutico , Complejo Vitamínico B/uso terapéutico , Deficiencia de Vitamina B 12/etiología , Deficiencia de Vitamina B 12/prevención & control , Chile , Encuestas sobre Dietas , Conocimientos, Actitudes y Práctica en Salud , Estudios Transversales Seriados , Suplementos Dietéticos , MotivaciónRESUMEN
Vitamins B9 (folate) and B12 are essential water-soluble vitamins that play a crucial role in the maintenance of one-carbon metabolism: a set of interconnected biochemical pathways driven by folate and methionine to generate methyl groups for use in DNA synthesis, amino acid homeostasis, antioxidant generation, and epigenetic regulation. Dietary deficiencies in B9 and B12, or genetic polymorphisms that influence the activity of enzymes involved in the folate or methionine cycles, are known to cause developmental defects, impair cognitive function, or block normal blood production. Nutritional deficiencies have historically been treated with dietary supplementation or high-dose parenteral administration that can reverse symptoms in the majority of cases. Elevated levels of these vitamins have more recently been shown to correlate with immune dysfunction, cancer, and increased mortality. Therapies that specifically target one-carbon metabolism are therefore currently being explored for the treatment of immune disorders and cancer. In this review, we will highlight recent studies aimed at elucidating the role of folate, B12, and methionine in one-carbon metabolism during normal cellular processes and in the context of disease progression.
Asunto(s)
Deficiencia de Ácido Fólico/prevención & control , Ácido Fólico/farmacología , Transferasas del Grupo 1-Carbono/metabolismo , Deficiencia de Vitamina B 12/prevención & control , Vitamina B 12/farmacología , Deficiencia de Ácido Fólico/genética , Humanos , Polimorfismo Genético , Deficiencia de Vitamina B 12/genéticaRESUMEN
INTRODUCTION: There has been an increase in the popularity of vegetarian diets, especially among adolescents and young adults. These diets seem to be healthy and balanced, but the recommendations are contro versial regarding potential nutritional deficits. OBJECTIVE: To identify the frequency and types of ve getarian diet used, their motivation, and sources of information. PATIENTS AND METHOD: Cross-sec tional analytical study in freshmen students from the Pontifical Catholic University of Chile (PUC). Through an online survey, we collected demographic information and diet characterization of those who considered themselves as vegetarians. Variables were analyzed using IDM SPSS Statistics® soft ware and in Excel® spreadsheet in a quantitative way. RESULTS: 152 students answered the survey (15.2% of the sample) and, out of these, 49.4% were vegetarian. 32.4% started this eating pattern bet ween the ages 12 and 18 and among their most frequent motivations were environmentalists (91.9%) and animalists (72.9%). 52.9% of vegetarians take vitamin B 12 supplementation but only 15.9% reported having this deficiency. 75.7% obtain information related to vegetarian diets through digital media. CONCLUSION: In the surveys answered, we found a high percentage of vegetarian students, the refore, health professionals need to be trained in this area to assure adequate nutritional education, supplementation if necessary, and follow-up.
Asunto(s)
Dieta Vegetariana/psicología , Dieta Vegetariana/estadística & datos numéricos , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Motivación , Estudiantes/psicología , Adolescente , Chile , Estudios Transversales , Encuestas sobre Dietas , Dieta Vegetariana/efectos adversos , Dieta Vegetariana/métodos , Suplementos Dietéticos , Femenino , Humanos , Masculino , Universidades , Vitamina B 12/uso terapéutico , Deficiencia de Vitamina B 12/etiología , Deficiencia de Vitamina B 12/prevención & control , Complejo Vitamínico B/uso terapéutico , Adulto JovenRESUMEN
BACKGROUND: In theory, proximal gastrectomy with double-tract reconstruction (PG-DT) was superior to total gastrectomy (TG) in hematologic and nutritional outcomes. However, its clinical effects in proximal early gastric cancer (EGC) have been controversial. METHODS: The purpose of this study was to investigate the outcomes of laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DT) for proximal EGC. For this systematic review and meta-analysis, we searched for articles published before December of 2018 in the following databases: PubMed, Web of Science, EBSCO, Medline, and Cochrane Library. RESULTS: The results showed no significant difference in the anastomotic stenosis (OR = 0.91, 95%CI = 0.33-2.50, p = 0.85) and reflux esophagitis (OR = 1.87, 95%CI = 0.62-5.65, p = 0.27) between LPG-DT and laparoscopic total gastrectomy (LTG). The vitamin B12 supplementation rate in the LPG-DT group was lower than the LTG group (OR = 0.06, 95%Cl = 0.01-0.59, p = 0.02). CONCLUSIONS: Due to comparable clinical effect, PG-DT is comparable to TG for patients with proximal EGC. In addition, LPG-DT not only appears superior to TG in terms of preventing vitamin B12 deficiency, but also does not increase the risk of anastomotic stricture and reflux esophagitis.
Asunto(s)
Gastrectomía/métodos , Laparoscopía/métodos , Neoplasias Gástricas/cirugía , Anastomosis Quirúrgica/efectos adversos , Constricción Patológica/etiología , Esofagitis Péptica/etiología , Gastrectomía/efectos adversos , Humanos , Laparoscopía/efectos adversos , Estudios Retrospectivos , Neoplasias Gástricas/patología , Resultado del Tratamiento , Deficiencia de Vitamina B 12/prevención & controlRESUMEN
Metformin (MET) is currently being used in several trials for cancer prevention or treatment in non-diabetics. However, long-term MET use in diabetics is associated with lower serum levels of total vitamin B12. In a pilot randomized controlled trial of the Mediterranean diet (MedDiet) and MET, whose participants were characterized by different components of metabolic syndrome, we tested the effect of MET on serum levels of B12, holo transcobalamin II (holo-TC-II), and methylmalonic acid (MMA). The study was conducted on 165 women receiving MET or placebo for three years. Results of the study indicate a significant overall reduction in both serum total B12 and holo-TC-II levels according with MET-treatment. In particular, in the MET group 26 of 81 patients and 10 of the 84 placebo-treated subjects had B12 below the normal threshold (<221 pmol/L) at the end of the study. Considering jointly all B12, Holo-TC-II, and MMA, 13 of the 165 subjects (10 MET and 3 placebo-treated) had at least two deficits in the biochemical parameters at the end of the study, without reporting clinical signs. Although our results do not affect whether women remain in the trial, B12 monitoring for MET-treated individuals should be implemented.
Asunto(s)
Neoplasias de la Mama/prevención & control , Metformina/uso terapéutico , Deficiencia de Vitamina B 12/inducido químicamente , Vitamina B 12/sangre , Anciano , Dieta Mediterránea , Femenino , Humanos , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/uso terapéutico , Metformina/administración & dosificación , Ácido Metilmalónico/sangre , Ácido Metilmalónico/metabolismo , Persona de Mediana Edad , Proyectos Piloto , Factores de Riesgo , Transcobalaminas/metabolismo , Deficiencia de Vitamina B 12/prevención & controlRESUMEN
INTRODUCTION: Introduction: interest in vegetarian diets is rising, however, it remains a very controversial topic, and with many reservations regarding it. Questions like their conceivable nutritional deficiencies, or if they are adequate or healthy, might be widely unknown. Objectives: exploring vegetarian diets, examining the current level of knowledge about them, and analyzing and improving, from a nutritional standpoint, the vegetarian menus of a restaurant with vegetarian options. Methods: this study was designed as an exploratory, crossover, descriptive study. Surveys with 17 items and a food frequency questionnaire were given among the customers of the restaurant. A total of 155 people, aged between 18 and 62, took part in it. A total of 30 menus were analyzed, and some suggestions were made in order to improve them. Results: out of the total sample, 138 people were omnivores, 12 people were vegetarians and two were vegans. More than half of the vegetarians did not know vitamin B12 is the only required supplement by default, and almost 60% of them stated never taking B12 supplements. The vegetarian menus which were analyzed provided a mean of 1,195 kcal, and covered 89% of the requirements of fiber, 212% of vitamin C, ≈30% of both calcium and zinc, 86% of iron, and 38% of B12. Conclusion: a great lack of knowledge regarding several aspects of vegetarian diets was found, even among vegetarian themselves. Informing the general public is essential for both avoiding dangerous nutritional deficiencies (like B12), and attracting more people towards this kind of diets, with all the benefits this would provide. In the vegetarian menus of Foodtopía, adequate levels of nutrients were observed. The main suggestions to improve the menus were: reducing the total calories and the amount of sunflower oil, and increasing the amount of legumes, nuts and seeds.
INTRODUCCIÓN: Introducción: el interés por las dietas vegetarianas está en auge, pero siguen existiendo muchas dudas y controversia al respecto. Temas como sus posibles deficiencias nutricionales, o si son adecuadas o saludables, podrían no ser ampliamente conocidos. Objetivos: explorar estas dietas, ver el nivel de conocimiento que existe sobre ellas y analizar y mejorar nutricionalmente los menús vegetarianos de un restaurante con opciones vegetarianas. Métodos: el diseño del estudio fue de tipo descriptivo, transversal y exploratorio. Se entregaron cuestionarios con 17 preguntas y un cuestionario de frecuencia de consumo de alimentos entre los clientes del restaurante. Participaron un total de 155 personas, con un rango de edad de 18-62 años. Se analizaron un total de 30 menús y se hicieron sugerencias para mejorarlos. Resultados: de la muestra total, 138 personas eran omnívoras, 12 eran vegetarianas y dos, veganas. Más de la mitad de los vegetarianos no sabían que la única suplementación necesaria por defecto es la B12 y el ≈60% de ellos dijo no suplementarse nunca con ella. Los menús vegetarianos analizados aportaban de media 1.195 kcal y cubrían el 89% de la ingesta recomendada de fibra, el 212% de vitamina C, ≈30% de calcio y zinc, el 86% de hierro y el 38% de B12. Se observaron niveles insuficientes de vitamina D. Conclusiones: existe un gran desconocimiento sobre muchos aspectos de las dietas vegetarianas, incluso entre los propios vegetarianos. Informar al público es primordial, tanto para evitar deficiencias nutricionales potencialmente peligrosas (B12), como para atraer a más personas hacia este tipo de dietas, con los beneficios que esto acarrearía. Se observaron niveles muy adecuados de nutrientes en los menús vegetarianos de Foodtopía. Las principales sugerencias de mejora fueron: reducir las calorías totales y la cantidad de aceite de girasol y aumentar la cantidad de legumbres, frutos secos y semillas.
Asunto(s)
Dieta Vegetariana , Restaurantes/estadística & datos numéricos , Adolescente , Adulto , Estudios Cruzados , Dieta Vegana , Conducta Alimentaria , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Necesidades Nutricionales , Encuestas y Cuestionarios , Vitamina B 12 , Deficiencia de Vitamina B 12/prevención & control , Vitaminas , Adulto JovenRESUMEN
INTRODUCTION: Vitamin B12 deficiency is highly prevalent in pregnant Indian women. Neuropsychological tests have shown an association between low maternal vitamin B12 status and poorer cognitive performances in the offspring, although findings from these studies have been inconsistent. Vitamin B12 has an important role in the formation of myelin which is important for the transmission speed of neural impulses and myelination in the central nervous system has been linked to cognition. Assessing neurophysiological measures using event-related potentials (ERPs) in children may provide additional information on the effect of maternal vitamin B12 supplementation on offspring brain function. The study examines the effects of oral vitamin B12 daily supplements (50 µg) to pregnant Indian women on child neurophysiological function at 72 months. METHODS AND ANALYSIS: We previously conducted a double-blind, placebo-controlled study to examine the effects of maternal vitamin B12 supplementation on cognitive outcomes in their offspring using the Bayley scales of infant development, third edition. In this extended follow-up of the same cohort of mother-child dyad, we propose to use ERP to study the long-term impact of maternal B12 supplementation on brain function in children at 72 months of age. We intend to use P300 and mismatch negativity (MMN) as measures of neurophysiological outcomes. The primary outcome of this study will be child neurophysiological measures (as measured by amplitude and latency of P300 and MMN) assessed at 72 months of age in children whose mothers received vitamin B12 compared with neurophysiological status of children whose mothers received placebo. ETHICS AND DISSEMINATION: The study was approved by the Institutional Ethical Board of St. John's Medical College and the Harvard School of Public Health Human Subjects Committee. Results obtained will be presented at national and international research meetings and published in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER: NCT00641862.
Asunto(s)
Potenciales Relacionados con Evento P300/fisiología , Efectos Tardíos de la Exposición Prenatal/fisiopatología , Deficiencia de Vitamina B 12/tratamiento farmacológico , Vitamina B 12/uso terapéutico , Complejo Vitamínico B/uso terapéutico , Niño , Preescolar , Potenciales Evocados/fisiología , Femenino , Estudios de Seguimiento , Humanos , India/epidemiología , Lactante , Recién Nacido , Masculino , Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Efectos Tardíos de la Exposición Prenatal/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Deficiencia de Vitamina B 12/epidemiología , Deficiencia de Vitamina B 12/prevención & controlRESUMEN
BACKGROUND: Elderly people are at risk for vitamin B12 deficiency. AIMS: We studied the ability of vitamin B12-enriched toothpaste vs. placebo to increase vitamin B12 status in elderly subjects. METHODS: We conducted a randomized double-blind placebo-controlled intervention in 103 elderly subjects. Serum concentrations of vitamin B12, holotranscobalamin (holoTC), methylmalonic acid (MMA), and plasma total homocysteine (tHcy) were measured at baseline and after 3 months. RESULTS: 92 subjects met the inclusion criteria, completed the 3 months study, and were included in the data analysis. After the intervention, concentrations of vitamin B12 were higher [mean (SD) = 368 (123) vs. 295 (123) pmol/L; p = 0.005] and holoTC tended to be higher [112 (48) vs. 91 (68) pmol/L; p = 0.088] in the vitamin B12 group compared with the placebo group. The changes of serum vitamin B12 [54 (74) vs. 3 (60) pmol/L, p < 0.001], holoTC [21 (34) vs. 2 (32) pmol/L, p = 0.007], and tHcy [- 0.9 (2.3) vs. 0.3 (1.9) µmol/L, p = 0.010] were significantly different between the intervention groups. Mean percentage increase of serum vitamin B12 (+ 23% corresponds to + 54 pmol/L) in the vitamin B12 toothpaste group suggests that the intervention had provided an additional daily intake of approximately + 7 µg oral B12. Common diseases and drugs did not predict the change of blood markers in the vitamin group. No side effects were observed. CONCLUSIONS: The toothpaste enriched with 100 µg cyanocobalamin/g has increased vitamin B12 status and can thus be used for preventing vitamin B12 depletion in elderly people. The trial was registered at ClinicalTrials.gov: NCT02679833.
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Pastas de Dientes/administración & dosificación , Deficiencia de Vitamina B 12/prevención & control , Vitamina B 12/administración & dosificación , Complejo Vitamínico B/administración & dosificación , Anciano , Biomarcadores/sangre , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vitamina B 12/farmacología , Deficiencia de Vitamina B 12/sangre , Complejo Vitamínico B/farmacologíaRESUMEN
SCOPE: The nutrition societies of Germany, Austria, and Switzerland are the joint editors of the "D-A-CH reference values for nutrient intake", which are revised regularly. METHODS AND RESULTS: By reviewing vitamin-B12 -related biomarker studies, the reference values for vitamin B12 were revised in 2018. For adults, the estimated intake is based on the adequate serum concentrations of holotranscobalamin and methylmalonic acid. The estimated values for children and adolescents are extrapolated from the adult reference value by considering differences in body mass, an allometric exponent, and growth factors. For infants below 4 months of age, an estimated value is set based on the vitamin B12 intake via breast milk. The reference values for pregnant and lactating women consider the requirements for the fetus and for loss via breast milk. The estimated values for vitamin B12 intake for infants, children, and adolescents range from 0.5 to 4.0 µg d-1 . For adults, the estimated values are set at 4.0 µg d-1 , and for pregnant and lactating women, they are set at 4.5 and 5.5 µg d-1 , respectively. CONCLUSION: Based on the data of several vitamin B12 status biomarkers studies, the reference value for vitamin B12 intake for adults is raised from 3.0 to 4.0 µg d-1 .
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Deficiencia de Vitamina B 12/prevención & control , Vitamina B 12/sangre , Vitamina B 12/farmacocinética , Adolescente , Adulto , Disponibilidad Biológica , Niño , Preescolar , Femenino , Homocisteína/sangre , Humanos , Lactante , Masculino , Embarazo , Valores de Referencia , Deficiencia de Vitamina B 12/sangre , Adulto JovenRESUMEN
Older adults have potential increased risk of nutrient deficiencies because of age-related decreased dietary intake and malabsorption; it is important to ensure nutrient needs are met to avoid adverse health outcomes. B vitamins are of particular interest: vitamin B12 deficiency can cause irreversible neurodegeneration; there is mandatory folic acid fortification in Canada; and suboptimal riboflavin status has been reported among older adults in the United Kingdom. In this exploratory secondary analysis study we assessed vitamin B12 and riboflavin biochemical status (via microparticle enzyme immunoassay and erythrocyte glutathione reductase activity coefficient (EGRac), respectively), and the vitamin B12, riboflavin, and folate content of menus served to a convenience sample of older adults (≥65 years) from 5 residential care facilities within the Lower Mainland of British Columbia, Canada. Diet was assessed from customized 28-day cycle meal plans. Participants (n = 207; 53 men and 154 women) were aged 86 ± 7 years, largely of European descent (92%), and nonsmokers (95%). The menus served had a low prevalence of inadequacy for vitamin B12 and riboflavin (only 4% and 1% of menus contained less than the estimated average requirement (EAR), respectively), but 93% contained less than the EAR for folate. Mean ± SD serum total vitamin B12 concentration was 422 ± 209 pmol/L, and EGRac was 1.30 ± 0.19. The majority of older adults in residential care were provided with adequate vitamin B12 and riboflavin menu amounts, and only 5% were vitamin B12 deficient (<148 pmol/L). However, 26% were riboflavin deficient (EGRac ≥ 1.4), which may warrant further investigation.
Asunto(s)
Hogares para Ancianos , Comidas , Planificación de Menú , Valor Nutritivo , Ingesta Diaria Recomendada , Deficiencia de Riboflavina/prevención & control , Riboflavina/administración & dosificación , Deficiencia de Vitamina B 12/prevención & control , Vitamina B 12/administración & dosificación , Anciano , Anciano de 80 o más Años , Colombia Británica , Estudios Transversales , Femenino , Ácido Fólico/administración & dosificación , Humanos , Masculino , Estado Nutricional , Riboflavina/sangre , Deficiencia de Riboflavina/sangre , Deficiencia de Riboflavina/diagnóstico , Deficiencia de Riboflavina/fisiopatología , Vitamina B 12/sangre , Deficiencia de Vitamina B 12/sangre , Deficiencia de Vitamina B 12/diagnóstico , Deficiencia de Vitamina B 12/fisiopatologíaRESUMEN
BACKGROUND: Pemetrexed is a folate analog inhibitor for the treatment of non-small-cell lung cancer (NSCLC) and malignant pleural mesothelioma. Folic acid and vitamin B12 supplementation before initiating pemetrexed is necessary because of high rates of cytopenias without supplementation. However, the timing of supplementation has not been thoroughly investigated. PATIENTS AND METHODS: This was a single-center, retrospective study investigating patients receiving pemetrexed from January 1, 2012, to June 30, 2015, who received same-day vitamin B12 supplementation versus ≥ 1 day before pemetrexed. The objective was to evaluate safety outcomes in patients who received vitamin B12 on the same day as pemetrexed (group A) versus vitamin B12 ≥ 1 day (group B) before pemetrexed. RESULTS: Two hundred eighty-one patients met the inclusion criteria: 137 patients in group A (same-day administration of vitamin B12) and 144 patients in group B (median time of vitamin B12 administration before pemetrexed, 7 days; range, 1-42 days). Mean changes in hematologic indices from cycle (C) 1 to C2 or C2 to C3 did not differ significantly between groups. There were no significant differences in clinical events between C1 and C2 or C2 and C3 requiring supportive care. There was a significant difference noted in treatment delay in C3 [28/114 (24.6%) group A vs. 14/118 (11.9%) group B, P = .0164]. In group A, significant predictors of delay in C3 were baseline hemoglobin (mean 13.3 g/dL vs. 12.4 g/dL, P = .0137) and ANC (mean 6 × 109/L vs. 5 × 109/L, P = .0003). CONCLUSION: Same-day vitamin B12 and pemetrexed administration is a safe practice in NSCLC and malignant pleural mesothelioma patients.
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Antineoplásicos/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/prevención & control , Antagonistas del Ácido Fólico/uso terapéutico , Neoplasias Pulmonares/tratamiento farmacológico , Mesotelioma/tratamiento farmacológico , Pemetrexed/uso terapéutico , Neoplasias Pleurales/tratamiento farmacológico , Deficiencia de Vitamina B 12/prevención & control , Vitamina B 12/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/efectos adversos , Femenino , Antagonistas del Ácido Fólico/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Pemetrexed/efectos adversos , Estudios Retrospectivos , Deficiencia de Vitamina B 12/etiologíaRESUMEN
OBJECTIVES: Patients are at risk of anemia post Roux-en-Y gastric bypass (RYGB). We sought to determine the prevalence of anemia and related nutritional deficiencies 5 years after RYGB and to evaluate adherence to nutritional supplements with iron, vitamin B12, and folate. MATERIAL AND METHODS: Patients operated with RYGB 2004-2006 were eligible for evaluation. Blood samples were collected and use of nutritional supplements was recorded preoperatively, and at outpatients' consultations 1, 2, and 5 years postoperatively. Of 203 patients operated, 184 (91%) completed the 5 year follow-up and were included in the study. Of these, 97% had valid measurements of hemoglobin both at baseline and after 5 years. RESULTS: During the 5 years after RYGB, the prevalence of anemia increased from 4% preoperatively to 24% in females, and from 0% to 7% in males. Ferritin levels decreased gradually in both genders. Iron deficiency increased from 6% preoperatively to 42% at 5 years in females, and from 0% to 9% in males. Vitamin B12 deficiency was not altered while folate deficiency decreased from 10% preoperatively to 1% at 5 years. Five years after surgery 25% reported the use of supplements with iron, while 83% used vitamin B12 and 65% used multivitamins with folate. CONCLUSIONS: We observed a long-term increase in anemia and iron deficiency after RYGB in both genders, but most pronounced in women. Our postoperative protocol for prevention of vitamin B12 and folate deficiencies appear acceptable. Iron status and iron supplementation seems to need stronger emphasis during follow-up after RYGB.
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Anemia Ferropénica/epidemiología , Deficiencia de Ácido Fólico/epidemiología , Derivación Gástrica/efectos adversos , Obesidad Mórbida/cirugía , Deficiencia de Vitamina B 12/epidemiología , Adulto , Anemia Ferropénica/etiología , Anemia Ferropénica/prevención & control , Suplementos Dietéticos , Femenino , Ácido Fólico/sangre , Deficiencia de Ácido Fólico/etiología , Deficiencia de Ácido Fólico/prevención & control , Estudios de Seguimiento , Humanos , Hierro/sangre , Modelos Lineales , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Noruega/epidemiología , Periodo Posoperatorio , Distribución por Sexo , Vitamina B 12/sangre , Deficiencia de Vitamina B 12/etiología , Deficiencia de Vitamina B 12/prevención & controlRESUMEN
Vitamin B12 deficiency is an urgent public health problem that disproportionately affects individuals in low- and middle-income settings, where the burden of neglected tropical diseases (NTDs) is also unacceptably high. Emerging evidence supports a potential role of micronutrients in modulating the risk and severity of NTDs. However, the role of vitamin B12 in NTD pathogenesis is unknown. This systematic review was conducted to evaluate the evidence on the role of vitamin B12 in the etiology of NTDs. Ten studies were included in this review: one study using an in vitro/animal model, eight observational human studies and one ancillary analysis conducted within an intervention trial. Most research to date has focused on vitamin B12 status and helminthic infections. One study examined the effects of vitamin B12 interventions in NTDs in animal and in vitro models. Few prospective studies have been conducted to date to examine the role of vitamin B12 in NTDs. The limited literature in this area constrains our ability to make specific recommendations. Larger prospective human studies are needed to elucidate the role of vitamin B12 in NTD risk and severity in order to inform interventions in at-risk populations.
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Helmintiasis/prevención & control , Enfermedades Desatendidas/prevención & control , Medicina Tropical , Deficiencia de Vitamina B 12/complicaciones , Animales , Helmintiasis/complicaciones , Helmintiasis/epidemiología , Humanos , Enfermedades Desatendidas/complicaciones , Enfermedades Desatendidas/epidemiología , Estudios Observacionales como Asunto , Factores de Riesgo , Deficiencia de Vitamina B 12/epidemiología , Deficiencia de Vitamina B 12/prevención & controlRESUMEN
Background: After Roux-en-Y gastric bypass (RYGB), patients often develop a vitamin B-12 deficiency. Objective: Our objective was to investigate whether oral supplementation increases and normalizes low vitamin B-12 concentrations (vitamin B-12 > 200 pmol/L) in RYGB patients as compared to intramuscular injections. Design: A randomized controlled trial in RYGB patients with subnormal serum B-12 concentrations was performed. One group (IM B-12) received bimonthly intramuscular hydroxocobalamin injections (2000 µg as loading dose and 1000 µg at follow-up) for 6 mo. The second group (oral B-12) received daily doses of oral methylcobalamin (1000 µg). Serum vitamin B-12 was determined at baseline (T0) and at 2 (T1), 4 (T2), and 6 mo (T3) after start of treatment. Concentrations of the secondary markers methylmalonic acid (MMA) and homocysteine (Hcy) were measured at T0 and T3. Results: Fifty patients were included and randomized, 27 in IM B-12 and 23 in oral B-12. The median vitamin B-12 concentration at T0 was 175 pmol/L (range: 114-196 pmol/L) for IM B-12 and 167 pmol/L (range: 129-199 pmol/L) for oral B-12. Vitamin B-12 normalized in all individuals, and there was no significant difference in vitamin B-12 between the two groups. MMA and Hcy concentrations decreased significantly after 6 mo within each group (P < 0.001 and P < 0.001 for MMA and P = 0.03 and P = 0.045 for Hcy, respectively). There was no significant difference between the groups at 6 mo for both MMA and Hcy (P = 0.53 and P = 0.79). Conclusion: The efficacy of oral vitamin B-12 supplementation was similar to that of hydroxocobalamin injections in the present study. Oral supplementation can be used as an alternative to hydroxocobalamin injections to treat RYGB patients with low values of serum vitamin B-12. This trial was registered at clinicaltrials.gov as NCT02270749.