Cross-Sectional Study of the Prevalence of Cobalamin Deficiency and Vitamin B12 Supplementation Habits among Vegetarian and Vegan Children in the Czech Republic

Abstract

Vegetarian (VG) and vegan (VN) diets in childhood are of growing interest due to their perceived health and environmental benefits. Concerns remain due to the possible disruption of healthy growth and development of children because of the scarcity of evidence-based studies. Among the nutrients of special concern is vitamin B12. Therefore, the Czech Vegan Children Study (CAROTS) decided to examine the relationship between B12 metabolism parameters and B12 intake through diet and supplementation. We analyzed laboratory parameters within n = 79 VG, n = 69 VN, and n = 52 omnivores (OM) children (0–18 years old). There were no significant differences in levels of holotranscobalamin (aB12), folate, homocysteine (hcys), or mean corpuscular volume. However, there was a significant difference in levels of cyanocobalamin (B12) (p = 0.018), even though we identified only n = 1 VG and n = 2 VN children as B12 deficient. On the other hand, we identified n = 35 VG, n = 28 VN, and n = 9 OM children with vitamin B12 hypervitaminosis (p = 0.004). This finding was related to a high prevalence of over-supplementation in the group (mean dose for VG 178.19 ± 238.5 µg per day; VN 278.35 ± 394.63 µg per day). Additionally, we found a significant (p < 0.05) difference between B12, aB12, and hcys levels of supplemented vs. non-supplemented VG/VN children. This can show that the intake of vitamin B12 via diet in the VG group might not be sufficient. Secondly, we analyzed a relation between supplement use in pregnancy and breastfeeding and its impact on vitamin B12 levels of children aged 0–3 years. Out of n = 46 mothers, only n = 3 (e.g., 6.5%) were not supplemented at all. We have not identified any clinical manifestation of B12 deficiency and only n = 1 child with low serum cobalamin, a child who did not receive vitamin B12 supplementation and whose mother took only low doses of vitamin B12 (25/µg/day).To conclude, we did not observe any life-threatening or severe consequences of laboratory-stated vitamin B12 deficiency; thus, our group was well supplemented. On the other hand, we have identified many subjects with vitamin B12 hypervitaminosis of unknown impact on their health. Further research and new guidelines for B12 supplementation among VG and VN children are needed.

High prevalence of iodine deficiency among vegan compared to vegetarian and omnivore children in the Czech Republic: cross sectional study

“…While the knowledge about the necessity of vitamin B12 supplementation seems to be well known among vegans (40) we do not have any information about their iodine status. Therefore, the reason to run this study was a description of iodine saturation, intake, and supplement use in Czech children consuming plant-based diets, and to describe if these children are at possible risk of iodine de ciency, as described reported from cross-sectional studies in adults.…”

“…Unlike pregnant and lactating women, no attention has been paid to this group so far by public health authorities. Considering the increasing prevalence of plant-based diets, especially in the paediatric population, there is an urgent need for proper guidelines accessible for health professionals for assessing iodine de ciency using suitable markers (40), and the prevention of iodine de ciency via iodine supplementation should be enforced. In this regard, the present research should stimulate an evidence-based discussion concerning medical guidelines and recommendations with a speci c focus on the paediatric population consuming plantbased diet in European countries.…”

Vitamin B12 supplementation and health behavior of Austrian vegans: a cross-sectional online survey

“…The most frequently taken supplements were B12 (82%), vit D (80%), omega-3 (51%), and iron (50%). B12 supplementation was similarly assessed for German vegans (82%) 2 and Czech children (86%) 32 . In a survey of healthcare professionals who were physically present at an international conference on plant-based nutrition, 98% of vegans self-reported supplementing B12 33 .…”

The role and impact of abnormal vitamin levels in autism spectrum disorders

“…124 Studies on ASD have found that alterations in the methylation cycle commonly cause a buildup of homocysteine, which can harm neurons and interfere with the production of proteins and neurotransmitters through its metabolic products it produces. 125 In the presence of VB12 deficiency, tetrahydrofolate cannot be converted to folic acid, and homocysteine levels are elevated. This finding was also confirmed by Guo et al through a meta-analysis of 1641 studies, where serum levels of Hcy were significantly higher in patients with ASD compared to healthy controls (Hedges's g = 0.56, 95% CI = 0.36 to 0.76, P < 0.001).…”