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With increasing popularity of plant-based or vegan diets, B12 deficiency is of increasing concern. B12 deficiency can have significantly wide-spread implications through virtually effecting every cell of the body through its role in DNA synthesis and energy metabolism. This is of particular concern amongst women of reproductive age, who are more likely to follow vegan diets overall, as B12 deficiency can have significant implications on the development of infants and babies, with poor maternal intake, regardless of the mother’s B12 liver stores being associated with high risk of neural tube defects in infants. However, despite poor population knowledge of the dietary sources of B12 and the importance of B12 supplementation in vegan populations, this deficiency is entirely preventable and with adequate intake, and if appropriate steps are taken, the risks of deficiency can be minimised.

In this informative and relevant presentation, Accredited Practising Dietitian Dr Amanda Benham provides her knowledge and expertise from her direct clinical experience and research on the prevalence of B12 deficiency, as well as proactive ways to minimise risk, including specific supplementation. While in theory many clinicians in training were taught that we have adequate levels of B12 in our livers for 5 years, Amanda discusses that caution should be taken in making this assumption as many vegans have reduced their intake of B12 for years prior. Further to this, it is difficult to measure B12 stores and there is great inter-person variation in B12 storage.

When considering supplementation in relation to requirements, it is critical to remember that the Recommended Dietary Intake is based on the intake of food, and the bioavailability of B12 can be affected in combination supplements and by specific medications. In most cases, it is best to supplement more aggressively, although this should also be determined alongside measures such as methylmalonic acid (MMA) levels and life-stage factors.

Overall, B12 deficiency is of significance amongst vegans and appropriate steps should be taken to educate and support individuals following this way of eating to optimise their nutritional status and experience the benefits of vegan diets.

Summary:

• The increasing popularity of vegan or plant-based diets calls for appropriate nutritional education on B12 deficiency risks, especially amongst at risk groups, such as women of reproductive age. Vitamin B12 deficiency in pregnancy is associated with neural tube defects, recurrent miscarriages, preeclampsia, gestational diabetes, low birth weight and preterm birth.
• Methylmalonic acid (MMA) is the most specific measure of B12 status, although steps to reduce deficiency, including regular supplementation should be considered.
• When considering B12 supplementation, this should be determined on a case-by-case basis, although initially doses of 1000mcg per day could be considered for an initial 1-2 months, followed by a potential daily 200-500mcg to meet requirements thereafter.

Dr Amanda Benham, APD completed her PhD on the Vitamin B12 intake of women of reproductive age on a vegan diet in Australia at Queensland University of Technology. Amanda is qualified in paediatric nutrition and is a Fellow of the Australasian Society of Lifestyle Medicine. As well as helping vegan and vegetarian parents raise healthy children on a plant-based diet, she offers them as a treatment option for obesity, type 2 diabetes and cardiovascular disease. Amanda has published in the area of planning plant-based diets as well as on her study into women on a vegan diet in Australia. She’s also co-written a vegan cookbook, Greenilicious (Arbon Publishing). Amanda has been a vegan since 1983 and her two adult children are lifelong vegans.

To register for the presentation and associated documents including the assessment quiz click here