Take home message:
Vitamin B12 deficiency in near-vegan
vegetarians in Pakistan – high
Need to educate vegetarians in
Pakistan about vitamin B12 – high
Study conducted in Mithi (District
Tharparkar, Sindh), Pakistan, in 2012 and 2013, by the Department of
Biochemistry, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate
Medical Center (JPMC), Karachi, Pakistan
Participants:
apparently healthy volunteers: 100
vegetarians + 100 non-vegetarians (ominvores), aged 20–40 years
“The present study has been carried
out in Mithi, District Tharparker (Sindh), because a large number of the
population in Mithi District belong to the Hindu community and most of the
people of this community adhere to a vegetarian diet because of family
conventions or religious reasons.”
“The vegetarian group had adhered to a vegetarian diet
since their childhood. Except for the small consumption of dairy products, they
ate no animal sourced food such as meat, poultry, fish, or eggs. The
omnivore group ate all types of food, including vegetables and animal foods
such as meat, poultry, fish, and eggs.”
“We excluded the subjects from this
study if they were taking multivitamins, […].”
Results:
44% of vegetarians were B12
deficient (based on serum MMA). 0% of non-vegetarians were B12 deficient.
Vegetarians had higher rates of depression, paresthesia (feeling of “pins and
needles” in hands or feet), and psychosis.
“Conclusion: Vegetarians [who do not
add sufficient amounts of vitamin B12 to their diets by consuming supplements
or fortified foods] have Vitamin B12 deficiency and are more prone to
developing neuropsychiatric and neurological problems.”
Results summarized:
|
Variables
|
Vegetarians
(n=100)
|
Non-vegetarians
(n=100)
|
|
Age (years) (Ø)
|
28
|
29
|
|
Men
|
77%
|
72%
|
|
Women
|
23%
|
28%
|
|
Vitamin B12(pg/ml)
(Ø)
|
238
|
401
|
|
Frequency of B12 deficiency (serum B12 <200 pg/mL)
|
51%
(48% in men, 61% in women)
|
3%
|
|
Folate (nmol/L) (Ø)
|
16
|
25
|
|
Frequency of folate
deficieny
|
0%
|
0%
|
|
MMA (nmol/L) (Ø)
|
285
|
191
|
|
Frequency of high MMA (serum MMA >271 nmol/L –
This indicates B12 deficiency.)
|
44%
|
0%
|
|
Frequency of
depression
|
31%
|
12%
|
|
Frequency of
paresthia
|
11%
|
3%
|
|
Frequency of
peripheral neuropathy (not statistically significant)
|
9%
|
2%
|
|
Frequency of
psychosis
|
11%
|
3%
|
|
Frequency of
personality changes
|
5%
|
1%
|
“Therefore, it is recommended that people should eat a diet
fortified with Vitamin B12 and folic acid to prevent these nutrient
deficiencies, particularly
in vegetarians. Early
detection of Vitamin B12 deficiency is necessary for preventing potentially
irreversible neuropsychiatric changes. So it is recommended that, in
vegetarians with neuropsychiatric problems, their Vitamin B12 levels should be
checked and treated if it is deficient to prevent irreversible neurological
loss.”
“[…] early replacement of Vitamin
B12 is suggested for preventing such catastrophic damages [irreversible nerve
damage and/or psychological problems] in this high-risk group [vegetarians].”
Vitamin B12 deficiency in non-vegetarians in Pakistan:
“Recently, a study in Pakistan
showed 57% prevalence of Vitamin B12 deficiency, after excluding strict vegetarians
from their study.“ [Nizamani GS, Memon IA, Memon A, Khoharo HK. Vitamin B12
Deficiency with Megaloblastic Anemia: An Experience at Tertiary Care Hospital
of Sindh. JLUMHS 2014; 13: 13-17.]
Reference:
Kapoor A, Baig M, Tunio SA, Memon
AS, Karmani H: Neuropsychiatric and neurological problems among vitamin B12
deficient young vegetarians. Neurosciences 2017; Vol. 22 (3): 228–232. doi:
10.17712/nsj.2017.3.20160445