Vitamin B12 levels in children and adolescents on plant-based diets: a systematic review and meta-analysis

Abstract Context The popularity of plant-based diets, characterized by a partial or complete exclusion of animal products, has increased significantly over the last 10 years. The exclusion of animal products removes the most common sources of vitamin B12, which can lead to vitamin B12 deficiency and...

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Bibliographic Details
Published in:Nutrition reviews Vol. 81; no. 8; pp. 951 - 966
Main Author: Jensen, Christopher F
Format: Journal Article
Language:English
Published: United States Oxford University Press 10.07.2023
Subjects:
Child
Diet
Diet, Vegetarian
Humans
Nutritional Status
Vitamin B 12
Vitamin B 12 Deficiency - epidemiology
nutrition
vitamin B
adolescents
children
meta-analysis
plant-based
vegetarian
macrobiotic
vegan
systematic review
levels
vitamin B12 levels
ISSN:0029-6643, 1753-4887, 1753-4887
Online Access:Get full text
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Summary:Abstract Context The popularity of plant-based diets, characterized by a partial or complete exclusion of animal products, has increased significantly over the last 10 years. The exclusion of animal products removes the most common sources of vitamin B12, which can lead to vitamin B12 deficiency and result in irreversible damage, such as growth stunting. Objective This aim of this systematic review and meta-analysis was to qualitatively evaluate all studies on this subject and to quantify the potential difference in vitamin B12 levels in healthy children and adolescents aged 5 to 18 years. Data Sources PubMed and Embase databases were searched for relevant studies investigating vitamin B12 levels in healthy children and adolescents aged 5 to 18 years on plant-based diets. Data Extraction Studies were assessed qualitatively with the AXIS tool and quantitatively with Stata 16.0 software. Data Analysis Overall, children and adolescents on plant-based diets had a significantly lower vitamin B12 level than omnivorous children and adolescents (−97 pmol/L; 95%CI, −187 to −7; I2 = 98.5%), a difference that remained statistically significant after adjusting for methodological confounders. After subgroup analyses, this effect was not statistically significant for children and adolescents on vegetarian diets but remained significant in children and adolescents on vegan or macrobiotic diets. Moreover, total vitamin B12 intake nullified the mean difference in vitamin B12 levels. Conclusion Despite high heterogeneity across studies, these results indicate that children and adolescents on plant-based diets, especially those on vegan and macrobiotic diets, may be at risk of developing vitamin B12 deficiency.
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ISSN:0029-6643
1753-4887
1753-4887
DOI:10.1093/nutrit/nuac096