This document summarizes a study that analyzed the association between vitamin B12 status, bone metabolism, and vegetarian diets. The study found that bone turnover was accelerated in vegetarians with vitamin B12 deficiency compared to non-deficient vegetarians. Vegans and long-term vegetarians were more likely to have vitamin B12 deficiency. While bone turnover markers did not differ by diet type, duration of a vegetarian diet may determine bone turnover through potential vitamin B12 deficiency over time. More research is needed to understand these relationships and whether vitamin B12 supplements could improve bone health for vegetarians.

1. VITAMIN B12 DEFICIENCY
IN VEGETARIANS
Nicole Borchers

2. OUTLINE
• Introduction
• Hypothesis/Goals
• Results
• Conclusion
• Citations and Acknowledgements

3. INTRODUCTION
• Vitamin B12 is a nutrient that helps keep the body's nerve and blood cells healthy
and helps make DNA
• The best sources of Vitamin B12 are beef liver and clams
• Fish, meat, poultry, eggs, milk, and other dairy products
• Types of Vegetarians
• Vegan
• Vegans do not consume any animal products or by-products
• Lacto-ovo
• Lacto-vegetarians do not eat red or white meat, fish, fowl or eggs.

4. INTRODUCTION CONTINUED
• Recent studies have linked low vitamin B12 and high totally homocysteine
concentrations to low bone mineral density (BMD).
• Some studies suggest there are effects of homocysteine and vitamin B12 on bone
metabolism.
• Vegans and vegetarians avoid products of animal origin which are a source of
vitamin B12 (Herrmann, Obeid, Schorr, 2009).

5. HYPOTHESIS/GOALS
• The study analyses the association of vitamin B12 status and bone metabolism in
vegetarians using biochemical markers of bone turnover and vitamin B12 status
(Herrmann, Obeid, Schorr, 2009).

6. RESULTS/DISCUSSION
• Bone turnover was accelerated in German vegetarians (Herrmann, Obeid, Schorr,
2009).
• We divided up the subjects according to vitamin B12 status into deficient and non-
deficient groups. Subjects deficient in vitamin B12 were those who had holoTC <35
pmol/L and MMA >271 nmol/L (Table 2) (Herrmann, Obeid, Schorr, 2009).

7. RESULTS/DISCUSSION CONTINUED

8. RESULTS/DISCUSSION CONTINUED
• The type of vegetarian diet had no additional impact on bone turnover.
• The majority of vegetarians in our study that had insufficient vitamin B12.
• The lowest concentration was seen in vegans.
• The duration, rather than the type of diet, probably determines bone turnover.
• The mechanisms explaining the relationship between vitamin B12 deficiency and
bone turnover is not well understood (Herrmann, Obeid, Schorr, 2009).

9. CONCLUSIONS
• Metabolic signs of vitamin B12 deficiency are related to accelerated bone turnover
in vegetarians.
• May have adverse effects on bone health.
• BTM concentration was not related to the type of vegetarian.
• More studies are needed to see if vitamin B12 supplements and vitamin D can
improve bone turnover and bone health in vegetarians (Herrmann, Obeid, Schorr,
2009).

10. CITATIONS & ACKNOWLEDGEMENTS
• Herrmann, W., Obeid, R., Schorr, H. (2009). Enhanced bone metabolism in
vegetarians – the role of vitamin B12 deficiency. Clinical Chemistry and Laboratory
Medicine. 47(11) 1381-1387.
• http://www.vegetarian-nation.com/resources/common-questions/types-levels-
vegetarian/