B12 Status: Elderly Vegetarians

Summary: Elderly lacto-ovo-vegetarians and vegans often have very low serum B12 levels. They should make sure they are getting a reliable source of B12. In fact, all people over age 50 should get some B12 by way of fortified foods or supplements due to lower stomach acid decreasing absorption of food-bound B12.

Studies of the B12 Status of Elderly Vegetarians

Brants et al. (1990, Netherlands) and Lowik et al. (1990, Netherlands) compared the B12 status of elderly (65-97 yrs) lacto-ovo-vegetarians to non-vegetarians. Results were:

Results of Brants et al.
	#	Serum B12 (pg/ml)	B12 < 186.3 pg/ml
NV males	54	NR	4%
NV females	54	NR	6%
LOV males	17	317 ± 277	35%
LOV females	23	247 ± 96	13%
LOV - Lacto-ovo-vegetarians NR - Not reported NV – Non-vegetarians

They concluded that a lacto-ovo or lacto-vegetarian diet can be adequate in old age, with positive impacts on heart disease risks, provided that it is carefully planned, especially with respect to iron, zinc, and B12.

References

Brants HA, Lowik MR, Westenbrink S, Hulshof KF, Kistemaker C. Adequacy of a vegetarian diet at old age (Dutch Nutrition Surveillance System). J Am Coll Nutr. 1990 Aug;9(4):292-302.

Lowik MR, Schrijver J, Odink J, van den Berg H, Wedel M. Long-term effects of a vegetarian diet on the nutritional status of elderly people Dutch Nutrition Surveillance System). J Am Coll Nutr. 1990 Dec;9(6):600-9.

Woo et al. (1998, Hong Kong) compared 106 elderly Chinese LOV and vegan women to 229 non-vegetarians:

All were older than 65 yrs (avg. 81); all were apparently healthy.
Vegetarians had been on the diet > 10 yrs.
Low B12 (< 203 pg/ml) occurred in 53.8% of the vegetarians (data not given for non-vegetarians).
16 vegetarians had B12-deficient anemia compared to 1 non-vegetarian.
Vegetarians had a lower prevalence of a history of smoking and heart disease.

Reference: Woo J, Kwok T, Ho SC, Sham A, Lau E. Nutritional status of elderly Chinese vegetarians. Age Ageing. 1998 Jul;27(4):455-61.