Metabolic Vitamin B₁₂ Status on a Mostly Raw Vegan Diet with Follow-Up Using Tablets, Nutritional Yeast, or Probiotic Supplements

Abstract

Background: Pure vegetarian diets might cause cobalamin deficiency due to lack of dietary intake. It was hypothesized that a population following a vegan diet consuming mostly raw fruits and vegetables, carrot juice, and dehydrated barley grass juice would be able to avoid vitamin B₁₂ deficiency naturally. Methods: Subjects were recruited at a health ministers’ reunion based on adherence to the Hallelujah diet for at least 2 years. Serum cobalamin and urinary methylmalonic acid (MMA) assays were performed. Follow-up with sublingual tablets, nutritional yeast, or probiotic supplements was carried out on subjects with abnormal MMA results. Results: 49 subjects were tested. Most subjects (10th to 90th percentile) had followed this diet 23–49 months. 6 subjects had serum B₁₂ concentrations <147 pmol/l (200 pg/ml). 37 subjects (76%) had serum B₁₂ concentrations <221 pmol/l (300 pg/ml). 23 subjects (47%) had abnormal urinary MMA concentrations above or equal to 4.0 µg/mg creatinine. Sublingual cyanocobalamin and nutritional yeast, but not probiotic supplements, significantly reduced group mean MMA concentrations (tablet p < 0.01; yeast p < 0.05, probiotic > 0.20). Conclusions: The urinary MMA assay is effective for identifying early metabolic cobalamin deficiency. People following the Hallelujah diet and other raw-food vegetarian diets should regularly monitor their urinary MMA levels, consume a sublingual cobalamin supplement, or consume cobalamin in their food.

Long-Term Consumption of a Raw Food Diet Is Associated with Favorable Serum LDL Cholesterol and Triglycerides but Also with Elevated Plasma Homocysteine and Low Serum HDL Cholesterol in Humans2

“…Raw food diets are extreme dietary regimens that have not been investigated extensively (11,(43)(44)(45)(46). To our knowledge, the Giessen Raw Food Study is the only study worldwide to date that examined a relatively large number of individuals following a strict raw food diet for a prolonged period of time (11).…”

“…To our knowledge, the Giessen Raw Food Study is the only study worldwide to date that examined a relatively large number of individuals following a strict raw food diet for a prolonged period of time (11). Two earlier reports examined the vitamin B-12 status of a small cohort (n ϭ 49) of individuals following the so-called "Hallelujah diet," a strict vegan diet composed mainly of raw fruits and vegetables (46), and the lipid and hematological profile of 12 subjects following a "living food diet," a strict uncooked vegan diet (47). According to dietary guidelines for the general population and as adapted for vegetarians, foods rich in complex carbohydrates such as cereals and potatoes, and fat from vegetable oils and nuts, should provide the main dietary sources of energy (48 -52).…”

Vitamin B12 among Vegetarians: Status, Assessment and Supplementation

“…Both blood markers, MMA and HCY, may be altered by renal failure and it is therefore useful to test glomerular function with creatinine [96]. The use of urinary MMA standardized for creatinine, although used less, may reduce the risk of an incorrect diagnosis [97]. Normally, the cutoff used for the assessment of Cbl deficiency by urinary MMA is >4 μg per mg of creatinine [98,99].…”

Vitamin B12-Containing Plant Food Sources for Vegetarians

“…Some vegetarian groups are ovo only or lacto only, i.e. , they consume only eggs or only milk and its products, respectively, as animal products; (2) Raw veganism [11]: this diet is mostly or entirely based on fresh fruits, vegetables, nuts, and seeds; (3) Fruitarianism [12]: this is generally a raw style of eating that primarily depends on fruits, nuts, and seeds; (4) Buddhist vegetarianism [13]: this is a vegan diet that excludes all animal products and Allium family vegetables (onion, garlic, leeks, and shallots) on ethical grounds; (5) Macrobiotic [14]: this diet is primarily focused on grains, beans, and similar staples, including some vegetables and other whole foods. Processed foods and most animal products are strongly avoided; and (6) Jain vegetarianism [15]: another religious dietary practice that includes dairy products, but excludes eggs and honey as well as root vegetables.…”