B12 an issue for vegans not only in India

https://www.nature.com/articles/ejcn201729



Vitamin B12 deficiency is a major threat to public health globally.1,2 The prevalence of vitamin B12 deficiency is highest in resource-limited settings, including South Asia.3–8 Vitamin B12 is obtained in the diet through consumption of animal products, including meat, poultry, fish, eggs and dairy. Several studies have reported low vitamin B12 status in vegan or vegetarian individuals and in low- and middle-income settings, particularly in populations with low intake of animal source foods.9,10 In particular, the burden of vitamin B12 deficiency in India is thought to be among the highest in the world.1 Maternal vitamin B12 deficiency has been associated with greater risk of pregnancy complications, such as spontaneous abortion, low birth weight, intrauterine growth restriction and neural tube defects.11 Children born to women with vitamin B12 deficiency have an increased risk of adverse health outcomes, including deficits in growth and development and anemia.12–14 In the parent-randomized trial in Bangalore, India, daily maternal vitamin B12 supplementation (50 μg/day) with iron and folic acid during pregnancy through 6 weeks postpartum significantly improved maternal vitamin B12 status (Po0.01), breast milk (Po0.01) and infant (Po0.01) vitamin B12 concentrations, compared to iron-folic acid alone.15 Previous studies in Turkey, Germany, Norway and Brazil have reported associations between maternal and infant vitamin B12 status at birth.15–18 However, few prospective studies have been conducted to examine the burden and determinants of vitamin B12 status in young infants, and there is limited data from India.