Vitamin B-12 deficiency can occur because of impaired absorption in the elderly, leading to a variety of neurological issues including cognitive decline, parasthesia, ataxia and mood changes.  If the deficiency is left untreated, these conditions may be irreversible.  Bioavailability of vitamin B-12 from different foods varies, thus, their relative importance in preventing deficiency may also differ.  Because the association between specific foods and vitamin B-12 status was unknown, Huang and colleagues conducted a study to explore these associations.  They report their results in the November 2022 issue of The Journal of Nutrition.

Subjects were participants in the Quebec Longitudinal Study on Nutrition and Successful Aging study.  They were between 67 and 84 years of age and were followed for 4 years during which three 24-hour dietary recalls were performed annually.  Blood and urine samples were also collected yearly for the analysis of serum vitamin B-12, and urinary methylmalonic acid (MMA).  Samples were collected for analysis from between 1230 and 1463 subjects.

Overall, 21.8-32.5% had low serum vitamin B-12 (<221 pmol/L), 12.5-17.0% had elevated urine MMA/creatinine ratios (> 2 µmol/mmol), and 10.1-12.7% were deficient in vitamin B-12.  The main sources of vitamin B-12 intake included dairy, or meat, poultry, and organ meats, and the intake averaged 3.19 µg/d.  No associations were found between meat, poultry and organ meat intake and serum vitamin B-12 or urinary MMA/creatinine ratios.  Higher intake of vitamin B-12 derived from dairy was associated with a decreased risk of low serum vitamin B-12 or vitamin B-12 deficiency.  The authors conclusions were that the foods from which vitamin B-12 is acquired may contribute differently to the reduction of vitamin B-12 deficiency, with diary sources providing greater protection than meats.

In an editorial, Lamers noted the observations of Huang and colleagues suggest the current age-specific dietary vitamin B-12 recommendations should be reviewed.  The opportunity to meet the requirements among older adults consuming milk may mitigate, in part, the need for supplement use or injections of the vitamin.  However, Lamers does caution the increased consumption of plant-based protein sources and avoidance of animal-sourced foods could lead to vitamin B-12 deficiencies unless more foods are fortified, or individuals consuming these dietary patterns also consume milk products.


He Helen Huang, Alan A Cohen, Pierrette Gaudreau, Christiane Auray-Blais, David Allard, Michel Boutin, Isabelle Reid, Valérie Turcot, Nancy Presse, Vitamin B-12 Intake from Dairy but Not Meat Is Associated with Decreased Risk of Low Vitamin B-12 Status and Deficiency in Older Adults from Quebec, Canada, The Journal of Nutrition, Volume 152, Issue 11, November 2022, Pages 2483–2492,

Yvonne Lamers, Vitamin B-12 Requirements in Older Adults—Increasing Evidence Substantiates the Need To Re-Evaluate Recommended Amounts and Dietary Sources, The Journal of Nutrition, Volume 152, Issue 11, November 2022, Pages 2317–2318,

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