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Vegan Diet, Subnormal Vitamin B-12 Status and Cardiovascular Health

Room 186, Science Centre South Block, Biochemistry Programme, School of Life Sciences, The Chinese University of Hong Kong, Shatin NT, Hong Kong
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
Sydney Medical School, The University of Sydney, Sydney 2050, Australia
Author to whom correspondence should be addressed.
Nutrients 2014, 6(8), 3259-3273;
Received: 24 June 2014 / Revised: 6 August 2014 / Accepted: 8 August 2014 / Published: 19 August 2014
(This article belongs to the Special Issue Vegan diets and Human health)
PDF [1565 KB, uploaded 19 August 2014]


Vegetarian diets have been associated with atherosclerosis protection, with healthier atherosclerosis risk profiles, as well as lower prevalence of, and mortality from, ischemic heart disease and stroke. However, there are few data concerning the possible cardiovascular effects of a vegan diet (with no meat, dairy or egg products). Vitamin B-12 deficiency is highly prevalent in vegetarians; this can be partially alleviated by taking dairy/egg products in lact-ovo-vegetarians. However, metabolic vitamin B-12 deficiency is highly prevalent in vegetarians in Australia, Germany, Italy and Austria, and in vegans (80%) in Hong Kong and India, where vegans rarely take vitamin B-12 fortified food or vitamin B-12 supplements. Similar deficiencies exist in northern Chinese rural communities consuming inadequate meat, egg or dairy products due to poverty or dietary habits. Vascular studies have demonstrated impaired arterial endothelial function and increased carotid intima-media thickness as atherosclerosis surrogates in such metabolic vitamin B-12 deficient populations, but not in lactovegetarians in China. Vitamin B-12 supplementation has a favourable impact on these vascular surrogates in Hong Kong vegans and in underprivileged communities in northern rural China. Regular monitoring of vitamin B-12 status is thus potentially beneficial for early detection and treatment of metabolic vitamin B-12 deficiency in vegans, and possibly for prevention of atherosclerosis-related diseases. View Full-Text
Keywords: vegan diet; vitamin B-12 deficiency; atherosclerosis surrogates; cardiovascular health vegan diet; vitamin B-12 deficiency; atherosclerosis surrogates; cardiovascular health

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Woo, K.S.; Kwok, T.C.; Celermajer, D.S. Vegan Diet, Subnormal Vitamin B-12 Status and Cardiovascular Health. Nutrients 2014, 6, 3259-3273.

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