Are You Getting Enough?
By Allan R. Handysides and Peter N. Landless
I have been a lacto-ovo vegetarian for many years; yet when I was tested recently for vitamin B12 they found my level to be very low. It’s true that I eat an egg only very occasionally—but I was still surprised. I thought lacto-ovo vegetarians were not supposed to be low in vitamin B12.
Your question is pertinent to all vegetarians, but also to people who feel they are protected because they take a little dairy, or even some fish. The General Conference Health Ministries Department recommends a well-balanced vegetarian diet—for those who live in a region of the world in which plenty of fresh fruits, grains, nuts, and vegetables are available.
Vitamin B12 is not found in a total-plant-based diet, except by a contamination of soil or manure. Folk often refer to an Edenic diet; unfortunately, we have been barred from such a diet since the Fall, with the tree of life now being an anticipated heavenly treat. It’s strongly recommended and widely practiced that those consuming a total-plant-based diet, referred to by some as “vegan,” use B12 supplements. Only soy milk that is fortified with B12 is a dairy equivalent. Soy milks that are not fortified do not count as dairy equivalents.
It’s interesting that participants in the current Adventist Health Study being conducted at Loma Linda University in California, United States, were found to ingest more vitamin B12 as lacto-ovo vegetarians than even nonvegetarians; and vegans ingested more B12 than pesco-vegetarians (those who eat no meat except fish). Given the (so far) very small differences between all types of vegetarians, it’s not possible to determine that one is clearly superior to another, though all vegetarians come out significantly ahead of nonvegetarians in nearly all categories so far examined. The study is still being unraveled, and the question “What is the best vegetarian diet?” cannot be answered with authority from the study results at this point.
Theoretically, those who consume a lacto-ovo vegetarian diet don’t need to supplement, but it’s a dangerous strategy to be “almost vegan” and not adopt the precaution most modern vegans do of using vitamin B12-fortified products.
There also is a condition called pernicious anemia, where the absorption of vitamin B12 is defective. As we grow older, our absorptive capacity also decreases. This means that even supplements of B12 may not be adequately absorbed. There are forms of B12 supplements that can be absorbed across the mucosa of the mouth. Injectable forms of B12 are also available. If you are a senior, the simple assumption that your diet is deficient may not be totally correct. Pernicious anemia should be considered, and you should be treated accordingly.
According to the Adventist Health Study 2 (AHS2), most lacto-ovo vegetarians are taking about two dairy equivalents per day, which is two eight-ounce glasses of milk or comparable amounts of dairy.
When we debate the superiority of one vegetarian diet over another, we are entering territory of opinion rather than of hard facts. Perhaps all argument will cease when we have firm data. We are not yet there.
During a time when the obesity epidemic is raging worldwide, we as Adventists sometimes are more focused on micronutrient differences than getting our children off the couch and active, as well as reducing their caloric intake of often highly refined foods.
The most pressing problems of a global prevalence are excess calories, inadequate exercise, and too much salt and fat. The simple approach to eating that focuses on the variety and sufficiency of whole, unprocessed foods is recommended.
Allan R. Handysides, a board-certified gynecologist,
is director of the General Conference Health Ministries Department.
Peter N. Landless, a board-certified nuclear cardiologist,
is associate director of the General Conference Health Ministries Department.