ArticleAnnals of medicine2023
A cross-sectional study of nutritional status in healthy, young, physically-active German omnivores, vegetarians and vegans reveals adequate vitamin B
Article in Annals of medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- The Certainty of the Evidence on Plant- vs Meat-Predominant Dietary Patterns and Depression: An Umbrella Review.Nutrition reviews · 2026Pooled it
- Impact of an eight-week isocaloric vegan dietary intervention on hemogram parameters and lymphocyte subsets: a randomized-controlled trial.BMC medicine · 2026Trial
- Bowel health, defecation patterns and nutrient intake following adoption of a vegan diet: a randomized-controlled trial.Annals of medicine · 2024Trial
- Physiological Adaptation to Plant-Based Diets: A Homeostatic Framework for Sustained Dietary Change.Biology · 2026Review
- Nutrient and Discretionary Food Intake in Vegan Adult Australians: A Cross-Sectional Study.Nutrition bulletin · 2026Article
- Eliminating Animal Products from the Diet Puts Dutch Older Adults at Risk of Micronutrient Deficiencies: A Simulation Study.Current developments in nutrition · 2026Article
- Plant-Based Diet and Pregnancy-Related Disorders: A Narrative Review.Current nutrition reports · 2026Review
- Targeting risk factors and strategies for prevention of peripheral neuropathy: focus on B-vitamin deficiencies and metabolic diseases.Neurological research and practice · 2026Review
- Vitamin B12 and D status in long-term vegetarians: Impact of diet duration and subtypes in Beijing, China.Asia Pacific journal of clinical nutrition · 2026Article
- The culinary medicine elective "Prospective Physicians For Fibre" improves fibre intake and nutrition knowledge in German medical students.BMC medical education · 2026Article
- Improving the protein quality of New Zealand vegan diets: an optimisation modelling approach incorporating energy constraints and diet acceptability.Frontiers in nutrition · 2026Article
- The German LAKE-score reliably predicts urinary and dietary potential renal acid load: a three-armed translational study.Annals of medicine · 2025Article
- Whole blood count data and hematological parameters in US vegetarians: a cross-sectional study.European journal of nutrition · 2025Article
- Peripheral Parenteral Nutrition and Personalized Nutritional Approach After Colorectal Resection Surgery: A Comprehensive Review of Current Evidence.Medicina (Kaunas, Lithuania) · 2025Review
- Plant-Based Diet and Risk of Iron-deficiency Anemia. A Review of the Current Evidence and Implications for Preventive Strategies.Current nutrition reports · 2025Review
- Supplementation Behavior and Expenditures in Healthy German Vegans, Lacto-Ovo-Vegetarians and Omnivores: A Cross-Sectional Study.American journal of lifestyle medicine · 2025Article
- Analyzing dietary exposure to critical nutrients on a plant-based diet using the food- and total nutrient index.Nutrition journal · 2025Article
- Ultra-processed foods and plant-based alternatives impair nutritional quality of omnivorous and plant-forward dietary patterns in college students.Scientific reports · 2025Article
- The role of plant-based dietary compounds in gut microbiota modulation in inflammatory bowel disease.Frontiers in nutrition · 2025Review
- Plant-Based Diet and Sports Performance.ACS omega · 2024Review
Corrections and comments
- Erratum issuedCorrection.2024
Authors and funding
11 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivePlant-based diets reduce the risk of cardiovascular disease but also increase the risk of certain micronutrient deficiencies, particularly, of vitamin B12 (B12). The extent to which the unsupervised use of oral nutrient supplements is sufficient to prevent these deficiencies is not well established. We analyzed nutrient intake, laboratory biomarkers, supplementation behavior, and B12 status adequacy amongst young, healthy, physically active omnivores, lacto-ovo-vegetarians and vegans from Germany.
methodsWe recruited 115 participants (
resultsEnergy intake and macronutrient distribution were comparable across diets. Major differences included intake of fiber, cholesterol, and several vitamins. Vegans had the lowest intake of B12 from foods (0.43 (0.58) µg/d), compared to omnivores (2.14 (2.29) µg/d) and lacto-ovo-vegetarians (0.98 (1.34) µg/day). Multivariate analysis of 36 blood biomarkers revealed that three major classes of biomarkers contributed the most to the clustering of individuals by dietary group, namely, biomarkers of B12 status (B12, holoTC, Hcy), iron (iron, ferritin, transferrin) and lipid metabolism (vitamin A, HDL, LDL, total cholesterol, TAG). This suggests that nutrients that modify the metabolic pathways represented by these biomarkers have the most penetrating effect on health status across diets. Analysis of B12 status (including 4cB12) revealed adequacy in omnivores and vegans, and a poorer B12 status amongst lacto-ovo-vegetarians. Fewer lacto-ovo-vegetarians used B12 supplements compared to vegans (51% versus 90%).
conclusionsEven amongst homogeneously healthy Germans, each diet manifested with measurable differences in dietary intakes and biomarkers of health. Plant-based diets, in particular the vegan diet, exhibited the most favorable patterns of lipid metabolism and glycemic control, but the lowest food intake of B12. Supplementation of healthy vegans with B12 (median 250 µg B12/day, over 2 years) secured an adequate B12 status that was comparable to that of healthy omnivores.
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