Substituting animal protein foods with plant protein foods influences vitamin B12 and folate statuses in a multiethnic Asian population.

purposeThe influence of a shift from animal-based to plant-based diets on vitamin B12 and folate statuses in Asian populations remains unclear. We examined the associations between substituting animal protein foods with plant protein foods and vitamin B12 and folate statuses in an Asian population.

methodsA cross-sectional analysis was conducted using data collected from 993 Singapore residents (aged 21-75 years) from the Singapore Multi-Ethnic Cohort. Dietary intake was assessed using a validated food frequency questionnaire. Fasting blood samples were collected. Serum vitamin B12 and folate concentrations were determined by microbiological assay and deficiencies were defined by < 148 pmol/L and < 10 nmol/L respectively. Multivariable logistic and linear regression analyses were conducted to examine the associations.

resultsSubstituting white fish or oily fish with 30 g per day equivalent of various plant protein foods was associated with higher odds of vitamin B12 deficiency [odds ratio (OR) ranged from 1.62 to 1.85, 1.98 to 2.23 for white and oily fish respectively; p < 0.05]. Similarly, substituting a combination of meats (including red and white meat, processed meat and processed seafood) simultaneously with an equivalent portion of refined grains (30g per day) was associated with a higher odds of vitamin B12 deficiency (OR 1.12; p < 0.05). In contrast, substituting processed meat and processed seafood with an equivalent portion of vegetables or nuts and seeds was associated with higher folate serum levels (β: 1.19 and 2.50 respectively; p < 0.05).

conclusionsTotal elimination of meats and replacing them with refined grains may pose a greater risk of vitamin B12 deficiency than reduction of individual meats. Dietary guidelines in Asia should encourage higher intakes of high quality, nutrient-dense plant-based foods and lesser red and processed meats to prevent vitamin B12 and folate deficiencies. Similarly, an emphasis on fish intake, especially oily fish, to prevent vitamin B12 deficiency in the Asian population is needed.