Vitamin B12: Diet, Age and Supplementation

An ongoing 18 year long study challenges several commonly accepted truths about B12 deficiency. If you are young and eat meat you likely believe you have a reduced risk of deficiency – maybe not…

Study Found 39% at Risk of B12 Deficiency

Most of us believe if we follow a diet heavy in animal products including meat, eggs or dairy, we should have enough vitamin B12 in our bodies. Researchers at Tuft’s University suggest that this may not be the case. They cite the Framingham Offspring Study which found 39% of subjects were at risk of becoming vitamin B12 deficient.(1)  An important detail is the cross generational nature of this study: 26-49, 50-64 and 65-83.

Framingham Offspring directly contradicts the commonly held view being passed down to dinner tables over the generations: that heavy meat eaters are less likely to be clinically deficient than the rest of the population. In fact, participants who had the best vitamin B12 levels were those that ate fortified cereals. 

Vitamin Absorption and Resulting Deficiencies are not Necessarily Symptoms of Ageing

Remember when we noted that the Framingham Offspring was cross generational? The study participants most at risk of vitamin B12 deficiency provide insights on the relevance of age to vitamin absorption. Surprisingly, vitamin B12 deficiency is to date no more common among the older portion of the sample. Moreover, this finding challenges the widespread belief that absorption and resulting deficiencies are necessarily a symptom of ageing.

Supplementary Forms of Vitamin B12 May Yield the Highest Rate of Absorption

To re-cap, Framingham Offspring shows us:

  1. Meat eaters in the prime of life may actually be at most risk of developing vitamin B12 deficiency.
  2. People who eat fortified cereals are most likely to have optimum B12 blood serum levels, whatever their age.

The current results of Framingham Offspring are significant. To do the study justice it’s important to look at as many angles as possible and give it context. The higher incidence of vitamin b12 deficiency among heavy meat eaters may result from their assumptions that a meat rich diet will provide the nutrients they need. This may lead to a lack of dietary diligence and a habitual lack of balance in diet leading to deficiency. Just think of that carnivore of an uncle at family dinners who steadfastly rejects the veggies for another serving of prime rib? That uncle will likely load up his plate with breakfast sausages when everyone else at the table is enjoying a bowl of vitamin fortified breakfast cereal. The tendency of heavy meat eaters to skip cereals and other plant based foods is well documented.(2)

Is Age the Biggest Risk Factor?

Purists who avoid vitamin b12 supplementation might argue that studies have shown older people have a higher incidence of vitamin B12 deficiency. Deficiencies have historically been viewed as the result of an aging metabolism. The US National Institutes of Health states in it’s study backed literature that up to 30% of older adults are in danger of developing a vitamin b12 deficiency due to a form of gastritis. Atrophic gastritis is a condition which inhibits B12 absorption.(3)

Interestingly, the most recent research quoted by the US National Institute of Health dates back to1986. Further, most of the sources quoted by the health authority go back to the mid 60’s. It is worth noting that by 1999, as a result of publicity and public education by the bodies like the NIH and the The World Health Organization, 66% of American shoppers reported actively choosing vitamin fortified breakfast cereals to maintain optimal health.(4)

Age Or Diet?

Could it be that while age can be a factor, diet and more importantly supplementation are a bigger determiner of whether we develop vitamin b12 deficiencies. We submit that Framingham is yielding the results it is as a result of the food processing industry heading a call to action to infuse foods with supplementary B12. As a result, this supplementary B12 may have dramatically reduced vitamin b12 deficiency among susceptible segments of the population. If the same studies on atrophic gastritis were done today the results might be different. Framingham certainly suggests this might be the case.

Speculation aside, the findings discussed are exceptional in terms of what they tell us about absorption, supplementation and the relevance of age in vitamin b12 deficiency . The Framingham Offspring study shows that despite what we are generally told, it is supplementary forms of vitamin B12 that may yield the highest rate of absorption. A diet rich in whole foods is great, but maybe the addition of a vitamin B12 supplement is even better.



  1. B12 Deficiency May Be More Widespread Than Thought –
  2. Vitamin B12, Fact Sheet for Consumers –
  3. Trends in meat consumption in the United States –
  4. The History of Food Fortification in the United States: Its Relevance for Current Fortification Efforts in Developing Countries –

Image by Paul Townsend, Creative Commons

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