Biomarkers of Nutrition for Development (BOND) - vitamin B12 review

Authors: Allen, Lindsay - A; MILLER, JOSHUA - Rutgers University; DE GROOT, LISETTE - Wageningen University; ROSENBERG, IRWIN - Friedman School Of Nutrition; SMITH, DAVID - University Of Oxford; REFSUM, HELGA - University Of Oslo; RAITEN, DANIEL - National Institutes Of Health (NIH)

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/29/2016
Publication Date: 11/30/2018
Citation: Allen, L.H., Miller, J.W., De Groot, L., Rosenberg, I.H., Smith, D.A., Refsum, H., Raiten, D.J. 2018. Biomarkers of Nutrition for Development (BOND) - vitamin B12 review. Journal of Nutrition. 148(4):1995S-2027S. https://doi.org/10.1093/jn/nxy201.
DOI: https://doi.org/10.1093/jn/nxy201

Interpretive Summary: This report on vitamin B-12 (B12) is part of the Biomarkers of Nutrition for Development (BOND) Project, which provides state-of-the art information and advice on the selection, use, and interpretation of indicators (biomarkers) of nutrient exposure, status, and function. As with the other five reports in this series, which focused on iodine, folate, zinc, iron, and vitamin A, this B12 report was developed with the assistance of an expert panel and other experts who provided information during a consultation. The experts reviewed the existing literature and pulled together the existing relevant information on the biology of B12, including known and possible effects of insufficiency, and available and potential biomarkers of status. Unlike the situation for the other five nutrients reviewed during the BOND project, there has been relatively little previous attention paid to B12 status and its biomarkers, so this report is a landmark in terms of the available information on B12 nutrition. Historically, most focus has been on diagnosis and treatment of clinical symptoms of B12 deficiency, which result primarily from pernicious anemia (a disease in which the vitamin cannot be absorbed) or strict vegetarianism (which leads to a very low intake). More recently, we have become aware of the high prevalence of B12 insufficiency in populations consuming low amounts of animal source foods. This can be detected with one or more serum biomarkers but presents the new challenge of identifying adverse functional consequences that may require public health interventions such as food fortification or B12 supplementation programs.

Technical Abstract: This report on vitamin B12 is part of the Biomarkers of Nutrition for Development (BOND) project which provides state-of-the art information and advice on the selection, use and interpretation of biomarkers of nutrient exposure, status, and function. As with the other five reports in this series, which focussed on iodine, folate, zinc, iron, and vitamin A, this vitamin B12 report was developed with the assistance of an expert panel and other experts who provided information during a consultation. The experts reviewed the existing literature in depth in order to consolidate existing relevant information on the biology of the vitamin including known and possible effects of insufficiency, and available and potential biomarkers of status. Unlike the situation for the other five nutrients, there has been relatively little previous attention paid to vitamin B12 status and its biomarkers so this report is a landmark in terms of the consolidation and interpretation of the available information on vitamin B12 nutrition. Historically most focus has been on diagnosis and treatment of clinical symptoms of B12 deficiency, which result primarily from Pernicious Anemia or strict vegetarianism. More recently we have become aware of the high prevalence of vitamin B12 insufficiency in populations consuming low amounts of animal source foods, which can be detected with one or more serum biomarkers but presents the new challenge of identifying functional consequences that may require public health interventions.