A very popular argument against Veganism concerns taking supplements. As a Vegan, I’m sure you’ve heard the “I would love transitioning to Veganism, but I don’t want to spend my whole life taking pills, it’s so “unnatural”” drill way too many times.
Personally, I find using the argument of supplementation against Veganism incredibly useless; most of our food is fortified. From breakfast cereal, bread, spreads, to the cows and hens themselves, fortifying foods in B vitamins, Iron, Calcium, etc., is usually a great asset to said product; it actually is the main reason why the product becomes so attractive.
Why is it such a big deal then, when Vegans decide to take the matter into their own hands, and control the type and quantity of supplementation they would otherwise get in animal products?
Focusing on B12 and Omega-3, as both are one of the very few difficult to absorb/find in a Vegan diet, I interviewed Fida Fneiche, a licensed clinical dietitian and nutritionist, whose area of study and interests focus on medical nutritional therapy and metabolism, to help me address the controversy.
Should Vegans take supplements? Is it bad to take supplements? What are the roles of B12 and Omega-3? Should non-Vegans also consider fortifying their intake? Which kind of B12 pill is best? Where do animals get their B12 and Omega-3 from anyway? How can a Vegan ensure a healthy intake of both?
Backed by secondary sources, this blog post answers all these questions and more.
VW: What is Vitamin B12? What role does it play in the body?
FF: Vitamin B12 (AKA cobalamin), is a water-soluble vitamin necessary for lipid and amino acid metabolism, DNA synthesis, and proper nerve function.
It has several and notable roles: co-enzyme/co-factor for several methylation reactions necessary for energy release, synthesis of normal blood cells, maintenance of the myelin sheath on nerve cells, and the regulation of inflammatory immune responses
Deficiencies in vitamin B12 lead to an array of consequential pathologies such as neurological deficiencies (e.g. peripheral nerve disease, myopathies, etc.) and an altered hematological blood panel (indicative of pernicious anemia).
Bioavailable vitamers which work in humans are methylcobalamin and adenocobalamin. Vitamin B12 and its analogues come in many forms such as cyanocobalamin, methylcobalamin, adenocobalmin, hydroxycobalamin – it is a structurally complicated vitamin belonging to the corrinoid family (molecules with cobalt-containing tetrapyrrole rings). Excretion of the vitamin: kidneys – storage of vitamin: liver (unlike other water-soluble vitamins, cobalamin has a high retention in organs, i.e. can be stored for a longer period).
VW: What about Omega-3?
FF: Omega-3 fats are fat molecules made from long-chained essential fatty acids. They are ‘essential’ because our body does not produce them and therefore should be obtained from our diet. Two types of these omega-3s [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] are known to have anti-inflammatory and protective effects on our cardiovascular health and are recommended for consumption. These are obtained from fish and fish oil products mainly.
Alpha-linoleic acid (ALA) is also an important omega-3 essential fatty acid derived from plant-based sources and can be converted into EPA and DHA through a series of complex reactions in the body.
VW: What exactly is the issue with ALA conversion in plant-based diets?
FF: ALA is inefficiently converted to EPA and DHA in our bodies, and this is imposed by the large amounts of omega-6 fatty acids found in our diet that is regularly consumed with respect to omega-3s.
The efficiency of converting ALA into EPA and DHA also depends on a lot of other factors including age, disease, and dietary/lifestyle patterns. For example, fasting and alcohol consumption can limit this conversion, and people with hypertension or a zinc deficiency cannot efficiently achieve this conversion either.
A large intake of omega-6 fatty acids can reduce omega-3 fatty acid conversion by 40% to 50%.
For vegetarians who consume few sources of EPA and DHA, a ratio of omega-6 to omega-3 fatty acids ranging from 2:1 to 4:1 has been suggested as being optimal to ensure maximum conversion of ALA to EPA and DHA.
[More recent research suggests that optimal conversion is achieved with a ratio of 1:1, although this is more difficult to achieve]
There is evidence that the conversion is significantly better in young women than in men; hypotheses suggest this is due to the nature of females pertaining to the expected increased needs during pregnancy and lactation.
Although conversion is slow and incomplete, it appears to be sufficient to meet the needs of most healthy people if ALA intake is sufficient.
Scroll down to Section 1 for references.
VW: Where do B12 and Omega-3 come from?
FF: Bacteria & archaea are the only synthesizers of vitamin B12. Naturally, vitamin B12- synthesizing bacteria are commonly found in soil & feces.
With the current farming practices, most livestock acquire vitamin B12 from fortified feed due to the urbanized agricultural settings which lack vitamin B12 synthesizing bacteria
Vitamin B12 is also synthesized by bacteria in humans at the site of the colon but is not utilized since it is past the level of absorption (absorption of the vitamin happens at the level of the small intestine)
In conclusion: geographical location, animal breeding practices, and the type of vitamin B12 analogue used (in fortified feed and food) affect quantity and quality of B12 in food products
Small note: Vitamin B12 metabolic pathway polymorphisms determined genetically also dictate the efficiency of absorption of the vitamin in our body.
Omega-3 fats primarily come from phytoplankton and algae from the sea. Marine animals feeding on these sources become sources of omega-3 fats accordingly.
Livestock living in free-range areas and fed grass are a source of omega-3 fats; however, most livestock consume fortified feed and the amount of total fat consumed from meat renders the protective benefits of omega-3 useless.
Meat contains high saturated fat content, so it does not change the dominant fat composition. Poultry fed fortified feed can produce omega-3 eggs as well.
Some plant sources contain it too, like flax/chia seeds, walnuts, etc. Microalgae and seaweed are a very rich source as well.
Scroll down for references.
VW: What are some of the misconceptions surrounding vitamin supplementation?
FF:
X Supplements are ineffective and unnecessary if dairy/meat/algal or yeast food sources are integrated into one’s diet:
Most foods are nutrient sparse from industrial processing and food handling (transport, washing, cooking, etc.) and vitamin B12 is overlooked because of this generalization.
X Supplements as a bad sign of dietary habits:
Supplements are not a sign of bad dietary habits being put into practice; most people should adapt to the concept that enzymes, probiotics, and vitamin/mineral supplements should be part of a normalized nutritive plan for a functional human body, as this is how our bodies are adapting to urbanized modalities of living.
VW: How dangerous is it to take vitamin B12 supplements?
FF:
The contamination of vitamin B12 supplements with heavy metals is a constant worry since these metals (cyanide, cadmium, arsenic, mercury, etc.) are known to cause toxicity.
This all depends on the brand and the studies conducted to prove and ensure their product safety.
Certified approved brands make sure to keep these heavy metal concentrations under a level that is safe for consumption.
However, I would recommend supplementing with methylcobalamin rather than cyanocobalamin (the synthetic form of vitamin B12), as there aren’t any conclusive results on the long-term side effects of cyanide (compounded to cyanocobalamin) accumulation in our organs, mainly our liver.
I would generally recommend methylcobalamin or adenocobalamin over cyanocobalamin because they are forms of vitamin B12 that are retained for a longer period over cyanocobalamin, making them more efficient for storing enough of the vitamin.
This does not mean that cyanocobalamin is not necessary to take if the other forms are not available. The risk of not getting any of this vitamin is far worse than an exposure to unwanted chemicals.
VW: Should vegans take vitamin B12 supplements?
FF: People with digestive problems that are constantly overlooked such as gastritis, ulcerative colitis, Crohn’s disease, celiac, IBS, etc. should supplement with vitamin B12.
People with a prolonged history of anemia and a hematological blood panel that is chronically abnormal (MCV, Hgb, and Hct) should consult with a physician and consider supplementing. In fact, people with a history of unresolved anemias should investigate this and possibly consider B12 injections.
People with inflammatory diseases such as pancreatitis should consider supplementing since the pH and enzymatic functions are compromised in this case.
These are all conditions that should be considered whether a person is on a plant-based diet or not. Genetics also play a very important role that is very much overlooked in terms of vitamin B12 metabolism, as this can interfere with proper vitamin B12 intake that might require supplementation.
Vegans, vegetarians, and anyone following a plant-based lifestyle should consider synthetic supplementation of vitamin B12 (common commercial analogues are methylcobalamin and cyanocobalamin), as most food consumed is devoid of that vitamin and fortified food consumption [in its moderate amounts] wouldn’t suffice the daily requirements.
Avoid using algal-based supplements with vitamin B12 or during a meal rich in vitamin B12, as these might contain vitamin B12 inhibitors that would exasperate a vitamin B12 deficiency.
All studies on algal-derived vitamin B12 compounds have been proven to be other compounds with similar molecular configuration to the vitamin, making them act as a pseudovitamin, thus interfering with vitamin B12 absorption by competing on.
VW: Is it dangerous to take Omega-3 supplements?
FF: Most omega-3 supplements are fish oil-derived or based, and the manufacturing process does not eliminate the heavy metal or industrial product content in them, as most products in the market are high in mercury and PCBs.
Fish oil in the form of omega-3 supplementation is not necessary and will not make our bodies healthier (studies done on fish oil supplementation are inconclusive in terms of their beneficial effects, and other studies done on their negative impact from pollutants prove harmful risks on an individual’s health).
It is always advised to eat the fish over the fish oil supplement – at least this way the individual is aware of the omega-3 source. The bigger the fish, the higher the mercury content. Despite available studies proving that these metals are insignificant with respect to other food sources in eggs, vegetables, and meat, the long-term exposure of these supplements may cause harm.
VW: Should Vegans take omega-3 supplements?
FF:
The best way to ensure proper omega-3 intake is to invest in plant-based sources like flaxseed oil, walnuts, chia seeds, and supplements/powders derived from microalgae such as Spirulina.
It is also best to maximize omega-3 intake by not eating large amounts of omega-6 with the meal (e.g. not adding peanut butter or olive oil when adding flax or chia seeds).
While I don’t advise the intake of Spirulina for vitamin B12, it could be a good addition in terms of EPA and DHA. The best way to take it is possibly on a meal where vitamin B12 is not a dominant nutrient in the food and if the B12 supplement has been taken on a previous meal.
Scroll down for references.
VW: Are fortified foods enough to cover supplementation?
FF: This goes down to a lot of factors we need to consider:
- The efficiency of our bodies in nutrient absorption, especially in terms of digestive and other related health problems like Crohn’s disease, pancreatitis, gastrectomy surgery, etc.
- The amount of fortified food consumed per day and the quantities being absorbed per one meal.
- Aging is a contributing factor which leads to reduced nutrient absorption with time – this phenomenon might require specific chemical compounding of nutrients that are available via pharmaceutical supplements that would give the greatest yield of nutrient absorption which fortified food wouldn’t suffice.
- The type of diet being practiced: people following a plant-based diet are definitely advised to take supplements along with fortified food products, as the amount that totals at the end of the day does not ensure complete absorption due to the metabolic fate of these nutrients that is normally skewed from interacting compounds in plant food sources that interfere with nutrient absorption and distribution. This skewness in metabolic fate is also evident with people that consume meat, but the difference is an efficiency in metabolic pathways that have been assembled over the years for a greater yield in absorption from meat and animal consumption.
- The socio-economic factor that is almost not taken into consideration: a lot of these fortified commodities are not available as widely as we may think they are – supplementation, even if through nutritional aid, is necessary and might be essential in this case.
VW: Any other general recommendations for supplementing B12/Omega-3 in a plant-based diet?
FF:
General Dietary Recommendations for Vitamin B12:
- Recommended daily amount of vitamin B12 is 2.4 micrograms/day. A human excretes an average of 5-6 micrograms of B12 per day.
- A recommended daily amount of 6-7 micrograms/day or higher (e.g. in supplemental form of 1,0000 mcg/day) can also be used with people suffering from gastritis, celiac disease, and other inflammatory digestive problems).
- 30-40% of the elderly population has a significant reduction of vitamin B12 absorption due to decreased digestive potency and will require high dose supplementation.
- Vegetarian and vegan populations are at a risk of developing vitamin B12 deficiencies, especially if they commonly use yeast and algae-derived supplements for vitamin supplementation.
- More studies are needed on algal food samples, since the growing conditions of algae can alter vitamin B12 content in them (they aren’t main vitamin synthesizers and possibly contain many other active unidentified compounds which might possibly interfere with vitamin B12 metabolism).
- With every meal eaten, only 1-2 micrograms of vitamin B12 can be absorbed. This is due to the intrinsic factor (IF) binding capacity to the vitamin, with a maximum binding capacity of 2 mcg/meal. The intrinsic factor is an important transporter found in the stomach which transports B12 from the food to the small intestine where it can be absorbed.
The higher the B12 ingestion during one meal, the less it is absorbed..
General Dietary Recommendations for Omega-6 and Omega-3:
Based a 2,000-kcal diet:
9 -18 g of omega-6 f.a.s
2.2 — 4.4 g of omega-3 f.a.s
To achieve a ratio of 1:1, you would need to reduce omega-6 fatty acids, increase omega-3 fatty acids, or do both: this would translate to the following: 7-9 g of omega-6 fatty acids & 7 – 9 g of omega-3 fatty acids.
References
Section. 1:
Dewell, A., Marvasti, F. F., Harris, W. S., Tsao, P., & Gardner, C. D. (2011). Low- and high-dose plant and marine (n-3) fatty acids do not affect plasma inflammatory markers in adults with metabolic syndrome. The Journal of nutrition, 141(12), 2166–2171. https://doi.org/10.3945/jn.111.142240
Doughman SD, Krupanidhi S, Sanjeevi CB. Omega-3 fatty acids for nutrition and medicine: Considering microalgae oil as a vegetarian source of EPA and DHA. Curr Diabetes Rev. 2007;3(3):198-203.
Harnack K, Andersen G, Somoza V. Quantitation of alpha-linolenic acid elongation to eicosapentaenoic and docosahexaenoic acid as affected by the ratio of n6/n3 fatty acids. Nutr Metab (Lond). 2009;6:8.
Indu M, Ghafoorunissa. n-3 fatty acids in Indian diets—comparison of the effects of precursor (alpha-linolenic acid) vs product (long-chain n-3 polyunsaturated fatty acids). Nutr Res. 1992;12:569-582.
Kusbak R, Drapeau C, van Cott E, Winter H. Blue-green algaaphanizomenon flos-aquae as a source of dietary polyunsaturated fatty acids and a hypocholesterolemic agent. Presented at: Annual Meeting of the American Chemical Society; March 21-25, 1999; Anaheim, Calif.
Masters C. Omega-3 fatty acids and the peroxisome. Mol Cell Biochem. 1996;165(2):83-93.
Dangers behind taking supplements:
Eilander A, Hundscheid DC, Osendarp SJ, Transler C, Zock PL. Effects of n-3 long chain polyunsaturated fatty acid supplementation on visual and cognitive development throughout childhood: a review of human studies. Prostaglandins Leukot Essent Fatty Acids. 2007;76(4):189‐203. doi:10.1016/j.plefa.2007.01.003
Hong, M. Y., Lumibao, J., Mistry, P., Saleh, R., & Hoh, E. (2015). Fish Oil Contaminated with Persistent Organic Pollutants Reduces Antioxidant Capacity and Induces Oxidative Stress without Affecting Its Capacity to Lower Lipid Concentrations and Systemic Inflammation in Rats. The Journal of nutrition, 145(5), 939–944. https://doi.org/10.3945/jn.114.206607
Kris-Etherton PM, Harris WS, Appel LJ; American Heart Association. Nutrition Committee. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease [published correction appears in Circulation. 2003 Jan 28;107(3):512.]. Circulation. 2002;106(21):2747‐2757. doi:10.1161/01.cir.0000038493.65177.94
Other:
Dagnelie, Pieter & van W. A, Staveren & Berg, H.M. (1991). Vitamin B12 from algae appears not to be bioavailable. American Journal of Clinical Nutrition – AMER J CLIN NUTR. 53. 695-697.
Foods highest in Vitamin B12 (based on levels per 100-gram serving)”. Nutrition Data. Condé Nast, USDA National Nutrient Database, release SR-21. 2014. Retrieved October 29, 2018
Watanabe, H. Katsura, S. Takenaka, T. Fujita, K. Abe, Y. Tamura, T. Nakatsuka, Y. Nakano: Pseudovitamin B12 is the predominate cobamide of an algal health food, spirulina tablets. J Agric Food Chem, 1999, 47, 4736–474
Greer JP (2014). Wintrobe’s Clinical Hematology Thirteenth Edition. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins. ISBN 978-1-4511-7268-3. Chapter 36: Megaloblastic anemias: disorders of impaired DNA synthesis by Ralph Carmel
Herbert, G. Drivas: Spirulina and vitamin B12. JAMA, 1982, 248(23), 3096-7
Merchant, R. E., Phillips, T. W., & Udani, J. (2015). Nutritional supplementation with chlorella pyrenoidosa lowers serum methylmalonic acid in vegans and vegetarians with a suspected vitamin B₁₂ deficiency. Journal of Medicinal Food, 18(12), 1357.
Miller A, Korem M, Almog R, Galboiz Y (June 2005). “Vitamin B12, demyelination, remyelination and repair in multiple sclerosis”. Journal of the Neurological Sciences. 233 (1–2): 93–7. doi: 10.1016/j.jns.2005.03.009. PMID 15896807
Pratt, E. Johnson: Deficiency of vitamin B12 in Chlorella. J Pharm Sci, 1968, 57(6), 1040-1
Watanabe, F. (2007). Vitamin B12 sources and bioavailability. Experimental Biology and Medicine (Maywood, N.J.), 232(10), 1266.
Watanabe, S. Takenaka, H. Katsura, S. A. Masumder, K. Abe, Y. Tamura, Y. Nakano: Dried green and purple lavers (Nori) contain substantial amounts of biologically active vitamin B12 but less of dietary iodine relative to other edible seaweeds. J Agric Food Chem, 1999, 47(6), 2341-3
Watanabe, Y. Yabuta, T. Bito, F. Teng: Vitamin B12-Containing Plant Food Sources for Vegetarians. Nutrients, 2014, 6, 1861-1873
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