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@ARTICLE{Selinger:148762,
      author       = {E. Selinger and T. Kühn$^*$ and M. Procházková and M.
                      Anděl and J. Gojda},
      title        = {{V}itamin {B}12 {D}eficiency {I}s {P}revalent {A}mong
                      {C}zech {V}egans {W}ho {D}o {N}ot {U}se {V}itamin {B}12
                      {S}upplements.},
      journal      = {Nutrients},
      volume       = {11},
      number       = {12},
      issn         = {2072-6643},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2019-03275},
      pages        = {3019},
      year         = {2019},
      abstract     = {As not much is known about the prevalence and predictors of
                      nutritional deficiencies among vegans in the Czech Republic,
                      we evaluated whether supplement use and duration of
                      adherence to the vegan diet are associated with the risk of
                      cobalamin and iron deficiencies. Associations between
                      self-reported supplementation and duration of vegan diet
                      with biomarkers of cobalamin (serum cobalamin,
                      holotranscobalamin, homocysteine, folate) and iron status
                      (serum ferritin, iron binding capacity, transferrin and
                      saturation of transferrin) were assessed by cross-sectional
                      analyses of medical data from a clinical nutrition center.
                      Data from 151 (72 females) adult vegans (age 18-67 years),
                      who were free of major chronic diseases and 85 (40 females)
                      healthy non-vegans (age 21-47 years) were analyzed. Overall,
                      vegans had significantly lower cobalamin, hemoglobin and
                      ferritin levels, but higher folate and MCV values compared
                      to non-vegans. Vegans not using cobalamin supplements were
                      at higher risk of low plasma cobalamin than regularly
                      supplementing vegans (OR: 4.41, $95\%$ CI 1.2-16.16 for
                      cobalamin, OR: 19.18, $95\%$ CI 1.02-359.42 for
                      holotranscobalamin), whereas no significant differences in
                      cobalamin status related to duration of the vegan diet were
                      observed. Regularly supplementing vegans had similar levels
                      of cobalamin/holotranscobalamin as non-vegans. Despite lower
                      ferritin and hemoglobin levels, there was no indication of a
                      higher risk of iron-deficiency among vegans. To conclude
                      cobalamin deficiency risk depends on supplementation status
                      and not on the duration of an exclusive vegan diet, which
                      underlines the need to integrate cobalamin status monitoring
                      and counselling on supplement use in routine clinical care
                      in the Czech Republic.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31835560},
      doi          = {10.3390/nu11123019},
      url          = {https://inrepo02.dkfz.de/record/148762},
}