Compromiso neurológico por déficit de vitamina B12 en un lactante / Neurologic involvement due to vitamin B12 deficiency in an infant

El déficit de vitamina B12 es una de las complicaciones más importantes que puede producir el vegetarianismo. Los lactantes hijos de madres vegetarianas tienen riesgo aumentado de deficiencia y de presentar compromiso neurológico irreversible si esta no se identifica y corrige adecuadamente.Se describe el caso de un lactante de un mes y veinte días que consultó por episodios paroxísticos de mecanismo epileptógeno, en el cual los estudios complementarios permitieron identificar un déficit de vitamina B12 como causa de estos. Tras la confirmación diagnóstica, se instauró el tratamiento con vitamina B12 intramuscular, con remisión completa de los síntomas, buena evolución posterior y desarrollo psicomotor sin alteraciones.Teniendo en cuenta las tendencias alimentarias actuales, es necesario incorporar, en la práctica clínica habitual, la anamnesis nutricional materna detallada para detectar precozmente el riesgo de déficit de esta vitamina y prevenirlo

Vitamin B12 deficiency is one of the main complications of vegetarianism. Infants of vegetarian mothers have greater risk of deficiency and irreversible neurological compromise if deficiency is not identified and treated. We describe the case of a 1 month 20 days-old infant who consulted due to paroxysmal episodes of epileptogenic mechanism; laboratory tests identified a deficiency in vitamin B12 as the cause. After confirmation of diagnosis, treatment with intramuscular vitamin B12 was established with full remission of symptoms, good evolution and psychomotor development without alterations.Considering current alimentary trends, it is necessary to include a detailed maternal nutritional anamnesis in regular clinical practice, in order to detect the risk of this vitamin deficiency at an early stage and to prevent it.

Dietas vegetarianas en alumnos universitarios / Vegetarian diets in first year university students

INTRODUCCIÓN: Se ha observado un aumento en la popularidad de las dietas vegetarianas, en especial en la población adolescente y adulto joven. Estas dietas se presentan como saludables y balanceadas pero las recomendaciones son controversiales en cuanto a los potenciales déficit nutricionales. OBJETIVO: Identificar la frecuencia y tipos de dieta vegetariana utilizada, su motivación y fuentes de información. PACIENTES Y MÉTODO: Estudio transversal y analítico en universitarios de primer año de la Pontificia Universidad Católica de Chile (PUC). Se realizó una encuesta vía online obteniendo información demográfica y caracterización de dietas de aquellos que se consideraban vegetarianos. Las variables fueron analizadas mediante el software IDM SPSS Statistics® y en planilla Excel® de forma cuantitativa. RESULTADOS: 152 alumnos respondieron la encuesta (15,2% del total), siendo el 49,4% de estos vegetariano. El 32,4% inició este patrón alimentario entre los 12-18 años; sus motivaciones más frecuentes fueron las medio ambientalistas (91,9%) y animalistas (72,9%). El 52,9% de los vegetarianos reciben suplementación de vitamina b 12 pero solo un 15,9% reportó presentar este déficit. El 75,7% obtiene información relacionada acerca de las dietas vegetarianas a través de medios digitales. CONCLUSIÓN: Se encontró un alto porcentaje de estudiantes vegetarianos en las encuestas contestadas, lo que hace necesario que los profesionales de salud estén capacitados en esta área para asegurar una adecuada educación nutricional, suplementación si es necesario, y seguimiento.

INTRODUCTION: There has been an increase in the popularity of vegetarian diets, especially among adolescents and young adults. These diets seem to be healthy and balanced, but the recommendations are contro versial regarding potential nutritional deficits. OBJECTIVE: To identify the frequency and types of ve getarian diet used, their motivation, and sources of information. PATIENTS AND METHOD: Cross-sec tional analytical study in freshmen students from the Pontifical Catholic University of Chile (PUC). Through an online survey, we collected demographic information and diet characterization of those who considered themselves as vegetarians. Variables were analyzed using IDM SPSS Statistics® soft ware and in Excel® spreadsheet in a quantitative way. RESULTS: 152 students answered the survey (15.2% of the sample) and, out of these, 49.4% were vegetarian. 32.4% started this eating pattern bet ween the ages 12 and 18 and among their most frequent motivations were environmentalists (91.9%) and animalists (72.9%). 52.9% of vegetarians take vitamin B 12 supplementation but only 15.9% reported having this deficiency. 75.7% obtain information related to vegetarian diets through digital media. CONCLUSION: In the surveys answered, we found a high percentage of vegetarian students, the refore, health professionals need to be trained in this area to assure adequate nutritional education, supplementation if necessary, and follow-up.

La dieta vegetariana en niños y preadolescentes / Vegetarian diet in children and pre-adolescents

Basándonos en una consulta de una niña que desea realizar una dieta vegetariana se realizó una búsqueda bibliográfica para identificar evidencia sobre el impacto de este tipo de dieta en la salud. La evidencia actual indica que la dieta vegetariana es una opción saludable que no produciría un impacto negativo en el crecimiento y desarrollo de los niños, si bien existiría la posibilidad de déficit de micronutrientes. (AU)

Based on a consultation of a girl who wishes to make a vegetarian diet, a literature search was conducted to identify evidence on the impact of this type of diet on health. Current evidence indicates that the vegetarian diet is a healthy option that would not have a negative impact on the growth and development of children, although there is a possibility of micronutrient deficits. (AU)

Manifestaciones neurológicas del déficit de vitamina B12 en pediatría / Neurological manifestations of vitamin B12 deficiency in pediatrics

Introducción: El déficit de vitamina B12 genera un proceso de desmielinización neuronal, manifestándose con anormalidades cerebrales y degeneración del cordón espinal. En pediatría, las manifestaciones neurológicas son una de las formas de presentación. Usualmente, se observa en niños alimentados con lactancia materna exclusiva cuyas madres tienen escaso consumo de alimentos de origen animal. Objetivo: Describir las manifestaciones neurológicas del déficit vitamínico e identificar factores de riesgo alimentario. Pacientes y método: Se realizó un estudio de serie de casos de 6 pacientes internados en el Hospital Garrahan con deficiencia de vitamina B12 en el periodo comprendido entre julio 1996 y diciembre 2013 cuyo diagnóstico se realizó mediante determinación sérica de vitamina B12. Resultados: La edad media de presentación de los síntomas fue de 3,6 meses. El 83.3% de los pacientes presentaron convulsiones, 60% las manifestaron de forma exclusiva y en el 40% se asociaron a hipotonía y pérdida de pautas madurativas. Un 16.7% presentó hipotonía más pérdida de pautas sin presentar convulsiones. Respecto de la alimentación, la totalidad recibía lactancia materna, el 83.3% de forma exclusiva, el 16.7% asociada a leche maternizada. En cuanto a la dieta de las madres de pacientes alimentados con pecho materno exclusivo, el 40% realizaba dieta vegetariana estricta, en otro 40% no se hallaron datos relacionados con su alimentación, pero se diagnosticó déficit de vitamina B12 por dosaje sérico, y el 20% restante refería recibir dieta general. Conclusión: Ante el aumento de la incidencia de la población vegetariana/vegana, se debería considerar la deficiencia de vitamina B12 ante pacientes con manifestaciones neurológicas de etiología desconocida, dado que es una enfermedad con un tratamiento inocuo y efectivo, y se evidencia mejoría clínica, y de los parámetros de laboratorio en todos los casos (AU)

Introduction: Vitamin B12 deficiency may cause a process of neuronal demyelination associated with brain abnormalities and degeneration of the spinal cord. In pediatrics, neurological manifestations are one of the forms of presentation. It is usually observed in exclusively breast fed children whose mothers do not consume food of animal origin. Aim: To describe neurological manifestations of vitamin B12 deficiency and identify nutritional risk factors. Patients and method: A series of 7 patients admitted to Hospital Garrahan with vitamin B12 deficiency diagnosed by vitamin B12 serum level testing were evaluated between July and December of 1996-2013. Results: Mean age at symptom presentation was 3,6 months. Overall, 83.3% of the patients presented with seizures, in 60% as the only symptom and in 40% associated with hypotonia and developmental delay. Hypotonia and developmental delay without seizures were observed in 16.7%. A single patient presented with pancytopenia only. All infants were breastfed, 83.3% exclusively, 16.7% in combination with formula, and the remaining 14.3% in combination with food. Regarding the diet of the mothers of the exclusively breastfed children, 40% followed a strict vegetarian diet, for another 40% no data on their diet were available but they were diagnosed with vitamin B12 based on serum values, and the remaining 20% followed a general diet. Conclusion: As the incidence of vegetarianism/veganism is increasing in the population, vitamin B12 deficiency should be considered in patients with neurological symptoms of unclear etiology, as treatment of the condition is innocuous and effective and leads to clinical and laboratory parameter improvement in all cases (AU)

Compromiso neurológico y hematológico por déficit de vitamina B12 en lactante hijo de madre vegetariana: caso clínico / Hematological and neurological compromise due to vitamin B12 deficit in infant of a vegetarian mother: case report

Introducción: La deficiencia de vitamina B12 es una de las complicaciones del vegetarianismo y sus variantes. Los lactantes de madres vegetarianas tienen mayor riesgo de deficiencia y son más lábiles a sus efectos. Objetivo: Relatar un caso para alertar sobre la importancia de la sospecha de deficiencia de vitamina B12 en hijos de madres con hábito vegetariano. Caso clínico: Se presenta una lactante de 12 meses, hija de una mujer vegetariana de larga data, que se presenta con compromiso neurológico y hematológico por déficit de vitamina B12. Luego de un corto período de administración de cianocobalamina parenteral y apoyo enteral nutricional, evoluciona con una notoria mejoría clínica y de laboratorio, aunque aún presenta retraso del desarrollo residual. Conclusiones: La deficiencia de vitamina B12 no es frecuentemente sospechada por el pediatra en lactantes sanos. Sus manifestaciones clínicas pueden ser tan inespecíficas, como la apatía, el rechazo alimentario y el deterioro progresivo del desarrollo psicomotor. Una anamnesis nutricional breve realizada a la madre (con mayor énfasis en aquellas vegetarianas) para estimar sus reservas en el periodo previo, durante y después del parto pueden ser fundamentales para detectar el riesgo déficit de esta vitamina en el niño pequeño.

Introduction: Vitamin B12 deficiency is extremely common in strict vegetarians and their variants. Infants of vegetarian mothers have a higher risk of deficiency and are more prone to its effects. Objective: To report a case in order to warn people about the importance of suspected vitamin B12 deficiency in children of vegetarian mothers. Case report: A 12-month old infant, daughter of a longtime vegetarian woman, who presented neurological and hematological compromise due to vitamin B12 deficiency, is discussed. After a short period of parenteral administration of cyanocobalamin and enteral nutrition, the patient evolved with clinical and laboratory improvement, although she still had residual development delay. Conclusions: Vitamin B12 deficiency is often not suspected by the pediatrician in healthy infants. Clinical manifestations can be nonspecific, such as apathy, food refusal and progressive impairment of psychomotor development. A nutritional anamnesis performed on the mother (with great emphasis on those strict vegetarians) to estimate her reserves in the period prior to, during and after delivery can be critical to detect the risk of this vitamin deficiency in young children.

Estado nutricional, estilo de vida e risco cardiovascular de ovolactovegetarianos e onívoros / Nutritional status, lifestyle and cardiovascular risk in lacto-ovo vegetarians and omnivores

O objetivo do presente trabalho foi avaliar características sócioeconômicas, estilo de vida, consumo alimentar, estado nutricional e o risco cardiovascular através de indicadores antropométricos de obesidade central de ovolactovegetarianos e onívoros. Para cada ovolactovegetariano foram selecionados dois onívoros de mesmo sexo e idade semelhante, visando ao pareamento das amostras nesses critérios e ao aumento do poder dos testes estatísticos. A amostra foi composta por 87 indivíduos, sendo 29 ovolactovegetarianos e 58 onívoros, com média geral de idade de 40 + 13 anos e 58,6% do sexo masculino. Dentro das características socioeconômicas, apenas o número de moradores por domicílio diferiu; os ovolactovegetarianos apresentaram um percentual maior na categoria de 5 ou mais pessoas. Quanto ao estilo de vida, os grupos diferiram apenas no hábito do tabagismo (p < 0,001), onde os onívoros apresentaram maior proporção de fumantes. Não houve diferença significativa nos valores médios entre os grupos em nenhuma das variáveis antropométricas estudadas. Nas variáveis de consumo, não foi encontrada diferença na ingestão calórica, porém o consumo de proteínas, lipídios totais, gordura saturada e colesterol foram maiores na dieta dos onívoros. Já o consumo de carboidratos e fibras foi maior nos ovolactovegetarianos. O presente estudo sugere que embora o perfil de consumo alimentar entre os ovolactovegetarianos seja considerado mais saudável, pelo menor consumo de gordura total, ácidos graxos saturados e colesterol, quando o estilo de vida e o consumo calórico total são semelhantes não há diferenças significativas no estado nutricional e nos indicadores antropométricos de risco cardiovascular.

The aim of the present study was to assess socioeconomic characteristics, dietary intake, nutritional status and cardiovascular risk (using anthropometric indicators of central obesity) in lacto-ovo vegetarians and non-vegetarians. Two non-vegetarians were selected for each vegetarian (paired for gender and age) in order to increase the power of the statistical tests. The sample was made up of 87 individuals (58.6% males; 29 vegetarians and 58 non-vegetarians) with a mean age of 40 + 13 years. Among the socioeconomic characteristics, only the number of residents per household differed between groups, with a greater percentage of homes with five or more residents in the vegetarian group. Concerning lifestyle, the groups differed with regard to smoking habits (p < 0.001), with a higher proportion of smokers among the non-vegetarians. There were no significant differences between groups in any of the anthropometric variables studied. Concerning dietary intake, no difference between groups was found with regard to total calorie intake, but the consumption of proteins, total lipids, saturated fat and cholesterol was higher among the non-vegetarians, whereas carbohydrate and fiber intake was higher among the vegetarians. The results of the present study suggest that, although a lacto-ovo vegetarian diet is considered healthier due to the lower consumption of total fat, saturated fatty acids and cholesterol, there are no significant differences in nutritional status or anthropometric indicators of cardiovascular risk when lifestyle and total calorie intake are similar.

Megaloblastic anemia: Back in focus.

Megaloblastic anemia (MA), in most instances in developing countries, results from deficiency of vitamin B12 or folic acid. Over the last two to three decades, incidence of MA seems to be increasing. Of the two micronutrients, folic acid deficiency contributed to MA in a large majority of cases. Now deficiency of B12 is far more common. In addition to anemia, occurrence of neutropenia and/or thrombocytopenia is increasingly being reported. Among cases presenting with pancytopenia, MA stands out as an important (commonest cause in some series) cause. This article focuses on these and certain other aspects of MA. Possible causes of increasing incidence of MA are discussed. Observations on other clinical features like neurocognitive dysfunction, associated hyperhomocysteinemeia and occurrence of tremors and thrombocytosis during treatment are highlighted.

Dieta vegetariana en la edad pediátrica / Vegetarian diet at pediatric age

The vegetarian diet constitutes an option among particular nutrition practices that can be adopted by the family or by the child-adolescent inspired by different motivations. A good planning is critical in order to appropriately satisfy the macro- and micro-nutrient requirements at different ages and stages of life, so that the child achieves normal growth and development. There are nutrients to which we must pay attention, because by excluding certain types of food from our diet a deficiency may arise. Among this types of food are: Omega-3 fatty acids, specially docosahexaenoic acid (DHA) which is important for the neurodevelopment and for the improvement of the sense of vision during pregnancy and the first year of life; iron deficiency can cause anemia; zinc, calcium and vitamin D deficiency that can have an impact on bone mineralization in the long term; and vitamin B12, this one is very important because its deficiency can cause potential neurological damages and hematological alterations in the child. This article presents a review on how to assess the diet of the child, the suggested study and the management of deficiencies, which can be handled by a well-balanced intake of other types of food and by the consumption of fortified foods or pharmacological supplementation in order to prevent clinical complications resulting from specific deficiencies. The benefits of a vegetarian diet are mainly the following: an improvement of the lipid panel, a reduction in the risk of cardiovascular diseases and cancer. In addition, people that follow a vegetarian diet have healthier life habits.

La dieta vegetariana es una opción dentro de las alimentaciones especiales, la cual por diferentes motivaciones, la familia o el niño-adolescente puede adoptar. Resulta muy importante una buena planificación de ésta para cubrir adecuadamente los requerimientos de macro y micronutrientes en las diferentes edades de manera que el niño logre un crecimiento y desarrollo normales. Existen nutrientes a los cuales debemos estar atentos, porque al excluir ciertos alimentos de la dieta se puede propiciar su deficiencia. Dentro de estos alimentos están: los ácidos grasos omega 3, especialmente el docosahexaenoico (DHA) que participa en el neurodesarrollo y mejora la agudeza visual al estar presente durante el período de gestación y primer año de vida; el hierro, que al estar deficiente puede producir anemia; zinc, calcio y vitamina D que puede repercutir en la mineralización ósea como consecuencia a largo plazo; y la vitamina B 12, esta última de gran importancia por el potencial daño neurológico y alteraciones hematológicas que puede producir su carencia en el niño. En este artículo se revisa cómo evaluar la dieta de cada niño; el estudio sugerido y el manejo de las deficiencias, la cuales pueden ser manejadas mediante el consumo de otros alimentos en forma balanceada; y la utilización de alimentos fortificados o suplementación farmacológica de manera de evitar las complicaciones clínicas derivadas de las deficiencias específicas. Los beneficios de una dieta vegetariana son principalmente una mejoría del perfil lipídico, reducción del riesgo de enfermedades cardiovasculares y cánceres. Además, las personas que siguen una dieta vegetariana tienen hábitos de vida más saludables.

Risco cardiovascular em vegetarianos e onívoros: um estudo comparativo / Cardiovascular risk in vegetarians and omnivores: a comparative study

FUNDAMENTO: Estudos clínicos e epidemiológicos demonstram grande associação da dieta com os agravos crônicos, particularmente com os eventos cardiovasculares, apesar de ainda não compreendidos todos os seus mecanismos de ação. OBJETIVO: Descrever e analisar o risco cardiovascular em vegetarianos e onívoros residentes na Grande Vitória/ES, na faixa etária de 35 a 64 anos. MÉTODOS: Para avaliação do risco cardiovascular foi realizado estudo de coorte histórico com 201 indivíduos. Foram incluídos 67 vegetarianos há no mínimo 5 anos, provenientes da Grande Vitória, e 134 onívoros, participantes do Projeto MONICA/Vitória, pareados por classe socioeconômica, sexo, idade e raça. Medidas bioquímicas e hemodinâmicas foram obtidas na Clínica de Investigação Cardiovascular da UFES. Para comparação de proporções, foi usado o teste chi2 e calculada a razão de prevalência. O risco cardiovascular foi calculado por meio do algoritmo de Framingham. RESULTADOS: A idade média do grupo foi de 47 ± 8 anos e o tempo médio de vegetarianismo 19 ± 10 anos, sendo a dieta ovolactovegetariana seguida por 73 por cento dos vegetarianos. Pressão arterial, glicemia de jejum, colesterol total, colesterol de lipoproteína de baixa densidade (LDL-colesterol) e triglicerídeos foram mais baixos entre vegetarianos (p<0,001). O colesterol de lipoproteína de alta densidade (HDL-colesterol) não foi diferente entre os grupos. De acordo com o algoritmo de Framingham, os vegetarianos apresentaram menor risco cardiovascular (p<0,001). CONCLUSÃO: A alimentação onívora desbalanceada, com excesso de proteínas e gorduras de origem animal, pode estar implicada, em grande parte, no desencadeamento de doenças e agravos não-transmissíveis, especialmente no risco cardiovascular.

BACKGROUND: Clinical and epidemiological studies have demonstrated a strong association between eating habits and chronic diseases, particularly cardiovascular events, although not all the mechanisms of action are understood. OBJECTIVE: To describe and analyze the cardiovascular risk (CVR) in vegetarians and omnivores residing in Greater Vitória, State of Espírito Santo, Brazil, in the age range from 35 to 64 years. METHODS: To evaluate CVR in the groups, a historical cohort study with 201 individuals was conducted. Sixty seven individuals who had been following a vegetarian diet for at least five years, and who were from Greater Vitória, as well as 134 omnivores participating in the MONICA Project/Vitória matched for socioeconomic class, gender, age and race were included. Biochemical and hemodynamic measurements were obtained in the Cardiovascular Investigation Clinic of UFES. For comparison of proportions, the chi2 test was used, and the Prevalence Ratio was calculated. The CVR was calculated using the Framingham algorithm for the group as a whole, and for separate genders. RESULTS: The mean age of the group was 47±8 years and the mean duration of vegetarianism was 19±10 years; the lacto-ovo vegetarian diet was followed by 73 percent of the vegetarians. Blood pressure, fasting plasma glucose, total cholesterol, LDL-c, and triglycerides were lower among vegetarians (p<0.001). HDL-c levels were not different between the groups. According to the Framingham algorithm, vegetarians had a lower CVR (p<0.001). CONCLUSION: Unbalanced omnivorous diet with excess animal protein and fat may be implicated, to a great extent, in the development of noncommunicable diseases and conditions, especially in the CVR.

Rol biológico y nutricional de la taurina y sus derivados / Biological and nutritional role of taurine and its derivatives

La taurina es ubicua en la naturaleza y su distribución y cantidad difiere en los diferentes organismos biológicos. Su rol antioxidante y osmoregulador ha sido ampliamente conocido. Su síntesis puede diferir en las distintas especies, lo cual tiene importancia en su rol fisiológico y en condiciones patológicas. La taurina es un nutriente esencial en felinos, como el gato, donde su ausencia en la dieta causa una serie de anormalidades. En el humano, la taurina puede ser considerada como un nutriente condicionalmente esencial, especialmente en niños que reciben nutrición parenteral total por tiempos prolongados. En niños prematuros, que son alimentados con fórmulas se recomienda su suplementación. En adultos, su importancia clínica está por ser demostrada en diferentes patologías

Hematological parameters, ferritin and vitamin B12 in vegetarians.

Hematological parameters and serum ferritin were compared between 179 vegetarians and 58 control subjects using Hematology analyzer H3 and microparticle enzyme immunoassay, respectively. Serum Vitamin B12 was also compared between 68 vegetarians and 30 control subjects using microparticle enzyme immunoassay. It was found that hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, white blood cells, neutrophils, serum ferritin and serum vitamin B12 in vegetarian were significantly lower than control subjects (P < 0.05). In addition, red cell distribution width and lymphocytes in vegetarians were significantly higher than control subjects (P < 0.05). There were 34 cases of iron deficiency in 179 vegetarians (19.%) which can be classified to iron depletion (4 cases), iron deficient erythropoiesis (12 cases) and iron deficiency anemia (18 cases). Vitamin B12 deficiency was found in 27 cases of 68 vegetarians (40%).

Indicadores de ansiedad y depresión en sujetos con diferentes tipos de alimentación: vegetarianos y omnívoros / Indicators of anxiety and depression in subjects with different kinds of diet: vegetarians and omnivores

The following study, one of the first done in Puerto Rico, investigate the different kinds of diet and the level of anxiety and depression that the subjects present. The sample consists of 80 subjects between 25 and 70 years age divided into two main groups (vegetarian versus no vegetarian) depending their diet consumption. The basic findings in the three psychological tests given (IDARE-1, IDARE-2 and CES-D) to the subjects demonstrate significant differences in anxiety and depression between groups. More anxiety and depression where reported in the no vegetarian groups in comparison with the vegetarian groups. In addition, diet analysis found more nutritional antioxidant agents levels in the vegetarian group in comparison with the no-vegetarian group

Is vegetarianism a precipitating factor for gallstones in cirrhotics?

AIM: To study the association of factors such as alcohol, smoking and vegetarianism with presence of gallstones amongst cirrhotics. PATIENTS AND METHODS: Data on alcoholism, smoking and vegetarianism was collected from the case records of 669 cirrhotics with (76) or without gallstones (593) retrospectively. Relative risk for the factors was computed individually and in combination controlling for the effects of alcoholism and smoking on vegetarianism. RESULTS: Alcoholism and smoking were of low relative risk [R.R-1.27 (95% CI 0.82 to 1.96), and 1.02 (95% CI 0.65 to 1.61) respectively] while vegetarianism was associated with high risk for gallstone formation in cirrhotics [R.R 2.74 (95% CI 1.65-4.53)]. Vegetarian men had a relative risk of 3.02 (95% CI 1.75-5.22) irrespective of their alcoholic status. If women were alcoholic the relative risk increased to 7.03 (95% CI 3.26-15.12). Controlling for effects of gender and alcoholism, vegetarian cirrhotics had a 3 times greater risk for gallstone formation [Mantel Haenszel Relative Risk 3.18 (95% CI MHRR 1.82-5.56)]. CONCLUSIONS: Cirrhotic, vegetarian women in South India have a much higher risk for gallstones, if they are alcoholic. Alcoholic men who are vegetarians are at a greater risk for gallstone disease.

Vitamin B1, B2 and B6 status of vegetarians.

The vitamin B1, B2 and B6 status was determined in 132 healthy vegetarians, age range 25-57 years who have been practising vegetarianism for 1-22 years. Sixty-eight healthy non-vegetarians were chosen as controls. The conventional methods to measure the activation coefficient alpha ETK, alpha EGR and alpha EAST were applied to assess the vitamin status of B1, B2 and B6 respectively. The value of 1.25 alpha ETK, 1.5 alpha EGR and 2.0 alpha EAST and above indicate a deficiency in the vitamin status. The results showed significantly poorer vitamin B1 and B6 status in vegetarians than in non-vegetarians, whereas, no significant difference in vitamin B2 status was found. None of the non-vegetarians were deficient in vitamin B1 but 3 of them (4.4%) were deficient in vitamin B6. On the other hand, 10 of vegetarians (7.6%) were deficient in vitamin B1; 38 (28.8%) in vitamin B6. A high prevalence of riboflavin deficiency was found in 32 (24.2%) of the vegetarians; as well as in 15 (22.2%) of the non-vegetarians. Only riboflavin status was significantly related with the duration of vegetarianism practiced. Vegetarians should be considered as the vulnerable group for vitamin B2 and vitamin B6 deficiencies. B-vitamins status should be checked and efforts should be made to improve through dietary counselling and nutritional education should be included and stress in the health education program in order to improve nutritional deficiencies.

Blood cell production and hemostatic mechanism in Thai vegetarians.

The activity of hemostatic mechanism and blood cell production of 50 Thai vegetarians and 30 nonvegetarians were compared. The hemostatic mechanism of both vegetarians and nonvegetarians showed no significant difference, whereas, a significant decrease in hemoglobin, hematocrit and red blood cell count with significant increase in hypersegmented neutrophils were found in vegetarians who had taken vegetarian diets for over 4 years.