Vegetarians and Stroke Risk Factors—Vitamin B12 & Homocysteine?

B12 deficiency and higher homocysteine levels factor into stroke risk. Not taking B12 supplements or regularly eating B12 fortified foods may explain the higher stroke risk found among vegetarians.

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I have updated my recommendation (https://nutritionfacts.org/2011/09/12...) for B12 supplementation. I now suggest at least 2,000 mcg (µg) cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement taken on an empty stomach, or at least 50 mcg daily of supplemental cyanocobalamin (you needn’t worry about taking too much). You can also do servings of B12-fortified foods three times a day (at each meal), each containing at least 190% of the Daily Value listed on the nutrition facts label (based on the new labeling mandated to start January 1, 2020—the target is 4.5 mcg three times a day). Note that those over age 65 only have basically one option, taking 1000 micrograms a day.

We started this stroke series what to eat (http://nutritionfacts.org/video/what-...) and not eat (http://nutritionfacts.org/video/what-...) for stroke prevention, and whether vegetarians really have a higher stroke risk (http://nutritionfacts.org/video/do-ve....

The last few videos have looked at specific factors:
• Vegetarians and Stroke Risk Factors—Vitamin D? (http://nutritionfacts.org/video/veget...)
• Vegetarians and Stroke Risk Factors—Omega 3s? (http://nutritionfacts.org/video/veget...)
• Vegetarians and Stroke Risk Factors—Vegan Junk Food? (http://nutritionfacts.org/video/veget...)
• Vegetarians and Stroke Risk Factors—Saturated Fat? (http://nutritionfacts.org/video/veget...)
• Vegetarians and Stroke Risk Factors—Animal Protein? (http://nutritionfacts.org/video/veget...)
• Vegetarians and Stroke Risk Factors—Vitamin B12 & Homocysteine? (http://nutritionfacts.org/video/veget...)

Stay tuned for:
• How to Test for Functional Vitamin B12 Deficiency (http://nutritionfacts.org/video/how-t...)
• Should Vegetarians Take Creatine to Normalize Homocysteine? (http://nutritionfacts.org/video/shoul...)
• The Efficacy and Safety of Creatine for High Homocysteine (http://nutritionfacts.org/video/the-e...)

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Thanks for watching. I hope you’ll join in the evidence-based nutrition revolution!
-Michael Greger, MD FACLM

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