Question

Emma is a 25-year-old woman who has been following a vegan diet for two years and has not consumed any food from animal sources. Her food intake on a vegan diet has been well balanced. She generally follows Canada's Food Guide by consuming a variety of vegetables including spinach, romaine lettuce, broccoli, carrots, sweet potato, squash, tomatoes and sweet peppers, and fruits like berries, bananas, apples melons, and pears. She consumes only whole grains, such as whole grain breads, oatmeal and brown rice, and chooses her proteins from nuts, seeds, and a variety of legumes. She takes no supplements. When Emma visits her doctor for a check-up, she orders blood work to assess Emma's vitamin B12 status and finds that Emma's blood levels are insufficient, i.e. low but, fortunately, not yet so low that she is considered deficient.

Answer 1

Vitamin B12 or cobalamin is a water-soluble vitamin found in considerable amount only in animal-derived foods.

Thus, the recommendations should be a vitamin B12 supplement.

Intake recommendations provided in the Dietary Reference Intakes (DRIs) proposed by the Food and Nutrition Board (FNB) at the Institute of Medicine (IOM) of the National Academies (formerly National Academy of Sciences) includes the following:

Age	Male (microgram)	Female (microgram)	Pregnancy (microgram)	Lactation (microgram)
0-6 months	0.4	0.4
7-12 months	0.5	0.5
1-3 years	0.9	0.9
4-8 years	1.2	1.2
9-13 years	1.8	1.8
14+ years	2.4	2.4	2.6	2.8