Evaluation of vitamin B12 supplementation on nutritional status in vegan and vegetarian subjects

ISRCTN ISRCTN75099618
DOI https://doi.org/10.1186/ISRCTN75099618
Secondary identifying numbers 11/15 University of Milano - ethical comitee
Submission date
04/04/2017
Registration date
28/04/2017
Last edited
15/08/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
The vegetarian diet, or the stricter vegan diet, requires particular attention to any deficiency (shortage) in certain nutrients. In particular, vitamin B12 is present exclusively in animal products and is involved in many important reactions in the body. Vegans that exclude animal products from their diet may incur in a deficient nutritional status. The deficiency in the long term may lead to the onset of anemia (low blood iron) and neurological problems (issues with the brain, spine and nerves), as well as effects on the immune system (ability to fight off illness), hyperhomocysteinemia (an elevation of an amino acid in the blood that is linked to heart disease) and cognitive (mental) decline. In a situation where you people are unable to get enough B12 it is normal take supplements such as tablets that contain the nutrient. The aim of this study is to investigate the effect of the consumption of two different dosages (a high dose and a low dose) of vitamin B12 supplement sublingual tablets (a tablet that is inserted beneath the tongue to dissolve) in people with a marginal (low) deficiency.

Who can participate?
Vegan and vegetarian healthy adults aged 20-60 years old with a vitamin B12 deficiency.

What does the study involve?
Participants undergo a medical examination and complete questionnaires to determine eligibility. They are then randomly allocated to one of two groups. Those in the first group receive a low dose (350mcg/week) of a B12 dietary supplement (a tablet) that they take daily for three months. Those in the second group receive a high dose (2000mcg/week) of a vitamin B12 dietary supplement (a tablet) that they take weekly for three months (they take placebo pills the other six days of the week). Participants are followed up with blood samples before the study and at day 15, 30, 60 and 90 to monitor their nutritional levels and assess the concentration of the vitamin in their blood.

What are the possible benefits and risks of participating?
Participants may benefit from the expected improvement of vitamin B12 nutritional status. There is a slight risk of temporary headaches, balance problems or vision disorders associated with high dose supplements.

Where is the study run from?
University of Milano Department of Food, Environmental and Nutritional Sciences (Italy)

When is the study starting and how long is it expected to run for?
March 2015 to April 2017

Who is funding the study?
Phoenix SRL (Italy)

Who is the main contact?
1. Professor Salvatore Ciappellano (Scientific)
salvatore.ciappellano@unimi.it
2. Dr Antonella Brusamolino (Scientific)

Contact information

Prof Salvatore Ciappellano
Scientific

University of Milan
Department of Food, Environmental and Nutritional Sciences
Division of Human Nutrition
Via G. Celoria 2
Milan
20133
Italy

ORCiD logoORCID ID 0000-0002-2468-9557
Phone +39 02 503 16725
Email salvatore.ciappellano@unimi.it
Dr Antonella Brusamolino
Scientific

University of Milan
Department of Food, Environmental and Nutritional Sciences
Division of Human Nutrition
Via G. Celoria 2
Milan
20133
Italy

Study information

Study design12 week two armed dietary interventional randomised parallel trial
Primary study designInterventional
Secondary study designRandomised parallel trial
Study setting(s)Community
Study typeQuality of life
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleEvaluation of nutritional status of vitamin B12 in vegans and vegetarians with marginal deficiency after 12 weeks of supplementation with two dosages of a sublingual formulation
Study acronymNuCbl
Study hypothesisDietary supplementation with low dose of vitamin B12 sublingually administered to vegan subjects should allow the recovery of an adequate nutritional status related to vitamin B12.
Ethics approval(s)Ethics Committee of the University of Milan, 04/03/2015, ref: 11/15
ConditionHealthy volunteers with B12 marginal deficiency
InterventionParticipants are enrolled in the study after they complete a specific questionnaire and medical examination to determine eligibility. Participants are then randomly allocated to one of two groups based on when they joined the study.

Control group (Hd- high dose): Participants are given a high vitamin B12 concentration (2000mcg/week) dietary supplement that they take weekly for three months. Supplements are given tablets that dissolve under the tongue. Participants in this group take tablets everyday but only once a week take a pill that is enriched with B12, the other six days the tablets are placebo.

Test group (Ld- low dose): Participants are given a low vitamin B12 concentration (350mcg/week) dietary supplement that they take daily for three months. Supplements are given as tablets that dissolve under the tongue and are taken daily.

Fasting blood samples (about 30 mL) are obtained from all participants, at baseline and after 15, 30, 60 and 90 days to assess Vitamin B12, holotranscobalamine, metilmalonic acid, homocysteine, folic acid, vitamin B6 and complete blood count. This is also done to monitor the modification of the nutritional status during the entire intervention.
Intervention typeSupplement
Primary outcome measureNutritional status (vitamin B12, holotranscobalamin, methylmalonic and homocysteine concentrations) are measured using blood samples at baseline, day 15, day 30, day 60 and day 90
Secondary outcome measures1. Complete blood count is measured using blood samples at baseline, day 15, day 30, day 60 and day 90
2. Serum levels of folic acid is measured using blood samples at baseline, day 15, day 30, day 60 and day 90
3. Vitamin B6 is measured using blood samples at baseline, day 15, day 30, day 60 and day 90
Overall study start date12/02/2014
Overall study end date10/04/2017

Eligibility

Participant type(s)Healthy volunteer
Age groupAdult
SexBoth
Target number of participantsAt least 40 subjects
Total final enrolment40
Participant inclusion criteria1. Healthy men/women (20-60 years of age)
2. Moderate smoking (about 5-6 cigarette/day)
3. Moderate physical activity (25-30 min per day of brisk walk or jog)
4. Moderate alcohol consumption (up to 14 drinks per week)
5. Plasma levels of vitamin B12 lower than 220 pmol / L
6. Follow a vegan diet
7. No regular intake of drugs (for any type of disease)
8. Non allergic subjects
Participant exclusion criteria1. History of cardiovascular, coronary, diabetes, hepatic, renal, or gastrointestinal diseases.
2. Use of any drugs, medications at least one month before the beginning of the experiment.
3. Use of vitamin B12 supplements at least one year before the beginning of the experiment.
4. Omnivore subjects
Recruitment start date05/05/2015
Recruitment end date04/12/2016

Locations

Countries of recruitment

  • Italy

Study participating centre

University of Milan
Department of Food, Environmental and Nutritional Sciences
Via Celoria 2
Milano
20133
Italy

Sponsor information

Phoenix S.R.L. - LongLife Nutritional Supplements
Industry

Dr.ssa Licia Colombo
Sig. Giuseppe Galliani
Via 2 Giugno, 60/A1
Peschiera Borromeo
20068
Italy

Phone +39 02 5165531
Email l.colombo@pho.it
Website www.longlife.it

Funders

Funder type

University/education

University of Milan

No information available

Phoenix S.R.L. - LongLife Nutritional Supplements

No information available

Results and Publications

Intention to publish date31/12/2017
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a high-impact peer reviewed journal. Expected participation in conferences and public events to present the results.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Salvatore Ciappellano salvatore.ciappellano@unimi.it

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/04/2019 Yes No
Results article Association of cobalamin and vascular endothelial-cadherin in trial participants 16/07/2022 15/08/2022 Yes No

Editorial Notes

15/08/2022: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
08/03/2018: Publication reference added.