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13 Jan 2025
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3 min read
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by YINI Editorial team
Fermentation benefits Q&A

Focus on vitamin K

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The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
fermentatio gut microbiota lactic acid bacteria vitamin K
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Vitamin K is mostly known for its role on blood coagulation. But did you know that bacteria play a key role for this vitamin? Let’s dig more…

What is vitamin K?

Vitamin K is a fat-soluble vitamin, stored in our body in fat tissue and the liver. It is mostly present in two forms:

  • Phylloquinones (vitamin K1), synthesised by plants (as one of the components of the chloroplasts). Vitamin K1 is found primarily in green leafy vegetables.
  • Menaquinones or Vitamin K2, which bacterially synthesised. It is found mainly in the human gut microbiota, synthetised by the micro-organism of the microbiota. It is also found in fermented foods such as fermented beans and fermented dairy (cheese, butter, yogurt).

Vitamin K is necessary for the synthesis of coagulation factors (proteins that help control bleeding) and therefore normal coagulation. The “K” comes from its German name, “Koagulationsvitamin”.

In many countries, newborns receive vitamin K to prevent the possibility of bleeding, particularly in the brain. Indeed, the newborns do not get enough vitamin K from breast milk and as their gut microbiota is unmature, the synthesis of vitamin K2 due to fermentation is not sufficient to cover the needs.

Vitamin K also plays an important role in bone health. People who have higher levels of vitamin K have greater bone density, while low levels of vitamin K have been found in those with osteoporosis. Similarly, some studies suggest that low levels of vitamin K are associated with a higher risk of osteoarthritis.

Research shows that vitamin K may play other roles mainly in cardiovascular health.

Dietary recommendations

Dietary reference values (DRVs) for vitamin K is at:

  • 70 μg/day for adults including for pregnant and lactating women,
  • 65 μg/day for adolescents aged 15–17,
  • 45 μg/day for children aged 11–14,
  • 30 μg/day for children aged 7–10,
  • 20 μg/day for children aged 4–6,
  • 12 μg/day for children aged 1–3 years and
  • 10 μg/day for infants aged 7–11 months.

Source of vitamin K

It is known that green leafy vegetables, such as lettuce, spinach, cabbage and plant oils such as olive and rapeseed oil are sources of vitamin K:

  • Kale or Spinach = 390 μg/100g
  • Brocolis = 102 μg/100g
  • Avocado = 21 μg/100g
  • Olive oil = 53 μg/100g

Menaquinones or Vitamin K2 is bacterially synthesised. Recent research and the knowledge evolution on fermentation and bacteria shows that dairy products are a good source of K2.

A recent US study shows that K2 was more prevalent in the higher fat dairy and processing conditions can affect the K2 content (starter cultures, fermentation process, fat content). Vitamin K2 is found in considerable levels in cheese, with high variations across the cheese varieties.

Focus on the fermentation

The bacteria of yogurt and fermented milks can produce menaquinones (vitamin K-2).

Different strains of bacteria produce different types of menaquinones (e.g., MK-4, MK-7, MK-9):

  • Lactobacillus species produce various forms of menaquinones (MK-4, MK-7, and MK-9)
  • Streptococcus thermophilus is primarily involved in the initial stages of fermentation, creating an environment that supports the growth of other bacteria
  • Other Lactic Acid Bacteria (LAB) such as Lactococcus, Leuconostoc, and Pediococcus, used in dairy fermentation, can produce different menaquinones

References
  1. (1) Fu X, Harshman SG, Shen X, Haytowitz DB, Karl JP, Wolfe BE, Booth SL. Multiple Vitamin K Forms Exist in Dairy Foods. Curr Dev Nutr. 2017 Jun 1;1(6):e000638
  2. (2) Walther B, Chollet M. Menaquinones, Bacteria, and Foods: Vitamin K2 in the Diet [Internet]. Vitamin K2 - Vital for Health and Wellbeing. InTech; 2017
  3. (3) Zhou, S., Mehta, B.M. and Feeney, E.L. (2022), A narrative review of vitamin K forms in cheese and their potential role in cardiovascular disease. Int J Dairy Technol, 75: 726-737
  4. (4) Schurgers L J and Vermeer C (2000) Determination of phylloquinone and menaquinones in food. Pathophysiology of Haemostasis and Thrombosis 30 298–307
  5. (5) EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), Turck D, Bresson J-L et al. (2017) Scientific opinion on the dietary reference values for vitamin K. EFSA Journal 15(5) 4780, 78 pp
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06 Jan 2025
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5 min read
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by YINI Editorial team
Benefits for planet health

Balancing nutrition and nature: why cutting the animal protein in our diets has mixed environmental impacts

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The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
animal food environment proteins sustainable diet vegetable
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Shrinking the share of animal protein in our diet has become a focus for protecting both human and planetary health. But, while reducing animal protein is set to ease pressures on the environment, it could also come at a cost, latest research reveals (1).

If not carefully designed, our low animal protein diet could spell bad news for the wealth of the world’s fauna and flora which could fall victim to the changing agricultural practices.

The findings, based on diet modelling, have led researchers to call for further research into the best balance of animal-sourced protein in our shift towards more sustainable, plant-based diets. The modern diet should take account of all influences on sustainable eating and may require radical changes in our agriculture, the researchers say.

Modelling sustainable diets for human and planetary health

Environmental pressures created by the global food system are driven mainly by the high proportion of animal products in our diet (2). Reducing the share of animal-based foods we eat could therefore bring major benefits to the environment (3) and is a key target of food policies to increase sustainability (4,5). But because animal products are such an important source of protein and micronutrients, cutting down on them also risks making the diet less affordable or acceptable (6,7). Optimized diets may have difficulty to meet the requirement for certain nutrients (calcium, vit. B6 or B12, vit D, iodin), some of them being specific animal-sourced micro-nutrients.

Adding to this dilemma, a team of French scientists has shone a spotlight on the pros and cons for the environment of reducing animal protein in our diet (1).

They previously explored the minimum share of animal protein that met all food nutrient recommendation (8). For this new publication, using a national database of French adults’ diets, they developed five model low-animal-protein diets for different groups of adults based on gender and age. The observed diet is not are not fulfilling all nutrient recommendations, but these low-animal-protein diets contained the least animal protein needed to fulfil nutritional needs – around 50% of dietary protein – while minimising changes in the quantity and affordability of food consumed.

A low animal protein diet contains more fruits and vegetables (+103%), pulses, potatoes and unrefined grain products (+142%), more eggs (+96%), more dairy products but with variations within this category, with more milk (+222%), the same quantity of yogurt and less cheese (-97%) and of course, less meat –66%).

Tracking ecological impacts from field to fork

The researchers then used a lifecycle assessment to compare the environmental impacts of model low-animal-protein diets with those of typical French observed diets, where around 70% of protein is from animal sources. This method tracked various ecological effects from ‘field-to-fork’, including farming, processing, packaging, transport, retail, consumer use, and waste disposal. Here’s what they found…

Cutting down on animal protein has positive effects on the environment

Results suggested that reducing the share of animal protein from 70% to 50% of total protein intake could significantly ease several key environmental pressures. Differences between typical and low-animal-protein diets were similar for each of the five groups of adults studied:

  • Greenhouse gas emissions (GHGE): The levels of GHGEs fell by 30% in the modelled low-animal-protein diets, potentially helping to curb climate change.
  • Acidification: Emissions of acidifying gases, which can damage soil and water quality, fell by 40%.
  • Land occupation: The area of land needed for food production shrank by 35% with low-animal-protein diets.
  • Energy demand: The energy consumed throughout the life cycle of food products dropped by 24%.
  • Marine eutrophication: Nutrient runoff into marine environments, due to the emission of nitrogen compounds, fell by 13%.

Reducing animal protein can also have harmful environmental impacts

On the down-side, the researchers uncovered some concerning trade-offs that could occur with low-animal-protein diets, particularly in water use and biodiversity:

  • Freshwater eutrophication: Nutrient runoff into freshwater environments, due to the emission of nitrogen or phosphorus compounds, rose by 36% with low-animal-protein diets.
  • Water use: There was a 41% rise in the amount of water needed for food production associated with low-animal-protein diets.
  • Biodiversity loss: The estimated loss of species associated with changes in land use due to food production soared by 66% with low-animal-protein diets.

How can we balance these mixed environmental impacts?

The results of this modelling study suggest that cutting the share of animal protein we eat to 50% is compatible with nutritional needs, affordability and consumption constraints, but could have mixed effects on the environment. Therefore, any shift toward low-animal-protein diets should be carefully managed to balance these environmental trade-offs.

When designing sustainable diets, while covering all nutrient requirements of a population (taking into account age, gender and physical status specificities) it is important to consider all aspects of sustainability, the researchers say. In the modelling, they found that environmental benefits were driven by decreases in red meat consumption while introducing the concern on its impact on biodiversity. Increased consumption of fresh fruits, vegetables and fatty fish explained most environmental challenges related to water use.

The researchers propose that shifting the shares of plant and animal products in diets may require transforming agricultural practices and food systems to address concerns about climate change, biodiversity preservation and water consumption.

“While shifting toward a more plant-based diet is promoted, especially in Western countries, the optimal share of animal protein compatible with a sustainable diet has yet to be determined.”

Aubin J, et al., 2024

References
  1. (1) Aubin J, Vieux F, Le Féon S, Tharrey M, Peyraud JL, Darmon N. Environmental trade-offs of meeting nutritional requirements with a lower share of animal protein for adult subpopulations. Animal. 2024 May 10:101182.
  2. (2) Xu, X., Sharma, P., Shu, S., Lin, T.-S., Ciais, P., Tubiello, F.N., Smith, P., Campbell, N., Jain, A.K., 2021. Global greenhouse gas emissions from animal-based foods are twice those of plant-based foods. Nature Food 2, 724–732
  3. (3) Springmann, M., Wiebe, K., Mason-D’Croz, D., Sulser, T.B., Rayner, M., Scarborough, P., 2018. Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: a global modelling analysis with country-level detail. Lancet Planet Health 2, e451–e461.
  4. (4) Lonnie, M., Johnstone, A.M., 2020. The public health rationale for promoting plant protein as an important part of a sustainable and healthy diet. Nutrition Bulletin 45, 281–293
  5. (5) Willett, W., et al., 2019. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet (london, England) 393, 447–492.
  6. (6) Fehér, A., Gazdecki, M., Véha, M., Szakály, M., Szakály, Z., 2020. A comprehensive review of the benefits of and the barriers to the switch to a plant-based diet. Sustainability 12, 4136.
  7. (7) Monsivais, P., Scarborough, P., Lloyd, T., Mizdrak, A., Luben, R., Mulligan, A.A., Wareham, N.J., Woodcock, J., 2015. Greater accordance with the dietary approaches to stop hypertension dietary pattern is associated with lower diet-related greenhouse gas production but higher dietary costs in the United Kingdom. The American Journal of Clinical Nutrition 102, 138–145
  8. (8) Vieux F, Rémond D, Peyraud JL, Darmon N, Approximately half of total protein intake by adults must be animal-based to meet non-protein nutrient-based recommendations with variation due to age and sex, Journal of Nutrition, 152 (2022), pp. 2514-2525
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16 Dec 2024
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4 min read
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by YINI Editorial team
Cardiovascular health Nutri-dense food

Understanding the dairy-fat matrix: how does whole-fat dairy affect cardiometabolic health?

YINI Editorial team
The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
dairy fats lipids matrix
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A new US study has challenged the long-standing belief that whole-fat dairy foods can harm heart health. Instead, such foods could even be part of a healthy diet, the research suggests (1).

The findings are the latest in a growing body of evidence that calls into question dietary guidelines recommending we choose low-fat, rather than high-fat dairy products.  And it comes hot on the heels of British research suggesting that swapping saturated fats from meat with those from dairy products may help curb cardiovascular risk (2).

Questioning the link between whole fat dairy foods and heart conditions

Current dietary guidelines advise reducing the intake of whole-fat dairy, reflecting concerns about the effects of their high saturated fat content on heart health. But emerging research suggests that the relationship between whole-fat dairy foods and cardiometabolic health – conditions such as heart disease, diabetes, and obesity – might not be so straightforward.

The latest study, by researchers at the University of Vermont, sheds light on the unique structure and composition of the dairy-fat matrix and how it varies between dairy foods (1). The researchers studied whether differences in the dairy-fat matrix could help explain why individual dairy foods – milk, yogurt, cheese, and butter – might have varying effects on cardiometabolic health.

Examining the effects of dairy foods on cardiometabolic health

They analysed studies published over the past ten years, looking at how regular consumption of whole-fat dairy foods affects markers of cardiometabolic health including body weight, diabetes, inflammation, blood pressure, cholesterol levels, and the risk of developing heart disease.

The results were mixed. In most cases, no significant associations were found between eating whole-fat dairy and poor cardiometabolic outcomes. In fact, some studies suggested that whole-fat dairy foods, particularly milk and yogurt, may have beneficial effects on some cardiometabolic risk factors:

  • Milk – potentially beneficial effects on obesity
  • Yogurt – potentially beneficial effects on body weight regulation and the risk of developing obesity, type 2 diabetes (T2D) and cardiovascular disease (CVD)
  • Cheese – potentially beneficial effects on outcome measures related to T2D and CVD, such as cholesterol levels

What does this mean for our diet?

The study findings suggest that, rather than being a threat to heart health, regularly eating whole-fat dairy foods could be part of a healthy diet.

However, the researchers point to the need for more research to confirm the exact relationship between dairy foods and cardiometabolic health. They recommend further studies to understand better how dietary patterns that include plant- and animal-sourced foods, including dairy foods, contribute to nutritious diets that promote both human and planetary health.

“Evidence largely suggests no effect of consuming higher-fat varieties of dairy products on cardiometabolic health, with minor differences between individual dairy products, when stratified by both dairy product and fat content. More broadly, the current body of evidence suggests that regular fat dairy products may be a part of overall healthy eating patterns. “

Taormina VM, et al., 2024

What makes the dairy-fat matrix special?

Dairy fat is not just a single type of fat; it consists of a complex mixture of fatty acids, triglycerides, sterols, and phospholipids. These fats are all uniquely packaged into milk fat globules – tiny spheres surrounded by a membrane.

  • Fatty acids – at least 400 different dairy fatty acids have been identified. Approximately 68% of these are saturated, 27% mono-unsaturated and 4% poly-unsaturated, although these proportions can vary widely (3).
  • Triglycerides, phospholipids, and sterols – fatty acids combine to form these secondary structures. In milk, 97–98% of fatty acids are found in the form of triglycerides, with about 1% as phospholipids, and less than 1% each as sterols and free fatty acids (4).
  • The milk fat globular membrane (MFGM) – dairy fats are uniquely arranged as a globule surrounded by a distinct membrane with inner, central, and outer layers. The inner layer comprises polar lipids, the central layer of proteins, and the outer layer of phospholipids (5).

How does the dairy-fat matrix differ between foods?

In milk, the MFGM prevents the aggregation of milk fat globules, creating an emulsion and protecting the inner triglyceride core from being degraded by enzymes. However, the structure of the MFGM can be changed by processing methods, resulting in a distinct dairy-fat matrix for different dairy products. For example:

  • Milk homogenisation reduces the size of milk fat globules, leading to an overall increase in their surface area (6);
  • Yogurt and cheese fermentation creates a semi-solid milk gel with milk fat globules interspersed in a casein protein network (6,7);
  • Butter churning disrupts milk fat globules, releasing their triglyceride cores from within the MFGM to aggregate (8).

References
  1. (1) Taormina VM, Unger AL, Kraft J. Full-fat dairy products and cardiometabolic health outcomes: Does the dairy-fat matrix matter? Front Nutr. 2024 Jul 29:11:1386257.
  2. (2) Vogtschmidt YD, Soedamah-Muthu SS, Imamura F, Givens DI, Lovegrove JA. Replacement of Saturated Fatty Acids from Meat by Dairy Sources in Relation to Incident Cardiovascular Disease: The European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk Study. Am J Clin Nutr. 2024 Jun;119(6):1495-1503.
  3. (3) Palmquist DL. Milk fat: origin of fatty acids and influence of nutritional factors thereon, P.F. Fox and P.L.H. McSweeney, (Ed.), Advanced dairy chemistry. New York: Springer (2013). 43–92
  4. (4) Parodi P. Milk fat in human nutrition. Aust J Dairy Technol. (2004) 59:3–8.
  5. (5) Torres-Gonzalez M, Rice Bradley BH. Whole-Milk dairy foods: biological mechanisms underlying beneficial effects on risk markers for cardiometabolic health. Adv Nutr. (2023) 14:1523.
  6. (6) Lopez C. Focus on the supramolecular structure of milk fat in dairy products. Reprod Nutr Dev. (2005) 45:497–511.
  7. (7) Gilbert A, Turgeon SL. Studying stirred yogurt microstructure and its correlation to physical properties: a review. Food Hydrocoll. (2021) 121:106970.
  8. (8) Lopez C, Cauty C, Guyomarc’h F. Organization of lipids in milks, infant milk formulas and various dairy products: role of technological processes and potential impacts. Dairy Sci Technol. (2015) 95:863–93.
YINI Editorial team
The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
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09 Dec 2024
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4 min read
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by YINI Editorial team
Fermentation benefits Q&A

Focus on ferments

YINI Editorial team
The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
fermentation Fermented food ferments probiotics
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Yogurt is a fermented food, containing live cultures of specific bacteria. What are they? What role do they play? Let’s take a look at the fermentation and ferments’ effect on health.

What is fermentation?

Ferments are live agents, such as a bacteria or yeast, that causes fermentation, a process that has been used throughout history to preserve food, enhance the taste or the health benefits of food (1).

Many food products are the result of a fermentation carried out by bacteria and yeasts naturally found in the food or added. Cheese, yogurt, milk kefir, are dairy fermented foods (1-3).

A huge variety of fermented foods has been developed throughout history, including vegetables, cereals and breads, soybean products, fish products, and meats and we can distinguish:

  • Fermented foods without live microorganisms at the time we eat/drink them: bread, wine, cocoa or coffee beans, for instance.
  • Fermented foods with live microorganisms: sauerkraut, kimchi, kefir, yogurt, cheese, kombucha, or miso for example.

Consuming fermented food may also contribute to gut microbiota and its diversity, which is important for good health (5). The gut microbiome is composed of trillions of microorganisms that shelter in the gut and play a key role in maintaining the health of the host such as modulation of the immune system, helping to fight infections and even protecting against cancer.

The microbes in fermented food may help prevent infections by harmful bacteria in the gut by out-competing them in the gut environment.

Fermented foods consumption can exert changes to the gut microbiome in as little as 24 hours and help to minimise disruptions of gut microbiota balance

Focus on the specific ferments of yogurt

Yogurt is produced by the lactic fermentation of milk by two specific live bacteria. Lactobacillus Delbrueckii subsp. Bulgaricus and Streptococcus Thermophilus, which shall be viable, active and abundant in the product (4,7).

The fermentation process produces lactic acid by predigesting lactose into glucose and galactose resulting in the decrease of pH and the coagulation of milk casein proteins. This sets the milk into the gel-like signature texture of yogurt. Lactic acid fermentation also produces compounds such as carbon dioxide, peptides and amino acids which give yogurt its specific taste.

The decreased pH results in higher absorption of minerals such as calcium as it makes them more bioavailable.

Yogurt is also an interesting source of minerals for lactose intolerant people, as they are generally able to tolerate yogurt better than other dairy thanks to the pre-digestion of lactose, (5,6,8).

Fermentation in yogurt releases a wide range of metabolites such as:

  • Hight amount of vitamin B
  • Bioactive peptides which are antioxidants
  • Exopolysaccharides (EPS) and Conjugated Linoleic Acid (CLA) which provide health benefits such as anti-inflammatory and immune system modulatory properties.

Ferments and probiotics: the same?

Probiotics are defined as: “Live microorganisms that, when administered in adequate amounts confer a health benefit on the host”.

A fermented food may be described as a “probiotic food” only if:

  • It contains live microorganisms at the time it is eaten,
  • Those microorganisms (bacterial or yeast strains) are well defined and have shown a health benefit in a scientific study, and
  • The strains are present in the final food product in sufficient numbers to confer the health benefit.

In the case of yogurt, the live cultures do provide health benefits. Several studies show that yogurt with live active cultures may significantly enhance lactose digestion and reduce symptoms of intolerance in people with lactose maldigestion.

The European Food Safety Authority (EFSA) has approved the claim that yogurt improves digestion of lactose. According to EFSA, yogurt must contain at least 108 Colony Forming Units (CFU) of live microorganisms ((L. bulgaricus and S. thermophilus) per gram of yogurt, to obtain these probiotic beneficial effects (9).

See also

Live ferments & fermentation of milk into yogurt
Do all yogurts have probiotics?
Why we should eat more fermented foods
References
  1. (1) Rastogi YR, Thakur R, Thakur P, et al.  Food fermentation – Significance to public health and sustainability challenges of modern diet and food systems. Int J Food Microbiol. 2022. PMID: 35397315 Review
  2. (2) Rezac S, Kok CR, Heermann M, Hutkins R. Fermented Foods as a Dietary Source of Live Organisms. Front Microbiol. 2018;9.
  3. (3) Chilton SN, Burton JP, Reid G. Inclusion of Fermented Foods in Food Guides around the World. Nutrients. 2015;7: 390–404.
  4. (4) Nagaoka S. Yogurt Production. Methods Mol Biol. 2019;1887: 45–54.
  5. (5) Hadjimbei E, Botsaris G, Chrysostomou S. Beneficial Effects of Yoghurts and Probiotic Fermented Milks and Their Functional Food Potential. Foods. 2022;11: 2691
  6. (6) Fernandez MA, Panahi S, Daniel N, Tremblay A, Marette A. Yogurt and Cardiometabolic Diseases: A Critical Review of Potential Mechanisms. Advances in Nutrition. 2017;8: 812–829
  7. (7) Codex Alimentarius. Milk and Milk Products. Second Edition. FAO/OMS, 2011
  8. (8) Dennis A Savaiano, Robert W Hutkins. Yogurt, cultured fermented milk and health: a systematic review. Nutrition Reviews. 2020
  9. (9) EFSA. Scientific Opinion on the substantiation of health claims related to live cultures of yoghurt and improved lactose digestion (ID 1143, 2976) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal. 2010. Volume 8, Issue 10.
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02 Dec 2024
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4 min read
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by YINI Editorial team
Children Other studies Publications

Yogurt consumption is associated with a reduced risk of childhood eczema and allergies

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The YINI team includes nutritionists, food engineers, registered dietitians and scientific writers.
allergies Eczema immunity probiotic
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Eating yogurt during pregnancy or infancy is associated with changes to the immune system that may help protect against childhood eczema and food or respiratory allergies.

Infants whose mothers eat yogurt during pregnancy have a reduced risk of eczema and respiratory allergies

Eating yogurt frequently during pregnancy is associated with a reduced risk of offspring developing eczema and respiratory allergies during infancy, according to evidence from observational studies:

A study from Japan showed that infants had a reduced risk of eczema and asthma at the age of 2 years if their mothers consumed dairy products including milk, yogurt, and cheese, during pregnancy.

In a Turkish study, eating yogurt daily during pregnancy was associated with a 78% lower risk of infants developing eczema by the age of 2 years, compared with eating yogurt less frequently.

In the USA, a study showed that eating yogurt daily during pregnancy was associated with a lower risk of infants developing eczema, asthma, or hay fever by the age of 4 years, compared with eating yogurt less frequently.

Association between regular yogurt consumption and risk of childhood eczema and allergies - YINI

Infants who regularly eat yogurt have a reduced risk of childhood eczema and food allergies

Introducing yogurt to infants during their first year of life is associated with a reduced risk of developing eczema and food allergies later in life, according to evidence from observational studies:

In a Japanese study, eating yogurt before the age of 12 months was associated with a 30% lower risk of developing eczema and a 47% lower risk of developing food sensitivity by the age of 5 years, compared with eating no yogurt.

In a European study, introducing yogurt before the age of 12 months was associated with a 59% lower risk of developing eczema by the age of 4 years, compared with no introduction.

A further New Zealand study involved infants predisposed to allergy as their parents had a history of allergy. It found that introducing yogurt in the first year of life was associated with significant reductions in eczema and food allergy at 12 months old.

The risk of developing eczema and food allergies also appears to be associated with frequency of yogurt consumption during infancy.

In one study, infants who ate yogurt daily had a lower risk of developing both eczema and food sensitivity than those who ate yogurt less frequently.

In another study, infants who ate yogurt daily or 2–6 times a week were significantly less likely to develop eczema than those who ate yogurt less than once a month.

The possible allergy-protective effects of yogurt may be due to the strains of bacteria it contains

A comparison of foods introduced in the first year of life found the protective effect against developing eczema associated with yogurt was greater than that associated with other dairy products.

A series of randomised controlled trials showed that a Lactobacillus rhamnosus probiotic supplement, given daily to infants from birth for 2 years, was associated with protection against eczema and food allergy assessed up to 11 years old.

Another interventional study found that eating yogurt containing added Lactococcus lactis probiotic strains daily for 8 weeks reduced the severity of existing eczema in children aged 2–15 years.

A large observational study found that consumption of milk containing added Lactobacillus and Bifidobacterium probiotic strains by mothers during pregnancy and their infants was associated with a reduced risk of eczema at 18 months of age.

Protection against allergies may be achieved through the gut microbiota

Experts suggest that consumption of fermented dairy products during pregnancy or early infancy may protect against allergies in early childhood by increasing infant gut microbiome diversity and function; this helps to supress allergic responses.

Maternal diet may affect the infant microbiome and allergy outcomes either directly or indirectly via the maternal microbiome.

Research has reported that higher yogurt intake can increase the diversity of the gut microbiome in children and adults, and this can influence the development of the immune system to protect against allerigies.

““Growing evidence suggests that infants who regularly eat yogurt, or whose mothers frequently ate yogurt while pregnant, have a reduced risk of developing childhood eczema and allergies. This may be due in part to the allergy-protective effects of the bacteria commonly found in fermented dairy foods.” “

Professor Sharon Donovan

References
  1. (1) Donovan SM, Rao G. Health benefits of yogurt among infants and toddlers aged 4 to 24 months: a systematic review. Nutr Rev. 2019;77:478–86
  2. (2) Miyake Y, Tanaka K, Okubo H, et al. Maternal consumption of dairy products, calcium, and vitamin D during pregnancy and infantile allergic disorders. Ann Allergy Asthma Immunol. 2014;113:82–7.
  3. (3) Celik V, Beken B, Yazicioglu M, et al. Do traditional fermented foods protect against infantile atopic dermatitis. Pediatr Allergy Immunol. 2019;30:540–6.
  4. (4) Venter C, Palumbo MP, Glueck DH, et al. The maternal diet index in pregnancy is associated with offspring allergic diseases: the Healthy Start study. Allergy. 2022;77:162–72.
  5. (5) Shoda T, Futamura M, Yang L, et al. Yogurt consumption in infancy is inversely associated with atopic dermatitis and food sensitization at 5 years of age: A hospital-based birth cohort study. J Dermatol Sci. 2017;86:90–6.
  6. (6) Roduit C, Frei R, Loss G, et al. Development of atopic dermatitis according to age of onset and association with early-life exposures. J Allergy Clin Immunol. 2012;130:130–6.e5.
  7. (7) Crane J, Barthow C, Mitchell EA, et al. Is yoghurt an acceptable alternative to raw milk for reducing eczema and allergy in infancy? Clin Exp Allergy. 2018;48:604–6.
  8. (8) Wickens K, Barthow C, Mitchell EA, et al. Effects of Lactobacillus rhamnosus HN001 in early life on the cumulative prevalence of allergic disease to 11 years. Pediatr Allergy Immunol. 2018;29:808–14.
  9. (9) Suzuki T, Nishiyama K, Kawata K, et al. Effect of the Lactococcus Lactis 11/19-B1 Strain on Atopic Dermatitis in a Clinical Test and Mouse Model. Nutrients. 2020;12:763.
  10. (10) Bertelsen RJ, Brantsæter AL, Magnus MC, et al. Probiotic milk consumption in pregnancy and infancy and subsequent childhood allergic diseases. J Allergy Clin Immunol. 2014;133:165–71.e1–8.
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Diabetes prevention

Probiotic fermented milk holds promise as a new tool in managing Type 2 diabetes

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Fermented milk probiotic t2d type 2 diabetes
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Probiotic fermented milk could play a valuable role in helping to tackle Type 2 diabetes. Although yet to be confirmed, early research suggests that consuming fermented milk may be linked to improvements in several key health markers of Type 2 diabetes mellitus (T2DM), including indicators of blood sugar control (1).  

As such, consuming fermented milk products may offer a helping hand in delaying the progression and reducing complications of this chronic disease.

It’s welcome news for scientists as they struggle to stem the tide of the diabetes epidemic that is sweeping across the world and placing a huge burden on individuals and society as a whole.

What is probiotic fermented milk?

Fermented milk products, such as yogurt or kefir, contain live bacteria used in fermentation that may improve gut health. They can also be enriched with probiotics – additional live bacteria that confer further health benefits. Fermented milk products have properties that help the survival and growth of these probiotics in the gut (2).

Scientists have proposed that improving gut health might help manage T2DM by affecting how the body processes sugars and fats. Mounting evidence suggests that composition of the gut bacteria may have a role in the development of T2DM by influencing insulin sensitivity, inflammatory regulation, and lipid metabolism (3). Modulating the composition of the gut microbiota through consumption of probiotics has therefore been proposed as a potential therapy for T2DM.

With this in mind, researchers set out to investigate whether probiotic fermented milk can improve key health indicators in people with T2DM, including measures of glucose and lipid metabolism and inflammatory markers. They analysed the results of ten randomised controlled trials studying the effects of probiotic-enriched fermented milk in over 250 adults with T2DM.

Probiotic fermented milk has potential to benefit the health of people with T2DM

Based on their analysis of randomised controlled trial results, the meta-analysis concluded that probiotic-enhanced fermented milk has the potential to have positive impacts on certain health markers in people with T2DM, when compared with conventional fermented milk products.

  • Blood sugar control: Consuming probiotic fermented milk was associated with significantly reduced markers of blood sugar levels, including a fall in fasting plasma glucose by an average of 17 mg/dL and glycosylated haemoglobin (HbA1c) by 0.5%. These reductions suggest improvements in blood sugar management.
  • Cholesterol levels: in Total cholesterol levels were reduced significantly by 5.15 mg/dL in association with fermented milk consumption, indicating potential cardiovascular health benefits for people with T2DM. The effects on other lipid markers, such as triglycerides, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol, were not significant.
  • Inflammation reduction: The analysis found a significant decrease in levels of the inflammatory marker C-reactive protein (CRP), suggesting a potential anti-inflammatory effect associated with probiotic fermented milk. This could be a valuable finding, since inflammation plays a crucial role in the progression of T2DM and the development of complications (4).

Beneficial effects of probiotic fermented milk in T2DM may be mediated through the gut microbiota

The exact mechanisms behind the beneficial effects of probiotic fermented milk in people with T2DM are not fully understood and probably involve several factors. The authors highlight that one explanation for such benefits might be the change to the composition of the gut microbiota caused by probiotics.

An imbalance in gut microbiota composition is common in people with T2DM, and can lead to increased intestinal permeability, allowing bacterial toxins to enter the circulation, causing inflammation and raising levels of cholesterol and blood sugar (5,6). Probiotics can restore balance to the gut microbiota by promoting the growth of beneficial bacteria and inhibiting the number of harmful bacteria (7,8).

What further research is needed?

While probiotic fermented milk shows promise in helping to manage blood sugar, cholesterol, and inflammation in people with T2DM, further research is needed to confirm these benefits.

The number of studies and participants included in the analysis was relatively small, which limits the strength of the conclusions. The trials included also varied in terms of their study design and duration, as well as the probiotic strains and comparators used, making it difficult to compare results accurately across studies. The researchers propose that larger, more standardized trials are needed to determine whether probiotic fermented milk can become a reliable part of T2DM management.

“The present findings provide a crude indication of the potential benefits of probiotic fermented milk supplementation in improving glucose and lipid metabolism and inflammation in patients with T2DM. However, more robust evidence is needed to determine the clinical significance of probiotic fermented milk in the management of T2DM. “

Zhong H, et al., 2024

References
  1. (1) Zhong H, Wang L, Jia F, et al. Effect of Probiotic Fermented Milk Supplementation on Glucose and Lipid Metabolism Parameters and Inflammatory Markers in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials. Biology (Basel). 2024 Aug 21;13(8):641. doi: 10.3390/biology13080641. PMID: 39194579
  2. (2) Khorshidian N., Yousefi M., Mortazavian, A.M. Fermented milk: The most popular probiotic food carrier. Adv. Food Nutr. Res. 2020, 94, 91–114
  3. (3) Gurung M., et al, Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine 2020, 51, 102590
  4. (4) Goldberg R.B., Cytokine and cytokine-like inflammation markers, endothelial dysfunction, and imbalanced coagulation in development of diabetes and its complications. J. Clin. Endocrinol. Metab. 2009, 94, 3171–3182
  5. (5) Zhou Z., Sun B., Yu D., Zhu C., Gut Microbiota: An Important Player in Type 2 Diabetes Mellitus. Front. Cell. Infect. Microbiol. 2022, 12, 834485.
  6. (6) Cani P.D, et al. Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes 2007, 56, 1761–1772
  7. (7) Wang Y., Dilidaxi D., Wu Y., Sailike J., Sun X., Nabi X.H,. Composite probiotics alleviate type 2 diabetes by regulating intestinal microbiota and inducing GLP-1 secretion in db/db mice. Biomed. Pharmacother. 2020, 125, 109914
  8. (8) Markowiak-Kopec P., Slizewska K., The Effect of Probiotics on the Production of Short-Chain Fatty Acids by Human Intestinal Microbiome. Nutrients 2020, 12, 1107.
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Gut Health

New global guidelines unlock the effects of probiotics and prebiotics for gut health

ibd IBS Lactose NAFLD prebiotic probiotic WGO
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New global guidelines on identifying and using probiotics and prebiotics have been drawn up in recognition of their potential benefits in supporting gut health (1).

The guidelines, published by the World Gastroenterology Organisation, reflect the growing evidence for the efficacy of specific probiotic strains or prebiotics in a variety of gastrointestinal conditions. Developed by a worldwide team of gastroenterology experts, they represent a shift in the way health professionals view these popular food ingredients.

How do we define probiotics?

Over a century ago, scientists proposed that lactic acid bacteria – commonly used for food fermentation, e.g. such as for the fermentation of milk in yogurt by the strains Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus – can provide health benefits to consumers by modifying their gut microbiota. Today, over 1,500 clinical trials have studied the effects of numerous strains of potentially probiotic bacteria on various human health outcomes. But how do we know which strains of bacteria are probiotic?

According to the World Gastroenterology Organisation, probiotics are defined as live microorganisms that confer a health benefit to humans when consumed in adequate amounts (2). Common probiotics include several strains of Lactobacillus and Bifidobacterium lactic acid bacteria, along with some strains of other bacteria and yeasts. In general, the term “probiotic” should be reserved for live microbial strains that have demonstrated health benefits in controlled human studies.

For more information on the health benefits of probiotics, see Scientists unravel the healthy secrets of probiotics.

How do we define prebiotics?

The concept of prebiotics – compounds that are not digested by humans but lead to health benefits by influencing the gut microbiome – is more recent (3,4). Most prebiotics are either used as food ingredients or found naturally in many foods – common examples include lactulose and oligofructose.

The World Gastroenterology Organisation defines prebiotics as selectively fermented ingredients that result in specific changes to the composition and/or activity of gut microbiota, conferring health benefits. However, the extent to which we may experience these benefits varies due to several factors, including an individual’s gut microbiota and diet.

How do probiotics and prebiotics work?

The consumption of prebiotics or probiotics is intended to influence the gut environment, which is inhabited by trillions of microbes, for the benefit of human health.

Prebiotics affect intestinal bacteria by enhancing the numbers or activities of beneficial bacteria. This may result in decreasing the population of potentially pathogenic microorganisms or reducing potentially deleterious metabolic activities of host microbiota. Prebiotics may also have an impact on immune function.

Probiotic strains may mediate health effects through one or more of several mechanisms:

  • Probiotic strains can lead to immune benefits by activating local macrophages, modulating cytokine profiles, and raising tolerance to food antigens.
  • Probiotics can also lead to improved gut health and reduced inflammation though mechanisms including food digestion, altered acidity, pathogen inhibition, and intestinal barrier enhancement.

What are the potential health benefits of probiotics or prebiotics?

Both probiotics and prebiotics have been shown to have beneficial effects on gut health. Their effects are strain- and dose-specific for probiotics and based on a particular formulation for prebiotics. Based on current evidence, the World Gastroenterology Organisation has summarized several potential health benefits:

  • Diarrhoea treatment and prevention – some probiotic strains can reduce the severity and duration of acute infectious diarrhoea in children, as well as preventing of adult and childhood diarrhoea in certain settings (5).
  • Immune response – several probiotic strains and the prebiotic oligofructose are useful in improving the immune response to infectious diseases.
  • Lactose malabsorption – Probiotic strains of Streptococcus and Lactobacillus – commonly found in yogurt – improve lactose digestion and reduce symptoms related to lactose intolerance (6).
  • Irritable bowel syndrome (IBS) – some strains of probiotics may alleviate symptoms and provide pain relief from IBS.
  • Inflammatory bowel disease – certain probiotics may be effective in preventing pouchitis, inflammation in the lining of a pouch created during surgery to treat treatment of some ulcerative colitis (7).
  • Non-alcoholic fatty liver disease (NAFLD) – certain probiotics can improve markers of liver function in adults and children with NAFLD.
  • Hepatic encephalopathy prevention and treatment – prebiotics such as lactulose are commonly used for the prevention and treatment of hepatic encephalopathy (8).

Probiotics and prebiotics have also been shown to have effects beyond gut health, including allergy prevention and benefits for skin, dental, and respiratory health.

So, what does this mean for clinical practice?

Probiotic- and prebiotic-containing products are available in many forms, most commonly as foods or supplements. Recommendations for probiotic and prebiotic use should tie specific strains or formulations to potential health benefits based on clinical studies.

Different probiotics strains have unique properties that may account for their particular health benefits. However, scientists are increasingly recognising that some mechanisms of probiotic activity may be shared among strains.

“‘The administration or use of prebiotics or probiotics is intended to influence the gut environment, which is inhabited by trillions of microbes, for the benefit of human health. Both probiotics and prebiotics have been shown to have beneficial effects that extend beyond the gut.’”

Guarner F, et al. 2024

References
  1. (1) Source: Guarner F, Sanders ME, Szajewska H, et al. World Gastroenterology Organisation Global Guidelines: Probiotics and Prebiotics. J Clin Gastroenterol. 2024 Jul 1;58(6):533-553. doi: 10.1097/MCG.0000000000002002. PMID: 38885083.
  2. (2) Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014 Aug;11(8):506–14.
  3. (3) Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995 Jun;125(6):1401–12
  4. (4) Roberfroid MB et al Prebiotic effects: metabolic and health benefits; Br J Nutr . 2010 Aug:104 Suppl 2:S1-63
  5. (5) Collinson S, Deans A, Padua-Zamora A, Gregorio GV, Li C, Dans LF, et al. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2020 Dec 8;12(12):CD003048
  6. (6) Savaiano DA, Hutkins RW. Yogurt, cultured fermented milk, and health: a systematic review. Nutr Rev. 2021 Apr 7;79(5):599–614.
  7. (7) Su GL, Ko CW, Bercik P, Falck-Ytter Y, Sultan S, Weizman AV, et al. AGA Clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology. 2020 Aug;159(2):697–705
  8. (8) Dalal R, McGee RG, Riordan SM, Webster AC. Probiotics for people with hepatic encephalopathy. Cochrane Database Syst Rev. 2017 Feb 23;2(2):CD008716.
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Q&A

Focus on vitamin B2

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nutrient riboflavin vitamin B2
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Riboflavin known as vitamin B2 is essential to health. Let’s focus on its effects and its presence in the diet.

What is vitamin B2?

Vitamin B2 or Riboflavin is a water-soluble vitamin involved in the maintenance of energy levels. It forms an essential part of co-enzymes Flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD) which play major role in energy production, cellular function, growth and development, as well as in the metabolism of fats, drugs and steroids.

FAD is involved in the conversion of the amino acid tryptophan into niacin (vit B3). and FMN in the conversion of vit B6 into a co-enzyme.

Riboflavin helps maintain normal levels of homocysteine in blood.

Dietary recommendations

The daily dietary recommendations are:

  • 1.3mg for men,
  • 1.1mg for women,
  • 1.4mg during pregnancy,
  • 1.6mg during lactation.

When excess vitamin B2 is consumed, it is either not absorbed or is excreted in urine therefore consuming high quantities is relatively harmless and no safe upper limit has been defined.

Deficiency is very rare in developed countries. Symptoms are non-specific and include skin disorders, oedema of mouth and throat, cheilosis (swollen cracked lips), hair loss, reproductive problems, sore throat, itchy and red eyes. Typically, people who have a vitamin B2 deficiency also have deficiencies in other nutrients such as other B vitamins.

Sources of vitamin B2

90% of vitamin B2 found in the diet is in the form of FAD or FMN, only 10% is found in its free form, glycosides or esters. However, the main form found in eggs and milk is free riboflavin.

Vitamin B2 is found in a multitude of foods especially in animal sources such as eggs, organ meats, lean meats, milk and dairy products. It is present in some plant sources such as mushrooms, nuts (ex: almonds) and dark leafy green vegetables. Grains and cereals can be fortified in B2, this is the case in around 56 countries in the world including the USA.

Vitamin B2 in dairy

In the USA, the largest contributor to riboflavin in the diet is milk and milk-based drinks. Milk and dairy products contribute to around 25-27% of riboflavin daily intake in the UK population.

As such, dairy is a great source of vitamin B2. Yogurt is nutrient dense and provides a multitude of vitamins and minerals essential to health. 100g of yogurt contributes to around 15% of vitamin B2 daily intake.

It is recommended to consume about 2-3 portions of dairy per day. Such recommendation varies across countries.

References
  1. (1) Office of Dietary Supplements – Riboflavin
  2. (2) EUFIC – Riboflavin (vitamin B2): foods, functions, how much you need & more
  3. (3) Gliszczyńska-Świgło A, Rybicka I. Minerals and vitamin B2 in flavoured dairy products. Journal of Food Composition and Analysis. 2023;124: 105695.
  4. (4) Yeates AJ, Pourshahidi LK, O’Kane SM, Ward M, Mulhern MS, Lamers Y, et al. Effect of increasing cow’s milk consumption on riboflavin intake and plasma riboflavin measures in women of child-bearing age. Proceedings of the Nutrition Society. 2021;80: E138.
  5. (5) CIQUAL – La table de composition nutritionnelle des aliments. ANSES, France.
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Cardiovascular health Healthy Diets & Lifestyle

Could swapping meat with dairy products help protect heart health?

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cardiovascular CVD dairy meat saturated fats SFA
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Latest research suggests the type of food saturated fats come from might alter how they affect our heart health. Swapping saturated fats from meat with those from dairy products may help lower cardiovascular risk, the evidence suggests.

Eating too much food high in saturated fats has long been associated with increased risk to the heart and blood vessels. But a recent study highlights that not all saturated fats behave the same way – the type of food they come from can make a big difference in how they affect heart health.

Researchers from the UK investigated whether replacing saturated fatty acids (SFAs) from different meat products with those from individual dairy foods could reduce the risk of cardiovascular events, with intriguing results (1).

Understanding saturated fatty acids and cardiovascular health

Dietary recommendations to reduce risk of cardiovascular disease (CVD) include limiting SFAs to 10% of total energy intake and replacing meat consumption with other plant- and animal-based foods (2,3).

Previous modelling studies have shown a lower incidence of CVD when replacing SFAs from meat products with those from dairy foods (4,5). But scientists haven’t yet unravelled the associations between individual meat products or dairy foods and CVD risk.

With this in mind, researchers from the University of Reading in England looked into how replacing SFAs from meat products (including processed, red, and poultry) with those from individual dairy foods (milk, cheese, and yogurt) was associated with CVD in the UK population.

The researchers analysed data from over 21,000 participants, aged 40–79 years, who were part of the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk) study (6). Using food frequency questionnaires, they recorded dietary habits and followed participants for over two decades to track incidence of CVD, coronary artery disease (CAD), and stroke. Here’s what they found…

Swapping from meat to dairy foods may help reduce CVD risk

Results showed that overall, replacing 2.5% of daily energy intake from SFAs in meat with SFAs from dairy foods was associated with a significantly reduced risk of developing CVD. Specifically, replacing total meat SFAs with total dairy SFAs was associated with an 11% lower incidence of CVD and a 12% lower incidence of CAD. These results took other socio-demographic, lifestyle, cardio-metabolic, and dietary factors into account.

Replacing SFAs from red and processed meat may have the greatest CVD benefit

Analyses of individual meat products and dairy foods revealed significantly reduced CVD risks when replacing SFAs from red or processed meat with those from dairy foods.

So, replacing SFAs from processed meat with those from cheese was associated with a 23% lower incidence of CVD and coronary artery disease (CAD) and a 19% lower incidence of stroke, while replacement of SFAs from red meat with those from cheese was associated with a 14% lower incidence of CVD. Similarly, replacing SFAs from processed meat with those from milk was associated with a 16% lower incidence of CVD and a 17% lower incidence of CAD.

Replacing SFAs from poultry with those from dairy products was associated with an increased risk of CVD and stroke. However, the researchers urge caution in interpreting this result. The narrow range of poultry fat intake led to imprecise risk estimates, as indicated by the large confidence intervals, suggesting these findings cannot be generalized. Consequently, the study’s results do not align with previous research, which indicates that the intake of poultry meat and dairy products has a neutral effect on CVD risk.

Why does CVD risk change when replacing SFAs from meat with dairy?

The cause and underlying mechanisms of the changes seen in CVD risk when replacing SFAs from meat products with those from dairy foods remain unclear, but researchers propose several potentially contributing factors:

  • Different proportions of individual SFAs contained within meat and dairy foods may have a differential impact on CVD risk. For example, high concentrations of odd-chain fatty acids found in dairy foods have been linked with lower CVD risk.
  • Other constituents within meat (e.g., sodium, preservatives, and nitrates) and dairy matrices (e.g., protein, calcium, bacteria and the milk fat globule membrane) may also modulate the impact of SFAs on CVD risk.

The authors of this study suggest that future research should focus on the replacement of different types of red meat (unprocessed and processed) with different types of poultry and dairy foods to help specify food-based dietary recommendations for CVD prevention.

“Replacement of SFA from meat products, and especially processed meat, by dairy products may lower incidence of CVD and CAD. Our findings also add to the evidence that different types of meat (…) should be considered separately.”

Vogtschmidt YD, et al., 2024

References
  1. (1) Source: (1) Vogtschmidt YD, Soedamah-Muthu SS, Imamura F, Givens DI, Lovegrove JA. Replacement of Saturated Fatty Acids from Meat by Dairy Sources in Relation to Incident Cardiovascular Disease: The European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk Study. Am J Clin Nutr. 2024 Jun;119(6):1495-1503. doi: 10.1016/j.ajcnut.2024.04.007. PMID: 38608753.
  2. (2) A.H. Lichtenstein, L.J. Appel, M. Vadiveloo, F.B. Hu, P.M. Kris-Etherton, C.M. Rebholz, et al., 2021 Dietary Guidance to improve cardiovascular health: a scientific statement from the American Heart Association, Circulation 144 (23) (2021) e472–e487
  3. (3) Food Standards Agency, The Eatwell Guide: helping you eat a healthy and balanced diet, Food Standards Agency, United Kingdom, 2020
  4. (4) M.C. de Oliveira Otto, D. Mozaffarian, D. Kromhout, A.G. Bertoni, C.T. Sibley, D.R. Jacobs Jr., et al., Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis, Am. J. Clin. Nutr. 96 (2) (2012) 397–404,
  5. (5) L.E.T. Vissers, J. Rijksen, J.M.A. Boer, W.M.M. Verschuren, Y.T. van der Schouw, I. Sluijs, Fatty acids from dairy and meat and their association with risk of coronary heart disease, Eur. J. Nutr. 58 (7) (2019) 2639–2647
  6. (6) N.E. Day, S. Oakes, R.N. Luben, K.T. Khaw, S.A. Bingham, A.A. Welch, et al., EPIC-Norfolk: study design and characteristics of the cohort. European Prospective Investigation of Cancer, Br. J. Cancer. 80 (Suppl) (1999) 95–103
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Q&A

Focus on vitamin B12

nutrient vitamin vitamin B12
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Cobalamin known as vitamin B12 is essential to health. Let’s focus on its effects and its presence in the diet.

What is vitamin B12?

Vitamin B12 is a water-soluble vitamin part of the vitamin B complex. It is essential for the:

  • function of the nervous system,
  • red blood cell formation
  • DNA synthesis

It is a cofactor of two specific enzymes:

  • Methionine synthase which involved in the conversion of methionine, involved in DNA, RNA, proteins and lipids formation.
  • L-methyl malonyl-CoA mutase, involved in the metabolism of macronutrients.

Dietary recommendations

The dietary recommendation for adults is 4µg per day, it increases to 4.5µg during pregnancy and to 5µg during lactation. No safe upper limit has been determined as B12 has a low potential to become toxic since the body does not absorb or store excessive amounts.

When eating a balanced diet, the body is able to store 1000 to 2000 times more B12 than needed in a day which explains why it might take a while before the deficiency becomes symptomatic.

Symptoms of a deficiency can include megaloblastic anaemia (large abnormally nucleated red blood cells), palpitations, pale skin, dementia, weight loss, infertility, and neurological changes such as numbness and tingling in hands and feet. A deficiency during pregnancy and breastfeeding can lead to neural tube defects, developmental delays, failure to thrive and anaemia in the infant.

Deficiency remains rare in developed countries; it is most commonly caused by diet deficiency. People at risk of B12 inadequacy are mainly:

  • older adults,
  • vegetarians who consume little animal products (eggs, dairy)
  • vegans.
  • people with pernicious anaemia,
  • people with GI disorders, GI surgery which removes part of the stomach,

Sources of vitamin B12

Vitamin B12 is only found in animal sources such as fish, meat, poultry, eggs, and dairy.

Plant foods do not contain B12 naturally, but they can be fortified. For example: breakfast cereal, nutritional yeast, plant-based milk or yogurt alternatives such as fortified soy milk.

People who follow a vegan diet or a vegetarian diet with little to no dairy products should be mindful of their B12 intake and supplement if they do not consume enough fortified plant foods.

Vitamin B12 in dairy

Dairy is a great source of B12. People who consume dairy products are more likely to have adequate B12 levels. Furthermore, people who consume yogurt have a 7.1% higher B12 consumption than those who do not.

Dairy intake recommendations vary across countries. In most cases, it is recommended to consume 2-3 portions of dairy per day. This can help achieve about half of the daily recommended intake of B12.

References
  1. (1) Office of Dietary Supplements – Vitamin B12.
  2. (2) EUFIC – Vitamin B12: foods, functions, how much do you need & more
  3. (3) CIQUAL – La table de composition nutritionnelle des aliments. ANSES, France.
  4. (4) Cifelli CJ, Agarwal S, Fulgoni VL. Association of Yogurt Consumption with Nutrient Intakes, Nutrient Adequacy, and Diet Quality in American Children and Adults. Nutrients. 2020;12: 3435.
  5. (5) Cifelli CJ, Agarwal S, Fulgoni III VL. Association between Intake of Total Dairy and Individual Dairy Foods and Markers of Folate, Vitamin B6 and Vitamin B12 Status in the U.S. Population. Nutrients. 2022;14: 2441. doi:10.3390/nu14122441
  6. (6) Niklewicz A, Smith AD, Smith A, Holzer A, Klein A, McCaddon A, et al. The importance of vitamin B12 for individuals choosing plant-based diets. Eur J Nutr. 2023;62: 1551–1559. doi:10.1007/s00394-022-03025-4
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