Vegetarians, Pescatarians and Flexitarians with Adequate Vitamin B12 Levels Have No Increased Risk of Polyneuropathy

Article type: Research Article

Authors: van Doormaal, Perry T.C.^{a; b} | Warendorf, Janna K.^a | Visser, Nora A.^{a; 2} | de Vries, Jeanne H.M.^c | Notermans, Nicolette C.^{a; 1} | Vrancken, Alexander F.J.E.^{a; 1}

Affiliations: [a] Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands | [b] Department of Neurology, Tergooi Medical Center, Hilversum, The Netherlands | [c] Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands

Correspondence: [*] Correspondence to: Perry T.C. van Doormaal, UMC Utrecht, Department of Neurology G03.228, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. Tel.: +31 88 7557939; Fax: +31 30 2542100; E-mail: p.vandoormaal@umcutrecht.nl.

Note: [1] These authors jointly directed this work

Note: [2] Present adress: Nora A. Visser: Department of Neurology, Meander Medical Center, Maatweg 3, 3813 TZ, Amersfoort, The Netherlands

Abstract: Background:In recent years, an increasing number of people adapt to a vegetarian, pescatarian or flexitarian dietary pattern that reduces the consumption of meat and fish. Although these dietary patterns have a risk for developing vitamin B12 deficiency associated polyneuropathy, it is unknown whether this risk is still increased when vitamin B12 levels are adequate. Objective:To examine whether a vegetarian, pescatarian or flexitarian dietary pattern is associated with an increased risk for idiopathic axonal polyneuropathy. Methods:We conducted a case-control study that included 256 idiopathic axonal polyneuropathy patients with adequate vitamin B12 blood levels and 630 controls. We used questionnaire data to determine the frequency of meat and fish consumption and defined dietary patterns. Results:The vegetarian (no meat or fish consumption) and the pescatarian (fish consumption, no meat consumption) dietary patterns showed no increased risk of axonal polyneuropathy. Frequency-effect analysis and quantity-effect analysis also did not show that a reduction of meat or fish consumption (flexitarian dietary pattern), either small or large, changed the risk of axonal polyneuropathy. Conclusions:We did not find an increased risk for axonal polyneuropathy among people with a vegetarian, pescatarian or flexitarian diet and an adequate vitamin B12 level.

Keywords: Polyneuropathies, vegetarian diet, risk factors, case-control studies

DOI: 10.3233/JND-210775

Journal: Journal of Neuromuscular Diseases, vol. 9, no. 3, pp. 383-388, 2022