Nutritional management of immediate hypersensitivity to legumes in vegetarians
Main Article Content
Keywords
Allergy to Legumes, Food Allergy, Nutrition, Vegan
Abstract
Vegetarianism is becoming a common practice among people. Products of vegetable origin are also on the rise, such as vegetable “milk” and legume-based snacks, which may lead to legume sensitivity and allergies in vegetarian diet followers. Furthermore, products derived from legumes, such as lupin flour or fenugreek powder, are often used as food additives. They function as hidden allergens, not always evident on the precautionary labeling, favoring allergic reactions. As dietary allergen restriction is the fundamental pillar in managing patients with food allergies, this review aims to reflect on practical aspects—diagnosis and nutritional management—in managing legume allergies in vegetarians, aiming to reduce the negative nutritional impact of an even more restrictive diet.
References
1. Fewtrell M, Bronsky J, Campoy C, Domellöf M, Embleton N, Fidler Mis N, et al. Complementary feeding: A position paper by the European Society for Paediatric Gastroenterology, hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastrenterol Nutr. 2017;64(1):119–32. 10.1097/MPG.0000000000001454
2. American Dietetic Association, Dietitians of Canada. Position of the American Dietetic Assocation and Dietitians of Canada: Vegetarian diets. Can J Diet Pract Res. 2003;64(2):62–81. 10.3148/64.2.2003.62
3. Agnoli C, Baroni L, Bertini I, Ciappellano S, Fabbri A, Papa M, et al. Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition. Nutr Metab Cardiovasc Dis. 2017;27(12):1037–52. 10.1016/j.numecd.2017.10.020
4. Hargreaves SM, Nakano EY, Han H, Raposo A, Ariza-Montes A, Vega-Muñoz A, Zandonadi RP. Quality of life of Brazilian vegetarians measured by the WHOQOL-BREF: Influence of type of diet, motivation and sociodemographic data. Nutrients. 2021 Jul 30;13(8):2648. 10.3390/nu13082648
5. Sicherer SH, Sampson HA. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018;141(1):41–58. 10.1016/j.jaci.2017.11.003
6. Kivistö J, Protudjer JLP, Karjalainen J, Wickman M, Bergström A, Mattila V. Hospitalizations due to allergic reactions in Finnish and Swedish children between 1999 and 2011. Allergy. 2016;71(5):677–83. 10.1111/all.12837
7. Sethi S, Tyagi SK, Anurag RK. Plant-based milk alternatives an emerging segment of functional beverages: A review. J Food Sci Technol. 2016;53(9):3408–23. 10.1007/s13197-016-2328-3
8. Bansal AS, Sanghvi MM, Bansal RA, Hayman GR. Variably severe systemic allergic reactions after consuming foods with unlabelled lupin flour: A case series. J Med Case Rep. 2014;8:55. 10.1186/1752-1947-8-55
9. Bar-El Dadon S, Pascual CY, Reifen R. Food allergy and cross-reactivity-chickpea as a test case. Food Chem. 2014;165:483–8. 10.1016/j.foodchem.2014.05.138
10. Richard C, Jacquenet S, Sergeant P, Moneret-Vautrin DA. Cross-reactivity of a new food ingredient, dun pea, with legumes, and risk of anaphylaxis in legume allergic children. Eur Ann Allergy Clin Immunol. 2015;47(4):118–25.
11. Cabanillas B, Jappe U, Novak N. Allergy to peanut, soybean, and other legumes: Recent advances in allergen characterization, stability to processing and IgE cross-reactivity. Mol Nutr Food Res. 2018;62(1). 10.1002/mnfr.201700446
12. Smits M, Le TM, Welsing P, Houben G, Knulst A, Verhoeckx K. Legume protein consumption and the prevalence of legume sensitization. Nutrients. 2018;10(10):1545. 10.3390/nu10101545
13. Jappe U, Karstedt A, Warneke D, Hellmig S, Böttger M, Riffelmann FW, et al. Identification and purification of novel low-molecular-weight lupine allergens as components for personalized diagnostics. Nutrients. 2021;13(2):409. 10.3390/nu13020409
14. Hildebrand HV, Arias A, Simons E, Gerdts J, Povolo B, Rothney J, et al. Adult and pediatric food allergy to chickpea, pea, lentil, and lupine: A scoping review. J Allergy Clin Immunol Pract. 2021;9(1):290–301.e2. 10.1016/j.jaip.2020.10.046
15. Bingemann TA, Santos CB, Russell AF, Anagnostou A. Lupin: An emerging food allergen in the United States. Ann Allergy Asthma Immunol. 2019;122(1):8–10. 10.1016/j.anai.2018.09.467
16. Leonard SA, Pecora V, Fiocchi AG, Nowak-Wegrzyn A. Food protein-induced enterocolitis syndrome: A review of the new guidelines. World Allergy Organ J. 2018;11(1):4. 10.1186/s40413-017-0182-z
17. Kouris-Blazos A, Belski R. Health benefits of legumes and pulses with a focus on Australian sweet lupins. Asia Pac J Clin Nutr. 2016;25(1):1–17.
18. Leterme P. Recommendations by health organizations for pulse consumption. Br J Nutr. 2002;88:239–42. 10.1079/BJN2002712
19. Martinez SIM, Ibanez MD, Fernandez Caldas E, Carnes J. In vitro and in vivo cross-reactivity studies of legume allergy in a Mediterranean population. Int Arch Allergy Immunol. 2008; 147:222–30. 10.1159/000142045
20. Andreae DA, Grishina G, Sackesen C, Ibáñez MD, Sampson HA. High similarity between lentil and other lentil-like-proteins (dal) complicates recommendations on avoidance in lentil allergic patients. J Allergy Clin Immunol Pract. 2015;3(5):808. 10.1016/j.jaip.2015.05.010
21. Eigenmann PA, Oh JW, Beyer K. Diagnostic testing in the evaluation of food allergy. Pediatr Clin North Am. 2011;58:351–62. 10.1016/j.pcl.2011.02.003
22. Gupta M, Cox A, Nowak-Wegrzyn A, Wang J. Diagnosis of food allergy. Immunol Allergy Clin North Am. 2018;38(1):39–52. 10.1016/j.iac.2017.09.004
23. Verma AK, Kumar S, Das M, Dwivedi PD. A comprehensive review of legume allergy. Clin Rev Allergy Immunol. 2013;45(1):30–46. 10.1007/s12016-012-8310-6
24. Villa C, Costa J, Mafra I. Lupine allergens: Clinical relevance, molecular characterization, cross-reactivity, and detection strategies. Compr Rev Food Sci Food Saf. 2020;19(6):3886–915. 10.1111/1541-4337
25. Peeters KA, Nordlee JA, Penninks AH, Chen L, Goodman RE, Bruijnzeel-Koomen CA, et al. Lupine allergy: Not simply cross-reactivity with peanut or soy. J Allergy Clin Immunol. 2007;120(3):647–53. 10.1016/j.jaci.2007.05.032
26. Kakleas K, Luyt D, Foley G, Noimark L. Is it necessary to avoid all legumes in legume allergy? Pediatr Allergy Immunol. 2020;31(7):848–51. 10.1111/pai.13275
27. Roberts G, Lack G. Diagnosing peanut allergy with skin prick and specific IgE testing. J Allergy Clin Immunol. 2005;115(6):1291–6. 10.1016/j.jaci.2005.02.038
28. Popp J, Trendelenburg V, Niggemann B, Randow S, Völker E, Vogel L, et al. Pea (Pisum sativum) allergy in children: Pis s 1 is an immunodominant major pea allergen and presents IgE binding sites with potential diagnostic value. Clin Exp Allergy. 2020;50(5):625–35. 10.1111/cea.13590
29. Cox AL, Eigenmann PA, Sicherer SH. Clinical relevance of cross-reactivity in food allergy. J Allergy Clin Immunol Pract. 2021;9(1):82–99. 10.1016/j.jaip.2020.09.030
30. Bernhisel-Broadbent J, Sampson HA. Cross-allergenicity in the legume botanical family in children with food hypersensitivity. J Allergy Clin Immunol. 1989;83(2 Pt 1):435–40. 10.1016/0091-6749(89)90130-9
31. Green TD, LaBelle VS, Steele PH, Kim EH, Lee LA, Mankad VS, et al. Clinical characteristics of peanut-allergic children: Recent changes. Pediatrics 2007;120(6):1304–10. 10.1542/peds.2007-0350
32. Stutius L, Sheehan WJ, Rangsithienchai P, Bharmanee A, Scott JE, Young MC, et al. Characterizing the relationship between sesame, coconut, and nut allergy in children. Pediatr Allergy Immunol. 2010;21(8):1114–8. 10.1111/j.1399-3038.2010.00997.x
33. Chan ES, Greenhawt MJ, Fleischer DM, Caubet JC. Managing cross-reactivity in those with peanut allergy. J Allergy Clin Immunol Pract. 2019;7(2):381–6. 10.1016/j.jaip.2018.11.012
34. Andrew Bird J, Leonard S, Groetch M, Assa’ad A, Cianferoni A, Clark A, et al. Conducting an oral food challenge: An update to the 2009 Adverse Reactions to Foods Committee Work Group Report. J Allergy Clin Immunol Pract. 2020;8:75–90. 10.1016/j.jaip.2019.09.029
35. Singletary KW. Fenugreek. Nutr Today. 2017;52(2):93–111. 10.1097/NT.0000000000000209
36. Skypala IJ. Food-induced anaphylaxis: Role of hidden allergens and cofactors. Front Immunol. 2019;10:673. 10.3389/fimmu.2019.00673
37. Claver A, Morales M, Elduque C, Navarro B, Botey E, Fernandez MC, et al. Fenugreek: A hidden allergen to consider in peanut allergic patients. J Allergy Clin Immunol 143(2): AB241. 10.1016/j.jaci.2018.12.737
38. Ornellas HL. Técnica Dietética. 8th ed. São Paulo: Editora Atheneu; 2013.
39. Jukanti AK, Gaur PM, Gowda CL, Chibbar RN. Nutritional quality and health benefits of chickpea (Cicer arietinum L.): A review. Br J Nutr. 2012;108 Suppl 1:S11–26. 10.1017/S0007114512000797
40. Cozzolino SMF. Biodisponibilidade de Nutrientes. 4th ed. São Paulo: Manole; 2012. p. 1334.
41. Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr. 1994;59(5 Suppl):1203S–12S. 10.1093/ajcn/59.5.1203S
42. American Dietetic Association; Dietitians of Canada. Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets. J Am Diet Assoc. 2003;103(6):748–65. 10.1053/jada.2003.50142
43. Irevall T, Axelsson I, Naumburg E. B12 deficiency is common in infants and is accompanied by serious neurological symptoms. Acta Paediatr. 2017;106(1):101–4. 10.1111/apa.13625
44. Souza ECG, MSL, Duarte, LL Conceição, editors. Alimentação vegetariana: Atualidades na abordagem nutricional. Rio de Janeiro: Editora Rubio; 2016.
45. Mariotti F, Gardner CD. Dietary protein and amino acids in vegetarian diets—A review. Nutrients. 2019;11(11):2661. 10.3390/nu11112661
46. Joint FAO/WHO/UNU Expert Consultation on Protein and Amino Acid Requirements in Human Nutrition (2002: Geneva, Switzerland), Food and Agriculture Organization of the United Nations, World Health Organization & United Nations University. Protein and amino acid requirements in human nutrition: Report of a joint FAO/WHO/UNU expert consultation. Geneva: World Health Organization; 2007.
47. Bolaman Z, Kadikoylu G, Yukselen V, Yavasoglu I, Barutca S, Senturk T. Oral versus intramuscular cobalamin treatment in megaloblastic anemia: A single-center, prospective, randomized, open-label study. Clin Ther. 2003;25(12):3124–34. 10.1016/s0149-2918(03)90096-8
48. Weikert C, Trefflich I, Menzel J, Obeid R, Longree A, Dierkes J, et al. Vitamin and mineral status in a vegan diet. Dtsch Arztebl Int. 2020;117(35–36):575–82. 10.3238/arztebl.2020.0575
49. Clarys P, Deliens T, Huybrechts I, Deriemaeker P, Vanaelst B, De Keyzer W, et al. Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet. Nutrients. 2014;6(3):1318–32. 10.3390/nu6031318
50. Watanabe F, Yabuta Y, Tanioka Y, Bito T. Biologically active vitamin B12 compounds in foods for preventing deficiency among vegetarians and elderly subjects. J Agric Food Chem. 2013;61(28):6769–75. 10.1021/jf401545z
51. Rudloff S, Bührer C, Jochum F, Kauth T, Kersting M, Körner A, et al. Vegetarian diets in childhood and adolescence: Position paper of the nutrition committee, German Society for Paediatric and Adolescent Medicine (DGKJ). Mol Cell Pediatr. 2019;6(1):4. 10.1186/s40348-019-0091-z
52. Hannibal L, Lysne V, Bjørke-Monsen AL, Behringer S, Grünert SC, Spiekerkoetter U, et al. Biomarkers and algorithms for the diagnosis of vitamin B12 deficiency. Front Mol Biosci. 2016;3:27. 10.3389/fmolb.2016.00027
53. Martineau AR, Thummel KE, Wang Z, Jolliffe DA, Boucher BJ, Griffin SJ, et al. Differential effects of oral boluses of vitamin D2 vs vitamin D3 on vitamin D metabolism: A randomized controlled trial. J Clin Endocrinol Metab. 2019;104(12):5831–9. 10.1210/jc.2019-00207
54. Sezer RG, Bozaykut A, Akoğlu HA, Özdemir GN. The efficacy of oral vitamin B12 replacement for nutritional vitamin B12 deficiency. J Pediatr Hematol Oncol. 2018;40(2):e69–e72. 10.1097/MPH.0000000000001037
55. Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368(2):149–60. 10.1056/NEJMcp1113996
56. Shieh A, Chun RF, Ma C, Witzel S, Meyer B, Rafison B, et al. Effects of high-dose vitamin D2 versus D3 on total and free 25-hydroxyvitamin D and markers of calcium balance. J Clin Endocrinol Metab. 2016;101(8):3070–8. 10.1210/jc.2016-1871
2. American Dietetic Association, Dietitians of Canada. Position of the American Dietetic Assocation and Dietitians of Canada: Vegetarian diets. Can J Diet Pract Res. 2003;64(2):62–81. 10.3148/64.2.2003.62
3. Agnoli C, Baroni L, Bertini I, Ciappellano S, Fabbri A, Papa M, et al. Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition. Nutr Metab Cardiovasc Dis. 2017;27(12):1037–52. 10.1016/j.numecd.2017.10.020
4. Hargreaves SM, Nakano EY, Han H, Raposo A, Ariza-Montes A, Vega-Muñoz A, Zandonadi RP. Quality of life of Brazilian vegetarians measured by the WHOQOL-BREF: Influence of type of diet, motivation and sociodemographic data. Nutrients. 2021 Jul 30;13(8):2648. 10.3390/nu13082648
5. Sicherer SH, Sampson HA. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018;141(1):41–58. 10.1016/j.jaci.2017.11.003
6. Kivistö J, Protudjer JLP, Karjalainen J, Wickman M, Bergström A, Mattila V. Hospitalizations due to allergic reactions in Finnish and Swedish children between 1999 and 2011. Allergy. 2016;71(5):677–83. 10.1111/all.12837
7. Sethi S, Tyagi SK, Anurag RK. Plant-based milk alternatives an emerging segment of functional beverages: A review. J Food Sci Technol. 2016;53(9):3408–23. 10.1007/s13197-016-2328-3
8. Bansal AS, Sanghvi MM, Bansal RA, Hayman GR. Variably severe systemic allergic reactions after consuming foods with unlabelled lupin flour: A case series. J Med Case Rep. 2014;8:55. 10.1186/1752-1947-8-55
9. Bar-El Dadon S, Pascual CY, Reifen R. Food allergy and cross-reactivity-chickpea as a test case. Food Chem. 2014;165:483–8. 10.1016/j.foodchem.2014.05.138
10. Richard C, Jacquenet S, Sergeant P, Moneret-Vautrin DA. Cross-reactivity of a new food ingredient, dun pea, with legumes, and risk of anaphylaxis in legume allergic children. Eur Ann Allergy Clin Immunol. 2015;47(4):118–25.
11. Cabanillas B, Jappe U, Novak N. Allergy to peanut, soybean, and other legumes: Recent advances in allergen characterization, stability to processing and IgE cross-reactivity. Mol Nutr Food Res. 2018;62(1). 10.1002/mnfr.201700446
12. Smits M, Le TM, Welsing P, Houben G, Knulst A, Verhoeckx K. Legume protein consumption and the prevalence of legume sensitization. Nutrients. 2018;10(10):1545. 10.3390/nu10101545
13. Jappe U, Karstedt A, Warneke D, Hellmig S, Böttger M, Riffelmann FW, et al. Identification and purification of novel low-molecular-weight lupine allergens as components for personalized diagnostics. Nutrients. 2021;13(2):409. 10.3390/nu13020409
14. Hildebrand HV, Arias A, Simons E, Gerdts J, Povolo B, Rothney J, et al. Adult and pediatric food allergy to chickpea, pea, lentil, and lupine: A scoping review. J Allergy Clin Immunol Pract. 2021;9(1):290–301.e2. 10.1016/j.jaip.2020.10.046
15. Bingemann TA, Santos CB, Russell AF, Anagnostou A. Lupin: An emerging food allergen in the United States. Ann Allergy Asthma Immunol. 2019;122(1):8–10. 10.1016/j.anai.2018.09.467
16. Leonard SA, Pecora V, Fiocchi AG, Nowak-Wegrzyn A. Food protein-induced enterocolitis syndrome: A review of the new guidelines. World Allergy Organ J. 2018;11(1):4. 10.1186/s40413-017-0182-z
17. Kouris-Blazos A, Belski R. Health benefits of legumes and pulses with a focus on Australian sweet lupins. Asia Pac J Clin Nutr. 2016;25(1):1–17.
18. Leterme P. Recommendations by health organizations for pulse consumption. Br J Nutr. 2002;88:239–42. 10.1079/BJN2002712
19. Martinez SIM, Ibanez MD, Fernandez Caldas E, Carnes J. In vitro and in vivo cross-reactivity studies of legume allergy in a Mediterranean population. Int Arch Allergy Immunol. 2008; 147:222–30. 10.1159/000142045
20. Andreae DA, Grishina G, Sackesen C, Ibáñez MD, Sampson HA. High similarity between lentil and other lentil-like-proteins (dal) complicates recommendations on avoidance in lentil allergic patients. J Allergy Clin Immunol Pract. 2015;3(5):808. 10.1016/j.jaip.2015.05.010
21. Eigenmann PA, Oh JW, Beyer K. Diagnostic testing in the evaluation of food allergy. Pediatr Clin North Am. 2011;58:351–62. 10.1016/j.pcl.2011.02.003
22. Gupta M, Cox A, Nowak-Wegrzyn A, Wang J. Diagnosis of food allergy. Immunol Allergy Clin North Am. 2018;38(1):39–52. 10.1016/j.iac.2017.09.004
23. Verma AK, Kumar S, Das M, Dwivedi PD. A comprehensive review of legume allergy. Clin Rev Allergy Immunol. 2013;45(1):30–46. 10.1007/s12016-012-8310-6
24. Villa C, Costa J, Mafra I. Lupine allergens: Clinical relevance, molecular characterization, cross-reactivity, and detection strategies. Compr Rev Food Sci Food Saf. 2020;19(6):3886–915. 10.1111/1541-4337
25. Peeters KA, Nordlee JA, Penninks AH, Chen L, Goodman RE, Bruijnzeel-Koomen CA, et al. Lupine allergy: Not simply cross-reactivity with peanut or soy. J Allergy Clin Immunol. 2007;120(3):647–53. 10.1016/j.jaci.2007.05.032
26. Kakleas K, Luyt D, Foley G, Noimark L. Is it necessary to avoid all legumes in legume allergy? Pediatr Allergy Immunol. 2020;31(7):848–51. 10.1111/pai.13275
27. Roberts G, Lack G. Diagnosing peanut allergy with skin prick and specific IgE testing. J Allergy Clin Immunol. 2005;115(6):1291–6. 10.1016/j.jaci.2005.02.038
28. Popp J, Trendelenburg V, Niggemann B, Randow S, Völker E, Vogel L, et al. Pea (Pisum sativum) allergy in children: Pis s 1 is an immunodominant major pea allergen and presents IgE binding sites with potential diagnostic value. Clin Exp Allergy. 2020;50(5):625–35. 10.1111/cea.13590
29. Cox AL, Eigenmann PA, Sicherer SH. Clinical relevance of cross-reactivity in food allergy. J Allergy Clin Immunol Pract. 2021;9(1):82–99. 10.1016/j.jaip.2020.09.030
30. Bernhisel-Broadbent J, Sampson HA. Cross-allergenicity in the legume botanical family in children with food hypersensitivity. J Allergy Clin Immunol. 1989;83(2 Pt 1):435–40. 10.1016/0091-6749(89)90130-9
31. Green TD, LaBelle VS, Steele PH, Kim EH, Lee LA, Mankad VS, et al. Clinical characteristics of peanut-allergic children: Recent changes. Pediatrics 2007;120(6):1304–10. 10.1542/peds.2007-0350
32. Stutius L, Sheehan WJ, Rangsithienchai P, Bharmanee A, Scott JE, Young MC, et al. Characterizing the relationship between sesame, coconut, and nut allergy in children. Pediatr Allergy Immunol. 2010;21(8):1114–8. 10.1111/j.1399-3038.2010.00997.x
33. Chan ES, Greenhawt MJ, Fleischer DM, Caubet JC. Managing cross-reactivity in those with peanut allergy. J Allergy Clin Immunol Pract. 2019;7(2):381–6. 10.1016/j.jaip.2018.11.012
34. Andrew Bird J, Leonard S, Groetch M, Assa’ad A, Cianferoni A, Clark A, et al. Conducting an oral food challenge: An update to the 2009 Adverse Reactions to Foods Committee Work Group Report. J Allergy Clin Immunol Pract. 2020;8:75–90. 10.1016/j.jaip.2019.09.029
35. Singletary KW. Fenugreek. Nutr Today. 2017;52(2):93–111. 10.1097/NT.0000000000000209
36. Skypala IJ. Food-induced anaphylaxis: Role of hidden allergens and cofactors. Front Immunol. 2019;10:673. 10.3389/fimmu.2019.00673
37. Claver A, Morales M, Elduque C, Navarro B, Botey E, Fernandez MC, et al. Fenugreek: A hidden allergen to consider in peanut allergic patients. J Allergy Clin Immunol 143(2): AB241. 10.1016/j.jaci.2018.12.737
38. Ornellas HL. Técnica Dietética. 8th ed. São Paulo: Editora Atheneu; 2013.
39. Jukanti AK, Gaur PM, Gowda CL, Chibbar RN. Nutritional quality and health benefits of chickpea (Cicer arietinum L.): A review. Br J Nutr. 2012;108 Suppl 1:S11–26. 10.1017/S0007114512000797
40. Cozzolino SMF. Biodisponibilidade de Nutrientes. 4th ed. São Paulo: Manole; 2012. p. 1334.
41. Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr. 1994;59(5 Suppl):1203S–12S. 10.1093/ajcn/59.5.1203S
42. American Dietetic Association; Dietitians of Canada. Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets. J Am Diet Assoc. 2003;103(6):748–65. 10.1053/jada.2003.50142
43. Irevall T, Axelsson I, Naumburg E. B12 deficiency is common in infants and is accompanied by serious neurological symptoms. Acta Paediatr. 2017;106(1):101–4. 10.1111/apa.13625
44. Souza ECG, MSL, Duarte, LL Conceição, editors. Alimentação vegetariana: Atualidades na abordagem nutricional. Rio de Janeiro: Editora Rubio; 2016.
45. Mariotti F, Gardner CD. Dietary protein and amino acids in vegetarian diets—A review. Nutrients. 2019;11(11):2661. 10.3390/nu11112661
46. Joint FAO/WHO/UNU Expert Consultation on Protein and Amino Acid Requirements in Human Nutrition (2002: Geneva, Switzerland), Food and Agriculture Organization of the United Nations, World Health Organization & United Nations University. Protein and amino acid requirements in human nutrition: Report of a joint FAO/WHO/UNU expert consultation. Geneva: World Health Organization; 2007.
47. Bolaman Z, Kadikoylu G, Yukselen V, Yavasoglu I, Barutca S, Senturk T. Oral versus intramuscular cobalamin treatment in megaloblastic anemia: A single-center, prospective, randomized, open-label study. Clin Ther. 2003;25(12):3124–34. 10.1016/s0149-2918(03)90096-8
48. Weikert C, Trefflich I, Menzel J, Obeid R, Longree A, Dierkes J, et al. Vitamin and mineral status in a vegan diet. Dtsch Arztebl Int. 2020;117(35–36):575–82. 10.3238/arztebl.2020.0575
49. Clarys P, Deliens T, Huybrechts I, Deriemaeker P, Vanaelst B, De Keyzer W, et al. Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet. Nutrients. 2014;6(3):1318–32. 10.3390/nu6031318
50. Watanabe F, Yabuta Y, Tanioka Y, Bito T. Biologically active vitamin B12 compounds in foods for preventing deficiency among vegetarians and elderly subjects. J Agric Food Chem. 2013;61(28):6769–75. 10.1021/jf401545z
51. Rudloff S, Bührer C, Jochum F, Kauth T, Kersting M, Körner A, et al. Vegetarian diets in childhood and adolescence: Position paper of the nutrition committee, German Society for Paediatric and Adolescent Medicine (DGKJ). Mol Cell Pediatr. 2019;6(1):4. 10.1186/s40348-019-0091-z
52. Hannibal L, Lysne V, Bjørke-Monsen AL, Behringer S, Grünert SC, Spiekerkoetter U, et al. Biomarkers and algorithms for the diagnosis of vitamin B12 deficiency. Front Mol Biosci. 2016;3:27. 10.3389/fmolb.2016.00027
53. Martineau AR, Thummel KE, Wang Z, Jolliffe DA, Boucher BJ, Griffin SJ, et al. Differential effects of oral boluses of vitamin D2 vs vitamin D3 on vitamin D metabolism: A randomized controlled trial. J Clin Endocrinol Metab. 2019;104(12):5831–9. 10.1210/jc.2019-00207
54. Sezer RG, Bozaykut A, Akoğlu HA, Özdemir GN. The efficacy of oral vitamin B12 replacement for nutritional vitamin B12 deficiency. J Pediatr Hematol Oncol. 2018;40(2):e69–e72. 10.1097/MPH.0000000000001037
55. Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368(2):149–60. 10.1056/NEJMcp1113996
56. Shieh A, Chun RF, Ma C, Witzel S, Meyer B, Rafison B, et al. Effects of high-dose vitamin D2 versus D3 on total and free 25-hydroxyvitamin D and markers of calcium balance. J Clin Endocrinol Metab. 2016;101(8):3070–8. 10.1210/jc.2016-1871
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