@article{2988555, title = "Systematic review with dose-response meta-analyses between vitamin B-12 intake and European Micronutrient Recommendations Aligned's prioritized biomarkers of vitamin B-12 including randomized controlled trials and observational studies in adults and elderly persons", author = "Dullemeijer, C. and Souverein, O.W. and Doets, E.L. and Van Der Voet, H. and Van Wijngaarden, J.P. and De Boer, W.J. and Plada, M. and Dhonukshe-Rutten, R.A.M. and In't Veld, P.H. and Cavelaars, A.E.J.M. and De Groot, L.C.P.G.M. and Van't Veer, P.", journal = "AMERICAN JOURNAL OF CLINICAL NUTRITION", year = "2013", volume = "97", number = "2", pages = "390-402", issn = "0002-9165", doi = "10.3945/ajcn.112.033951", keywords = "cyanocobalamin; multivitamin; trace element, evidence based medicine; human; meta analysis; milk; nutritional requirement; observational study; randomized controlled trial (topic); review; vitamin intake, Adult; Aged; Aging; Biological Markers; European Union; Evidence-Based Medicine; Humans; Methylmalonic Acid; Nutrition Policy; Nutritional Requirements; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency", abstract = "Background: Many randomized controlled trials (RCTs) and observational studies have provided information on the association between vitamin B-12 intake and biomarkers. The use of these data to estimate dose-response relations provides a useful means to summarize the body of evidence. Objective: We systematically reviewed studies that investigated vitamin B-12 intake and biomarkers of vitamin B-12 status and estimated dose-response relations with the use of a meta-analysis. Design: This systematic review included all RCTs, prospective cohort studies, nested case-control studies, and cross-sectional studies in healthy adult populations published through January 2010 that supplied or measured dietary vitamin B-12 intake and measured vitamin B-12 status as serum or plasma vitamin B-12, methylmalonic acid (MMA), or holotranscobalamin. We calculated an intake-status regression coefficient (β) for each individual study and calculated the overall pooled β and SE (β) by using random-effects meta-analysis on a double-log scale. Results: The meta-analysis of observational studies showed a weaker slope of dose-response relations than the meta-analysis of RCTs. The pooled dose-response relation of all studies between vitamin B-12 intake and status indicated that a doubling of the vitamin B-12 intake increased vitamin B-12 concentrations by 11% (95% CI: 9.4%, 12.5%). This increase was larger for studies in elderly persons (13%) than in studies in adults (8%). The dose-response relation between vitamin B-12 intake and MMA concentrations indicated a decrease in MMA of 7% (95% CI: -210%, -24%) for every doubling of the vitamin B-12 intake. The assessment of risk of bias within individual studies and across studies indicated risk that was unlikely to seriously alter these results. Conclusion: The obtained dose-response estimate between vitamin B-12 intake and status provides complementary evidence to underpin recommendations for a vitamin B-12 intake of populations. © 2013 American Society for Nutrition." }