PT  - JOURNAL ARTICLE
AU  - Parente, Daniel J.
TI  - Food Insecurity Is Associated with Vitamin B12 Deficiency: The All of Us Database
AID  - 10.3122/jabfm.2023.230454R1
DP  - 2024 Nov 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - S156--S163
VI  - 37
IP  - Supplement2
4099  - http://www.jabfm.org/content/37/Supplement2/S156.short
4100  - http://www.jabfm.org/content/37/Supplement2/S156.full
SO  - J Am Board Fam Med2024 Nov 01; 37
AB  - Background: Vitamin B12 is an essential micronutrient obtained from dietary sources, but there is a paucity of information about how food security contributes to risk of vitamin B12 deficiency.Methods: I used multivariable logistic regression controlling for age, sex, and metformin exposure using the multicenter, United States National Institutes of Health All of Us precision medicine database. I included all adult participants 18 to 88 years old in the All of Us database who answered the social determinants of health survey and had a vitamin B12 measurement within 1 year of the survey.Results: 8,989 participants with median age 65.9 years (Q1 53.0, Q3 73.7), who were predominantly female (63.2%), White-identifying (87.4%), and not Hispanic or Latino (93.4%) were included. 9.8% of participants reported experience of food insecurity, and 12.9% reported worry about food insecurity. 15.1% had metformin exposures. Vitamin B12 levels less than 300 pg/mL were associated with experiencing food insecurity (multivariable OR [mOR] 1.24, 95% CI 1.01-1.51, P = .037). Age (mOR 0.92 per decade), and male biological sex (mOR 1.16) were also both associated with vitamin B12 deficiency, but I did not detect an effect due to metformin exposure (mOR 1.05, 95% CI 0.88-1.25, P = .59).Conclusions: Vitamin B12 deficiency is associated with food insecurity in United States adults enrolled in the NIH All of Us database. Future analyses designed to infer causality are warranted.