Welcome to the Nutrition Facts Podcast. I'm your host, Dr. Michael Greger.

The coronavirus pandemic has made many of us very aware of the importance of maintaining and improving our health.

Make that your silver lining.

Because the more positive change we can make to our diet lifestyle, the better.

Today, we have the final episode in our series on stroke and diet.

In our first story, we find that many doctors mistakenly rely on serum B12 levels in the blood to test for vitamin B12 deficiency.

Two cases. A young, strictly vegetarian individuals with no known vascular risk factors yet suffering a stroke or multiple strokes. Why?

Most probably because they weren't taking vitamin B12 supplements, which leads to high-home assisting levels which can attack your arteries.

So those eating plant-based failing to supplement may increase one's risk of both heart disease and stroke.

Now, vegetarians have so much heart disease risk factor benefit that they're still at lower risk overall.

But this may help explain why vegetarians were found to have more stroke.

Compared with non-vegetarians, vegetarians enjoy all these other advantages, better cholesterol, blood pressures, blood sugars, obesity rates.

Like, what about that stroke study? And even among studies that show benefits, they're not as pronounced as one might expect, which may be a result of that poor vitamin B12 status.

Vitamin B12 deficiency may negate some of the cardiovascular disease prevention benefits of vegetarian diet.

So in order to further reduce the risk of cardiovascular disease, vegetarians should be advised to use B12 supplements.

How can you determine your B12 status? By the time you're symptomatic with B12 deficiency, it's too late.

And initially, the symptoms can be so subtle that you might even miss them.

And well before you develop clinical deficiency, you develop metabolic vitamin B12 deficiency.

A missed opportunity to prevent strokes. We have enough B12 to avoid deficiency symptoms, but not enough to keep your homeocistine in check.

Under diagnosis of the condition results largely from failure to understand that a normal B12 blood level may not reflect adequate functional B12 status.

The levels of B12 in your blood does not always represent the levels B12 in your cells.

You can have a severe functional deficiency of B12, even though your blood levels are normal or even high.

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