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Brevetti G, Perna S, Sabba C, Martone VD, Condorelli M

10.1038/s41467-018-06158-5 152 PennistonK

So people at greatest risk for deficiency include those with low stomach acid (e.g., older adults and people on proton pump inhibitors or antacids) or low IF production (known as pernicious anemia), people on medications that interfere with B12 absorption (such as metformin), people who have had gastric surgery, those with GI conditions that impair nutrient absorption (like celiac or Crohn's disease), and people on vegan and vegetarian diets

Obesity is a growing public health concern, and a better understanding of the pathophysiology related to diet and lifestyle is needed