B Smart and B Healthy — Know Your Vitamins

Vitamin B12 is a nutrient that helps maintain the body’s nervous system, helps keep blood cells healthy, and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent megaloblastic anemia that makes people tired and weak.

What foods provide vitamin B12

Vitamin B12 is found naturally in a wide variety of animal foods and is added to some fortified foods. Plant foods have no vitamin B12 unless they are fortified. You can get recommended amounts of vitamin B12 by eating a variety of foods including the following:

  • Beef liver and clams, which are the best sources of vitamin B12
  • Fish, meat, poultry, eggs, milk, and other dairy products, which also contain vitamin B12
  • Some breakfast cereals, nutritional yeasts and other food products that are fortified with vitamin B12. To find out if vitamin B12 has been added to a food product, check the product labels.

What kinds of vitamin B12 dietary supplements are available?

Vitamin B12 is found in almost all multivitamins. Dietary supplements that contain only vitamin B12, or vitamin B12 with nutrients such as folic acid and other B vitamins, are also available. Check the supplement facts label to determine the amount of vitamin B12 provided.

A prescription form of vitamin B12 can be administered as a shot. This is usually used to treat vitamin B12 deficiency. Vitamin B12 is also available as a prescription medication in nasal gel form.

Am I getting enough vitamin B12?

Most people in the United States get enough vitamin B12 from the foods they eat. But some people have trouble absorbing vitamin B12 from food. As a result, vitamin B12 deficiency affects between 1.5% and 15% of the public. Your doctor can test your vitamin B12 level to see if you have a deficiency.

Certain groups may not get enough vitamin B12 or have trouble absorbing it, such as:

  • Older adults, who do not have enough hydrochloric acid in their stomach to absorb the vitamin B12 naturally present in food. People over 50 should get most of their vitamin B12 from fortified foods or dietary supplements because, in most cases, their bodies can absorb vitamin B12 from these sources.
  • People with pernicious anemia whose bodies cannot absorb vitamin B12. Doctors usually treat pernicious anemia with vitamin B12 shots, although very high oral doses of vitamin B12 might also be effective.
  • People who have had gastrointestinal surgery, such as weight-loss surgery, or who have digestive disorders, such as celiac disease or Crohn’s disease. These conditions can decrease the amount of vitamin B12 that the body can absorb.
  • Some people who eat little or no animal foods such as vegetarians and vegans. Only animal foods have vitamin B12 naturally. When pregnant women and women who breastfeed their babies are strict vegetarians or vegans, their babies might also not get enough vitamin B12.

What happens if I don’t get enough vitamin B12?

Vitamin B12 deficiency causes tiredness, weakness, constipation, loss of appetite, weight loss, and megaloblastic anemia. Nerve problems, such as numbness and tingling in the hands and feet, can also occur. Other symptoms of vitamin B12 deficiency include problems with balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue. Vitamin B12 deficiency can damage the nervous system even in people who don’t have anemia, so it is important to treat a deficiency as soon as possible.

In infants, signs of a vitamin B12 deficiency include failure to thrive, problems with movement, delays in reaching the typical developmental milestones, and megaloblastic anemia.

How much vitamin B12 do I need?

Vitamin B12 can interact or interfere with medicines that you take, and in some cases, medicines can lower vitamin B12 levels in the body. Talk with your physician or pharmacist for clarification. Also, tell your doctor, pharmacist, and other health care providers about any dietary supplements and medicines you take. They can tell you if those dietary supplements might interact or interfere with your prescription or over-the-counter medicines or if the medicines might interfere with how your body absorbs, uses, or breaks down nutrients.

The amount of vitamin B12 you need each day depends on your age. Average daily recommended amounts for different ages are listed below in micrograms (mcg):

Birth to 6 months 0.4 mcg
Infants 7–12 months 0.5 mcg
Children 1–3 years 0.9 mcg
Children 4–8 years 1.2 mcg
Children 9–13 years 1.8 mcg
Teens 14-18 years 2.4 mcg
Adults 2.4 mcg
Pregnant teens and women 2.6 mcg
Breastfeeding teens and women 2.8 mcg


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. Employees in this program have access to tools and information that can help improve their overall physical and mental well-being. The program is free to both you and your employees as part of your participation in CBIA Health Connections!

Taking Charge of Your Health Care

To make the most of your time with your personal physician it’s important to speak up and ask questions. When you play an active role in your health care, you can improve the quality of the care you and your family get.

Most people depend on different doctors, nurses, pharmacists, and insurance companies for their health care. It’s a team effort, and you are the most important member of the team. You can help take charge of your health care by practicing the following simple steps:

  • Keep track of important health information
  • See a doctor regularly for checkups
  • Be prepared for medical appointments
  • Ask your doctor or nurse questions
  • Maintain good personal records

Keep track and manage your medical history

Managing your health care is easier if you keep all your health information in one place. To start your own personal health record, write down:

  • Your name, birth date, and blood type (ask your doctor if you don’t know)
  • The name and phone number of a friend or relative to call if there’s an emergency
  • Dates and results of checkups and screening tests
  • List of shots (and the dates you got them)
  • Medicines you take, how much you take, and why you take them
  • Telephone numbers and addresses of places you go for health care, including your pharmacy
  • Any health conditions you have, including allergies

The health history of your family is also an important part of your personal health record.  You can use this handy online tool (https://familyhistory.hhs.gov/fhh-web/home.action) to keep track of conditions that run in your family.

It’s important to see a doctor regularly for checkups, even if you’re not sick. Your doctor or nurse can help you stay healthy. Adults typically need a checkup every one to five years, depending on age and overall health. Regular checkups can help the doctor find problems early, when they may be easier to treat.

So, remember to write down your questions ahead of time and take the list with you to your doctor, nurse, or pharmacist. Here’s a tool you can use to help you build your question list: (http://www.ahrq.gov/questionsaretheanswer/questionBuilder.aspx). When you do get to that appointment, remember to talk about any changes since your last visit, like:

  • New medicines you are taking, including over-the-counter medicines, herbs or home remedies, and vitamins
  • Recent illness or surgery
  • Health concerns or issues
  • Health information you’ve found on the Internet or heard from others

Then, follow up after your appointment, schedule follow-up appointments for tests or lab work, if you need to, and call if you have any questions or side effects from medicine. It’s up to you to make the most of your doctor visits, but remembering these tips will help you stay better involved in your health, and help your medical professionals help you!

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. Employees in this program have access to tools and information that can help improve their overall physical and mental well-being. The program is free to both you and your employees as part of your participation in CBIA Health Connections!

Eat Your Veggies – But Preparation Matters

We all grew up hearing about the health benefits of eating fresh fruit and vegetables. While we might prefer to indulge in cookies and ice cream, French fries and burgers – especially in the summer – eating a healthy diet rich in fruit and vegetables will keep you in better balance, nutritionally, and can help protect you from:

  • Heart disease
  • Bone loss
  • Type 2 diabetes
  • High blood pressure
  • Some cancers, such as colorectal cancer

To cook or not cook your veggies

Cooking is crucial to our diets. It helps us digest food without expending huge amounts of energy. It softens food that our small teeth, weak jaws and digestive systems aren’t equipped to handle. And while we might hear from raw food advocates that cooking kills vitamins and minerals in food, it turns out raw vegetables are not always healthier.

A study published in The British Journal of Nutrition last year found that a group of 198 subjects who followed a strict raw food diet had normal levels of vitamin A and relatively high levels of beta-carotene (an antioxidant found in dark green and yellow fruits and vegetables), but low levels of the antioxidant lycopene.

Lycopene is a red pigment found predominantly in tomatoes and other rosy fruits such as watermelon, pink guava, red bell pepper and papaya. Several studies conducted in recent years (at Harvard Medical School, among others) have linked high intake of lycopene with a lower risk of cancer and heart attacks, and research indicates it may be an even more potent antioxidant than vitamin C.

Cooked carrots, spinach, mushrooms, asparagus, cabbage, peppers and many other vegetables also supply more antioxidants, such as carotenoids and ferulic acid, to the body than they do when raw,  at least, that is, if they’re boiled or steamed. Boiling and steaming better preserves antioxidants, particularly carotenoid, in carrots, zucchini and broccoli, though boiling was deemed the best. Always avoid deep frying.

A study published in the Journal of Agricultural and Food Chemistry showed that cooking carrots actually increases their level of the antioxidant beta-carotene. The body converts beta-carotene into vitamin A, which plays an important role in vision, reproduction, bone growth and regulating the immune system.

Visit http://www.choosemyplate.gov/ to find out how many servings of fruit and vegetables you need based on your age, weight, level of physical activity, and gender.

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. Employees in this program have access to tools and information that can help improve their overall physical and mental well-being. The program is free to both you and your employees as part of your participation in CBIA Health Connections!

Wellness Works Better When Leaders Walk The Talk

There’s no better prescription for inspiring healthy change than leading by example. If leaders in small businesses truly want their employees to embrace wellness initiatives, the more they are involved leading that charge, the better the acceptance, participation, and results.

“Strategic business leaders at best-practice organizations are taking a strong leadership role in community health initiatives in tobacco control, preventive screenings and immunizations, obesity control, responsible alcohol use, and physical activity. In doing so, they act as catalysts within their community by influencing not only their employees and their families to make healthier choices, but their fellow citizens and neighbors as well,” said Jud Richland, president of Partnership for Prevention.

Partnership for Prevention’s Leading by Example program is designed to leverage the workplace to improve health by promoting greater business involvement in health promotion and disease prevention. Their publications address how nearly 20 small to medium-sized employers lowered barriers to creating effective worksite health programs through the active engagement of the CEO.

“Leading by Example: The Value of Worksite Health to Small- and Medium-Sized Employers” features nearly 20 businesses that are reaching out to improve the health and wellness of their companies. “Leading by Example: Creating Healthy Communities through Corporate Engagement” features 19 businesses that are reaching out to improve the health and wellness of their communities.

You can download PDF versions of the publications here:

 “Leading by Example: The Value of Worksite Health to Small- and Medium-Sized Employers” 

“Leading by Example: Creating Healthy Communities through Corporate Engagement” 

To reap the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!