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Vitamin B12 is an essential nutrient that is not made by plants; consequently, unfortified plant-based foods are not a reliable supply. Recent estimates suggest high rates of vitamin B12 deficiency among the vegetarian and vegan populations, particularly in pregnant women or women of child-bearing age who, for ethical and health reasons, are shifting towards higher consumption of plant-based foods in ever-increasing numbers. Vitamin B12 plays crucial metabolic roles across the life-course and in particular during pregnancy and in early development (first 1000days of life). Evidence now implicates vitamin B12 deficiency with increased risk to a range of neuro, vascular, immune, and inflammatory disorders. However, the current UK recommended nutrient intake for vitamin B12 does not adequately consider the vitamin B12 deficit for those choosing a plant-based diet, including vegetarianism and in particular veganism, representing a hidden hunger. We provide a cautionary note on the importance of preventing vitamin B12 deficits for those individuals choosing a plant-based diet and the health professionals advising them.

Additional file 1: Methods. Supplementary details in relation to magnetoencephalographic brain imaging. Table S1. Maternal characteristics during pregnancy in all FASSTT trial participants and in the sample whose children completed the FASSTT Offspring trial at 11 years. Table S2. Full Scale IQ, composite and subtest scores for the WISC-IV cognitive assessment in FASSTT Offspring trial participants. Table S3. Maternal characteristics during pregnancy in all FASSTT trial participants and in the sub-sample whose children completed the MEG assessment in the FASSTT Offspring trial.

Additional file 1: Table S1 General study characteristics by NANS and TUDA cohorts. Table S2 Blood pressure and use of antihypertensive drugs in adults 18–70 years by MTHFR genotype.