The number of elite athletes following vegan and vegetarian diets has grown substantially in recent years, driven by ethical, environmental and purported performance motivations. While plant-based diets offer numerous health advantages, they present specific nutritional challenges for winter sport athletes — most notably the complete absence of vitamin B12 in unfortified plant foods.
Vitamin B12 is essential for red blood cell production, neurological function and DNA synthesis. Deficiency develops insidiously over months to years as body stores are depleted, and the early signs — subtle fatigue, mild cognitive changes, slightly reduced exercise tolerance — are easy to attribute to training loads rather than nutritional deficit. By the time classic symptoms appear, deficiency can be severe.
For vegan and vegetarian athletes, oral B12 supplementation is generally effective, but absorption depends on the intrinsic factor mechanism which can be variable. High-dose oral supplements partially bypass this system via passive diffusion, but IV or intramuscular B12 administration guarantees 100% bioavailability regardless of any absorption limitations.
Beyond B12, plant-based athletes may also benefit from IV supplementation of zinc, which is less bioavailable from plant sources due to phytate inhibition; long-chain omega-3s if not adequately consuming algae-based EPA/DHA; iron, particularly for female athletes with high menstrual losses; and calcium if dairy is also excluded. Our Milan clinic offers comprehensive nutritional blood panels specifically designed for plant-based athletes.
📚 Scientific References
- Rogerson D (2017). Vegan diets: practical advice for athletes and exercisers. J Int Soc Sports Nutr.
- Watanabe F et al. (2014). Vitamin B12-containing plant food sources for vegetarians. Nutrients.
- Lynch HM et al. (2018). No significant differences in muscle strength and corrected arm muscle area between vegetarian and omnivore older adults. Nutrients.