title: Association of Vitamin B12 Deficiency and Use of Reverse Osmosis Processed Water for Drinking: A Cross-Sectional Study from Western India.
abstract: BACKGROUND
  Prevalence of Vitamin B12 deficiency has increased in community in recent time. Possibility is raised for new and yet unidentified factors being associated with this increased prevalence. One of these factors frequently questioned is use of Reverse Osmosis (RO) processed water for drinking.
  
  
  OBJECTIVE
  We aimed to study association of use of RO processed water for drinking with Vitamin B12 deficiency.
  
  
  METHODS
  This cross-sectional study was done at tertiary care centre of Western India. Total 250 participants were recruited after excluding those participants with known factors responsible for Vitamin B12 deficiency. Information about gender, type of diet, milk intake and duration, dairy product intake, use of RO water and Vitamin B12 level was collected.
  
  
  RESULTS
  Total 70 (28%) participants out of 250 were having Vitamin B12 deficiency. Forty (50.6%) of 79 participants using RO water were Vitamin B12 deficient against 30 (17.5%) of 171 using other sources. Logistic regression analysis showed independent association between use of RO water and Vitamin B12 deficiency. Although association of male gender, milk quantity of less than 100 ml per day and duration of RO water intake with occurrence of Vitamin B12 deficiency was found statistically significant in univariate analysis, logistic regression analysis did not show significant association.
  
  
  CONCLUSIONS
  Use of RO processed drinking water was associated with Vitamin B12 deficiency. This being cross- sectional study, further longitudinal studies with large sample size and taking confounding factors into consideration, are required to establish this association.
authors.affiliation: Consulting Physician, Ruchi Hospital , Palanpur, Dist. Banaskantha, Gujarat, India .
authors.forename: Ekant Surendra
authors.initials: ES
authors.lastname: Gupta
authors.affiliation: Professor, Department of Medicine, Pramukh Swami Medical College , Karamsad, Gujarat, India .
authors.forename: Sanket Pranjivan
authors.initials: SP
authors.lastname: Sheth
authors.affiliation: Assistant Professor, Department of Community Medicine, Pramukh Swami Medical College , Karamsad, Gujarat, India .
authors.forename: Jaishree Deepak
authors.initials: JD
authors.lastname: Ganjiwale
keywords: Dairy products; Demineralised water; Micronutrients; Milk intake; Vegetarian diet