Which of the following diets would place a client at the highestrisk for macrocytic anemia?

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Megaloblastic anemia is caused by vitamin B₁₂ or folic acid deficiency. Vitamin B₁₂ deficiency can also result in peripheral neuropathy and cognitive impairment. Vitamin B₁₂ is formed by microorganisms and found only in animal foods; some plant foods may contain minimal amounts of vitamin B₁₂ only if they accidentally contain animal particles. Natural sources of vitamin B₁₂ include meat, fish, poultry, eggs, and milk; some breads and cereals may be fortified with vitamin B₁₂ as well as some nutritional yeasts. Vegans are strict vegetarians; they exclude all animal products, including eggs, milk, and milk products, from the diet. They also may avoid foods that are processed or not organically grown, thereby eliminating potentially fortified food sources of vitamin B₁₂. Individuals who practice any form of vegetarianism are at risk for vitamin B₁₂ deficiency. A vegan diet, with its elimination of all animal products, poses the highest risk. A vitamin B₁₂ supplement is recommended when dietary intake is inadequate. (Option A) Lacto-ovo-vegetarian - eggs, milk, and milk products are included, but no meat is consumed. (Option B) Lacto-vegetarian - milk and milk products are included in the diet; eggs and meats are excluded. (Option C) Macrobiotic - whole grains, vegetables, fruits, and seaweeds are emphasized; fish and seafood may be included in the diet up to several times a week. Educational objective: Individuals who follow a plant-based diet, especially vegans, are at risk for vitamin B₁₂ deficiency and the resulting macrocytic anemia.

Which of the Following Diets Would Place a Client at the highestrisk