This is a very important article to read.

Vitamin B12: Vital Nutrient for Good Health

Written by Sally Fallon and Mary G. Enig, PhD

2005-Jul-27

One of the most important nutrients we get from animal foods is vitamin B12. The vitamin is also the largest known biomolecule and the only nutrient with a stable carbon-metal bond. One molecule of cobalt lies at the center of each B12 molecule, which has the approximate (and awesome!) chemical formula of C61-64H84-90N14O13-14PCo. Isolated B12 is a crystalline compound with a bright red color, due to the presence of cobalt. One practitioner has referred to B12 as "those ruddy drops that cheer sad hearts and strengthen faint hearts."1 Vitamin B12 works with folic acid in many body processes including synthesis of DNA, red blood cells and the insulation sheath (the myelin sheath) that surrounds nerve cells and facilitates the conduction of signals in the nervous system. Severe depletion manifests as pernicious anemia, which was invariably fatal until the discovery of B12 in liver. But long before anemia sets in, other conditions may manifest, most often neurological problems (numbness, pins and needles sensations, a burning feeling in the feet, shaking, muscle fatigue, sleep disorders, memory loss, irrational anger, impaired mental function and Alzheimer’s) or psychological conditions (dementia, depression, psychosis and obsessive-compulsive behavior). President Kennedy has been quoted as having said he would never have become president without injections of B12.2 Absorption Absorption of vitamin B12 is a complex process, subject to problems at several points. B12 from animal food enters the stomach as part of animal proteins and must first be liberated by pepsin and hydrochloric acid. Free B12 then attaches to R-protein, which is released from the salivary cells and parietal cells (the same cells that release hydrochloric acid). To be absorbed efficiently, B12 must attach to a protein called intrinsic factor (IF) which is also secreted in the stomach. This cannot happen until the R-protein complexes are broken down by pancreatic enzymes in the small intestine. B12 then binds with the intrinsic factor and proceeds through the gut to the lower portion of the small intestine, where the intrinsic factor-B12 complex attaches to cell receptors, a process that involves calcium. Thus, deficiencies in pepsin, hydrochloric acid, R-protein, pancreatic enzymes, intrinsic factor, calcium and cell receptors can all lead to B12 deficiency through blocked absorption. Once in the bloodstream, transport proteins bind to B12 and deliver it to the cells. Within the cells, enzymes liberate B12 from the protein complex and convert it to its two coenzyme forms, methylcobalamin and adenosylcobalamin. Deficiency in the required enzymes can block this conversion. Because the absorption process is so complicated, and therefore subject to various blocks, many people--particularly the elderly--may develop deficiencies even though they are taking in plentiful B12 in their food. Fortunately, the body absorbs about 1-5 percent of free B12 by a process of passive diffusion. Thus supplementation with large doses of crystalline B12 or with foods extremely rich in B12 can successfully treat deficiencies caused by compromised protein digestion or lack of R-protein, intrinsic factor or pancreatic enzymes. Supplementation with the coenzyme forms methylcobalamin and adenosylcobalamin (the forms found in the cells) can overcome B12 deficiency in the cells caused by lack of, or malfunction of, conversion enzymes. Vegetarians B12 is found almost exclusively in animal foods such as liver, kidney, meat, fish, shellfish, milk products and eggs but the original source of B12 in nature is bacteria, the only creatures able to manufacture this vitamin. In humans and animals, these bacteria produce B12 in the colon; however, little if any is absorbed across the colon wall so we must get our B12 from animal foods. Bivalves such as clams, mussels and oysters contain high levels of B12 because they siphon large quantities of vitamin B12-synthesizing microorganisms from the sea.3 Production of B12 supplements involves fermentation procedures similar to those used for penicillin and other antibiotics. Interestingly, while eggs contain B12, they also contain substances that block absorption,4 a fact that leaves only milk as a good source of B12 for vegetarians. Some studies indicate that B12 is better absorbed from milk than from meat.5 However, one source indicates that B12 in milk is destroyed by boiling.6 Analysis of B12 in pasteurized milk reveals only a 10 percent loss; however pasteurization deforms the milk proteins that aid in B12 absorption.7 Interestingly, some sources claim that fermentation of yoghurt from milk lowers B12 levels,8 although food tables indicate similar levels in commercial milk and yoghurt. The vitamin B12 molecule is resistant to temperatures in excess of the boiling point, unless exposed to an alkaline medium. The molecule breaks down at 250o C. Thus B12 is destroyed on the surface of grilled meat, but not in the interior. Eight percent of B12 in liver is lost by boiling for five minutes.9 Thus gentle braising or cooking steaks to rare or medium-rare best preserves B12 in meat. Until recently, vegetarian and vegan literature claimed that certain plant foods could provide B12--seaweeds, fermented soybeans, spirulina, even unwashed vegetables that have been fertilized with manure. Proponents of vegetarianism pointed to inhabitants of India, who did not seem to exhibit signs of B12 deficiency in spite of very low levels of animal foods in the diet. Yet as early as 1974, an American study found that 92 percent of vegans, 64 percent of lactovegetarians, 47 percent of lacto-ovovegetarians and 20 percent of semi-vegetarians have blood levels below normal, that is, below the low range that marks the onset of pernicious anemia.10 Today, most vegetarian literature does warn about the very real possibility of depletion and recommends routine supplementation with B12. We now know that a source of B12 in the tropical, mostly vegetarian diet in India was insect excrement and parts in stored grains and legumes.11 These would have been an unavoidable feature of traditional diets in hot climates until the advent of modern sterilization and storage techniques. Plant foods said to be sources of B12 actually contain B12 analogs (called cobamides)--substances that block the uptake of true B12 and increase the body’s need for the nutrient.12 A surprising source of cobamides is bacterial overgrowth in the small intestines, which can produce B12 analogs.13 The use of antibiotics, or a diet high in refined carbohydrates, can encourage the proliferation of bacterial overgrowth and lead to B12 deficiencies. Yet another area for concern is multivitamin products! The late Victor Herbert, a noted B12 researcher, maintains that many multivitamin products contain spurious and even dangerous analogs of B12 possibly formed when crystalline B12 interacts with other nutrients in multivitamin products, such as vitamin C, iron and copper.14 High levels of folic acid can accelerate neuropsychiatric complications in persons with B12 deficiency.15 Since folic acid intakes of vegetarians tend to be high (from green vegetables and from grain products that have been fortified with folic acid), those following a vegetarian lifestyle may be at increased risk of neurological and psychological problems. The body stores considerable B12 in the liver. Thus a delay of 5-10 years may separate the beginning of a vegetarian diet (or absorption problems) and the onset of deficiency symptoms. Interestingly, the body can recycle over 75 percent of the B12 it uses.16 Used B12 is excreted in bile and then reabsorbed in the small intestine by the same complex process described earlier. Some people have a more efficient recycling system than others and hence can go longer on a vegetarian diet without signs of deficiency. However, more B12 is excreted in the presence of high levels of fiber, a common feature of vegetarian diets.17 Vegan and vegetarian diets present a real danger for growing children because their stores are very low, especially if their mothers avoided animal foods during pregnancy and lactation. The scientific literature contains numerous case studies describing severe anemia, dramatic growth retardation, irritability and delays in the acquisition of motor skills in B12-deficient children from vegetarian families. In a recent study, researchers assayed cognitive development in 72 young people raised on diets free of all animal products until at least the age of six and then on a diet containing milk and eggs. When compared with children who had eaten normal mixed diets (including meat) all their lives, they scored substantially lower on tests measuring spatial ability, short-term memory and "fluid intelligence," that is, the capacity to solve complex problems, abstract thinking ability and the ability to learn.18 Measuring B12 Deficieny American medical opinion defines blood levels lower than 200 pg/mL as an indication of deficiency. This number is based on the level associated with the most severe manifestation of deficiency, pernicious anemia. In contrast, the lower limit in Japan and some European countries is 500-550 pg/mL, the levels associated with psychological and behavioral manifestations such as dementia and memory loss. Physicians in these countries consider blood levels of 500-1300 to be the normal range.19 According to Dr. John Dommisse, an expert in B12 deficiency, the acceptance of high levels as normal in Japan, and the willingness to readily treat psychiatric symptoms with B12 explains the low rates of Alzheimer’s dementia in that country--as well as the reason for the very high rates of Alzheimer’s in the US.20 Even with the very low cutoff currently considered the risk point, large numbers of Americans are deficient. In the ongoing Framingham Offspring Study, involving 3000 men and women in the town of Framingham, Massachusetts, researchers found that 39 percent had B12 levels in the so-called "low normal" range, that is below 258.21 Had the researchers chosen the optimal range of 1100-1300 as a measure of B12 status, very few would have qualified as B12 replete. One of the most surprising findings of this study was the fact that the youngest group (26 to 49 years old) had about the same B12 status as the oldest group (65 and up), an indication that deficiencies are becoming more common. Pernicious Anemia Pernicious (that is, "deadly") anemia occurs when a person lacks the intrinsic factor and cannot absorb B12. The most common underlying cause of pernicious anemia is an autoimmune reaction that attacks and destroys the stomach cells that produce intrinsic factor. The disease is characterized by immature, abnormally large red blood cells (macrocytes), which are very inefficient at carrying oxygen, and by white blood cells with abnormal nuclei. Early symptoms of pernicious anemia include paleness, weakness and fatigue; severe anemia causes shortness of breath, dizziness and a rapid heart rate. Those suffering from pernicious anemia require very high levels of B12 to overcome the lack of intrinsic factor. The traditional treatment was one pound per day of calf’s liver, providing almost 200 micrograms B12. Today doctors prescribe injections or oral supplements of even higher doses. Symptoms of Aging B12 deficiency mimics many of the features of old age--ataxia (shaky movements and unsteady gait) muscle weakness, spasticity, incontinence, slowed reactions, memory loss, disorientation, depression and confusion can all occur when B12 levels are low. Whether or not Alzheimer’s disease constitutes a condition of B12 deficiency is the subject of considerable debate among physicians. A recent and fascinating study of a family in Wales provides convincing evidence that low levels of B12 and Alzheimer’s are linked.22 Researchers evaluated members of a family with a genetic predisposition towards Alzheimer’s disease. They found that four out of six (67 percent) family members with confirmed Alzheimer’s disease had abnormally low blood levels of vitamin B12, compared to one out of 12 (8 percent) who were at equal genetic risk for developing Alzheimer’s but did not. The researchers speculated that a vitamin B12 deficiency could result in impaired methylation reactions in the central nervous system, a characteristic feature of Alzheimer’s, as well as the possibility that the genetic predisposition to Alzheimer’s may actually be related to a genetic impairment in the ability to absorb B12. Investigators have found vitamin B12 deficiency in 3-42 percent of persons aged 65 and older. In a recent study of geriatric patients, 43 percent had levels below 295 pmol/L.23 Should a higher point be used as bench mark, it is likely that almost all seniors would be diagnosed as deficient. Current medical practice has fixated on cholesterol as the marker for good health, using expensive lifelong drugs and soul-numbing diets to bring cholesterol levels as low as possible--a policy that has resulted in untold misery for millions and a huge financial burden on the medical system. How much more felicitous and cost effective to test everyone who reaches age 50 for B12 levels instead. For a fraction of the cost, old age could be transformed into a period of peace and contentment, instead of one of heartbreaking suffering for the elderly and their families. Research shows tremendous potential for B12 to reverse mental decline in elderly patients. In one study, 61 percent of patients with mental impairment had complete recovery with supplementation; investigators speculate that those that did not recover had suffered from deficiency so long that damage to the nervous system had become irreversible.24 Supplementation results in little improvement for those who have had full blown Alzheimer’s symptoms for greater than six months.25 Thus, routine early testing for B12 has the potential to prevent mental decline in the vast proportion of the elderly. By the time Alzheimer’s is conclusively diagnosed, it may be too late for supplementation to be effective. Heart Disease It was Dr. Kilmer McCully who elucidated high blood homocysteine levels as a marker for heart disease. Homocysteine is formed in the body from the amino acid methionine in a process that can be blocked by folic acid and vitamins B6 and B12. High homocysteine levels can result in endothelial dysfunction (a narrowing of the arteries) which in turn is believed to be a precursor of atherosclerosis. Researchers in Taiwan now report that homocysteine-induced endothelial narrowing can be avoided or at least reduced by supplementing with folic acid and vitamins B6 and B12.26 Ironically, the American Heart Association and government agencies have demonized B12-rich foods like liver and raw milk (which is also an excellent source of B6). Cancer Since B12 helps repair DNA that is damaged by radiation or oxidation, it plays a role in protection against cancer. Low levels of B12 are associated with cancer of the cervix27 and the breast28 in human studies. But research on B12 and cancer is contradictory. In one study, high levels of vitamin B12 were associated with an up to 3-fold increase in risk of developing prostate cancer.29 One explanation for these disparities lies in the fact that cancer cells develop receptors that allow them to absorb huge amounts of B12. In fact, researchers are looking at cancer drugs that combine B12 with cellular toxins such as nitric oxide. Inside the tumor cell, the nitric oxide component of the targeted drug is released, triggering cellular events leading to up-regulation of genes causing apoptosis--or programmed cell death.30 Yet, a recent study found that injections of large doses of methylcobalamin were non-toxic and suppressed tumor growth in mice fed a diet deficient in B12.31 Furthermore, holistic physicians have reported good results giving B12 to cancer patients. Dr. Max Gerson, who treated terminal cancer patients with extraordinary success, gave his patients liver injections, often combined with additional B12.32 Nervous Disorders One condition that would seem obviously correlated with B12 deficiency is multiple sclerosis (MS), a disease characterized by demyelination of the central nervous system. Yet many studies indicate that those with MS have normal blood levels of the vitamin. Japanese researchers have found that in MS patients, there is a decrease in the binding capacity of B12, thus inhibiting the transport of B12 into the cells, even in patients with normal levels in their blood.33 Even so, they were able to achieve some improvement with high-dose supplementation. The benefit of B12 for depression may be due to B12’s ability to activate a substance called tetrahydrobiopterin (BH4), a compound which in turn helps activate "feel good" neurotransmitters like serotonin and dopamine.34 Surprisingly, B12 has also proven successful in treating diabetic neuropathy, possibly because the condition of diabetes deranges B12 metabolism.35 Recurrent seizures may be a manifestation of B12 deficiency. One study found that individuals who suffered from seizures had low B12 levels.36 Other neurological problems associated with B12 deficiency include urinary incontinence37 and migraine headaches.38 In one case history, B12 worked better than steroids as a treatment for Bell’s palsy.39 Another case study reports that shaky leg syndrome responds well to B12 injections.40 Fertility B12 plays a critical role in cellular replication so it is no surprise that deficiency can manifest as low sperm count. High doses are key to successful treatment. In one study, 27 percent of men with sperm counts less than 20 million given 1000 mcg per day of vitamin B12 were able to achieve a total count in excess of 100 million;41 in a study in which men were given 6000 mcg per day, 57 percent of men with low sperm counts demonstrated improvement.42 As pernicious anemia often leads to infertility, B12 supplements can allow a woman to conceive. Traditional societies considered foods rich in B12 as important for fertility. B12 plays a key role in the development of new tissue; thus women who are deficient may not ovulate, or a fertilized egg may not develop, resulting in miscarriage. Prolonged B12 deficiency results in infertility. In one study, a woman who had suffered seven miscarriages before discovering her B12 deficiency went on to have three children once the problem was corrected.43 Other Diseases Osteoblast activity in the bones depends on B12 and bone metabolism is affected by deficiency.44 Low B12 is associated with osteoporosis45 and B12 supplements can help remineralize the bones.46 B12 deficiency occurs in 10-35 percent of all patients tested positive for HIV, attributed to various factors such as low intake, reduced absorption and depletion by drugs like AZT. B12 deficiency exacerbates neurological symptoms of AIDS. Most interesting is the fact that B12 inhibits the replication of the HIV virus. Thus B12 can serve as both a therapy against increased viral load and as nutritional support for the common symptoms of AIDS.47 B12 has been shown to be an effective treatment for asthma, especially for those whose asthma stems from sulfite sensitivity.48 Researchers in Germany have reported using B12 as part of the successful treatment of a variety of skin conditions, such as hives, seborrhea, dermatitis, eczema, shingles and lupus.49 One journal article describes a successful treatment for psoriasis.50 Huge doses were needed--30 injections of 1000 micrograms each. B12 has been used to treat both hypopigmentation (vitiligo) and hyperpigmentation.51 The carbohydrate disruption of diabetes may indicate B12 deficiency, and B12 has been used as a useful adjunct for the diabetic.52 The Russians have pioneered the treatment of glaucoma with B12, observing improvement in half of a group of 46 patients receiving 1/10 milligram dose of B12 daily;53 and a Japanese physician found that B12 injections improved various vision problems.54 Deafness is associated with B12 deficiency; supplements have been useful in treating tinnitus and noise-related hearing loss.55 B12 deficiency in pregnant women has been implicated as a factor in neural tube defects such as spina bifida in offspring.56 This raises real concerns about the contraceptive pill, which depletes B12.57 Women who have been taking the contraceptive pill should have their levels tested and supplement as necessary before becoming pregnant. B12 may be necessary for antibody response;58 low levels are associated with impaired immunity and increased infections.59 Mycotoxins from molds interfere with B12 function, which explains why a common reaction to molds is neurological problems.60 Pesticides and chemicals also deplete vitamin B12 High doses of B12 can protect against these xenotoxins.61 B12 injections have been beneficial in treating viral hepatitis.62 Finally, treatment with B12 can help with sleep disorders as the nutrient is involved in the production of melatonin.63 An Exception to Our Rule In these pages, we have consistently advised obtaining vitamins from food (including superfoods) rather than with vitamin supplements. One good reason to avoid supplements derives from research indicating that they can interfere with B12 uptake, exacerbate the symptoms of B12 deficiency or even cause the creation of B12 analogs that increase the body’s need for B12. However, when it comes to B12 itself, supplementation with isolated B12 is often necessary and appropriate. The many factors in our modern lifestlye that block the complicated uptake pathways of this important nutrient--from nutrient deficiencies to exposure to toxins to factors in processed foods that cause reduced stomach acid, autoimmune disease and enzyme disruption--make it difficult to obtain sufficient quantities from our normal diet; and since vitamin B12 in supplements is produced in exactly the same way as B12 in nature, that is, by bacterial fermentation, the danger of high doses in most cases is negligible. B12 supplements have the potential of making life better for a large portion of the population, and not just the elderly. Regular testing and treatment with supplements as needed is an important step in the transition from the modern diet back to a nutrient-dense traditional one, when, after a generation or two, supplements of any kind will no longer be needed. The authors wish to acknowledge the contribution of Lee Clifford, MS, CCN, for providing her extensive files on vitamin B12. Sidebar Articles Signs of B12 Deficiency Poor growth/failure to thrive in infants Inflamed tongue Premature grey hair Disturbed carbohydrate metabolism Fatigue Weakness Weight loss Constipation Infertility Vision problems Loss of hearing and tinnitus Numbness and tingling in the hands and feet Alcoholism Impotence Incontinence Hyperpigmentation and hypopigmentation (dark and light patches in the skin) Neuralgia, neuritis and bursitis Anemia, including pernicious anemia Spinal cord degeneration Psoriasis and other skin problems Brain degeneration Insomnia Irrational or chronic anger Violent behavior Lack of balance/abnormal gait Combat fatigue Any emotional disorder up to and including insanity Testing for B12 Deficiency The first step in determining B12 deficiency is a test of B12 levels in the blood. However, many doctors believe that blood levels are an unreliable indicator of deficiency and that tissue levels of B12 may be quite low even though blood levels are normal. They recommend also testing for elevated levels of homocysteine and methylmalonic acid (MMA), two precursors to the metabolic reactions controlled by B12. Since homocysteine levels can be elevated by a number of conditions (folic acid deficiency, B6 deficiencies, renal failure, hypothyroidism and certain genetic defects), doctors consider elevated MMA levels to be the more reliable indication of B12 deficiency. Other tests include the Schilling test, in which a tiny dose of radioactive B12 is given by mouth and the amount absorbed measured. If vitamin B12 is absorbed only when given with intrinsic factor, the diagnosis of pernicious anemia is confirmed. Because testing is so complicated, the levels considered normal in dispute, and disruption possible at numerous levels, many physicians have come to the conclusion that the only reliable way to assess the effects of subtle B12 deficiency on the blood, especially in older patients, is to observe changes (especially psychological changes) after treatment and determine empirically the best amount of supplementation for the individual patient. Since B12 is not toxic, except perhaps at extremely high levels, the empirical use of large doses to treat patients poses no danger. Avoiding B12 Deficiency Get a plentiful amount in your food. Liver or shellfish eaten at least once a week is the the best way to ensure that you are taking in adequate amounts. Avoid overconsumption of foods that block vitamin B12 intake or increase the body’s need for the vitamin, such as soy foods and spirulina. Avoid antacids and drugs that lower stomach acid levels: acid-suppressing drugs such as Tagamet, Zantac and Losec can lead to serious B12 deficiency (Koop H. Aliment Pharmacol Ther 1992;6:399-406 [review]; Marcaurd SP and others. Ann Intern Med 1994;120:211-215). Avoid diabetes drugs such as Glucophage which also interfere with B12 absorption (Archives Int Med 2002 Feb 25;162:484-85. Consume plenty of calcium. Calcium is involved in the absorption of B12 from the lower small intestine. Best sources are raw dairy products and bone broths. (Bone broths also help heal intestinal inflammation that could cause absorption problems.) Dolomite powder can also be used as a calcium source. Take coconut oil and consume lacto-fermented foods: these help fight against pathogens such as helicobacter pylori, which is associated with B12 deficiency. Eradication of the organism often clears up B12 deficiency. (Archives of Internal Medicine, May 8, 2000 160:1349-53) Avoid foods fortified with folic acid. Taking folic acid without B12 can mask signs of B12 deficiency in red blood cells but will not protect against deficiencies in the nervous system. Folic acid and B12 work together and any supplementation program should include both of these nutrients (Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academy Press. Washington, DC 1998). Avoid taking excess vitamin C, especially for long periods. The ability of vitamin C to destroy B12 has been observed by several researchers--although this is disputed by others. Small amounts of natural vitamin C are a better choice than large amounts of synthetic vitamin C. (Herbert V and Das KC. Folic acid and vitamin B12. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease. 8th ed. PhiladelphiaL Lea & Febiger, 1994:404.) Don’t smoke. Cigarette and cigar-smoking deplete vitamin B12 (New Eng J Med 1995 Nov 2;333(18):1176-82). Take extra B12 before and after surgery. Nitrous oxide anesthesia during surgery can deplete B12, a fact that may explain many cases of post-operative depression (Marie RM and others. Arch Neurol 2000 Mar;57(3):380-2). Avoid vaccinations containing thimerosol and other mercury-containing compounds. Vitamin B12 is depleted by mercury (J Molecular Psychiatry Apr 2004). Avoid molds in the environment and your food. Mycotoxins produced by molds disrupt or interfere with the normal functions of vitamin B12 (Anyanwi EC and others. Scientific World Journal 2004 Aug;4:736-45). Do not take oral contraceptives (the pill), which can deplete vitamin B12. (Henley S. Body Forum 1977 Jan 30;2(7):20; Sutterlin MW and others. Eur J Obstet Gynecol Reprod Biol 2003 Mar 26;107(1):57-61; Lussana F and others. Thromb Res 2003;112(1-2):37-41). Take B12 supplements if you have any conditions that might interfere with B12, such as celiac disease, Crohn’s disease and similar intestinal disorders, especially if you are elderly or exhibit any of the symptoms of B12 deficiency. B12 Supplementation--Shots or Pills? The standard treatment for B12 deficiency involves injections, which deliver B12 quickly into the bloodstream and bypass any defective components of the absorption mechanism. Injections are indicated in cases of extreme deficiency, when B12 stores must be replenished very quickly. The standard protocol is 1000 micrograms daily for three days, then weekly for a month, then one injection per month indefinitely. However, shots are unpleasant and expensive, requiring regular visits to the doctor’s office unless the patient is able to self administer. For all but the most urgent situations, a growing body of medical opinion supports the use of oral supplementation, especially sublingual tablets. Practitioners are now recommending a dose of 100-250 micrograms per day for maintenance purposes. Those with absorption problems may need 1000 -2000 micrograms per day. Such doses are safe because cobalamin has no known toxic effects. Those with absorption problems will absorb only a fraction of the dose (through a process of diffusion across the gut wall) but studies indicate that consistent use of oral supplementation will correct deficiency in most patients with malabsorption. In fact, a recent study showed that oral supplementation with 2000 micrograms per day was three times as effective as injections in increasing B12 levels in pernicious anemia patients (Journal of the American Geriatrics Society, January 1997 45(1):124). Dr. John Dommisse recommends very high dose lozenges (2000/2500 mcg) taken after one or two meals daily, as effective as injections in maintaining serum B12 levels in the ideal range (www.johndommisse.com/b12.html). Nasal gel perparations have also been found to be capable of maintaining ideal serum B12 levels, although this method of supplementation remains controversial. Another possible delivery method, recommended by Dr. Joseph Mercola, is delivery through the skin by mixing B12 with DMSO (www.mercola.com/2000/aug27/vitamin_b12_deficiency.htm). The most commonly used form of B12 for treatment in the US is cyanocobalamin. Only two forms are active in the body, however, methylcobalamin and adenosylcobalamin. Cyanocobalamin must be converted in the body to either methyl or adenosyl cobalamin by the enzymatic removal of a cyanide molecule. (The amount of cyanide produced during this process is very small but still could be problematical); whereas the body can immediately use supplements of methylcobalamin (the only active form of vitamin B12 commercially available in the US). In a study that looked at the ability of vitamin B12 to extend life in mice with cancer, methylcobalamin led to significant increases in survival time while cyanocobalamin had no effect (Tsao CS and Myashita K. Pathobiology 1993;61(2):104-8). The Patient Who Wept for Six Months From Your Nutrition Prescription by Dr. H.L. Newbold Several years ago a seventy-six-year-old woman was brought to my office by her daughter, who stated that the mother had been weeping uncontrollably for the past six months and had recently become so incapacitated that she was unable to do her housework. She had been to see five physicians who had treated her in five different ways, mostly with antidepressants and tranquilizers. One doctor had given her injections of multiple vitamins, which had not helped either. In spite of her normal B12 level, I gave her a trial injection of 1000 mcg of vitamin B12. I told myself that unless she quickly improved, she would need antidepressants. If the antidepressants didn’t help her a great deal within a month, she would need electroconvulsive therapy. When she returned to my office three days later, she was considerably improved. She was no longer crying, and reported that she felt much stronger and had slept throughout the night for the first time in many months. At the time of her next visit three days later, she looked happy and told me she could do her housekeeping again. During subsequent visits the daughter was taught to administer the injections to her mother twice a week, or more frequently if she seemed in greater need of the vitamin. When she returned several weeks later, the elderly lady told me that she could feel herself becoming depleted of the vitamin every three or four days, and always felt completely restored after receiving another injection. At the time of that visit she was feeling the way she had felt ten years earlier, and was busy with all the household chores which she, like so many good German housewives of her generation, immensely enjoyed. She was instructed to take the injections more often. If the injection gave her a lift, then she had waited too long. This woman is a good example of a vitamin-dependent individual. I am sure we had elevated her serum vitamin B12 level to enormous heights. It would have been a waste of money to retest her. Perhaps she was one of those people whose enzyme functions gradually fade with age. But this patient was restored to normal by giving her massive amounts of vitamins. It is even possible that certain metabolic pathways, not normally employing vitamin B12, switched pathways, and made use of this invigorated set of enzymes. At any rate, a few injections of B12 turned a crying, shuffling old woman into a bright-eyed, merry, elderly housewife who could once more take an active role in life and enjoy her remaining years. Such transformations are what chemistry and nutrition are all about. Vitamin B12 and the Nobel Prize The discovery, description, isolation and synthesis of B12 is a good example of science at its best and has resulted in four Nobel prizes, three in chemistry and one in medicine. 1934: Whipple (California), Minot and Murphy (Massachusetts) won the Nobel Prize in physiology and medicine for the discovery of the "anti-pernicious anemia factor" in liver. 1964: Dorothy Crowfoot Hodgkin (Oxford) won the Nobel Prize in chemistry for her crystal structure analysis of B12 crystal, using new X-ray techniques. 1965: R. B. Woodward (Harvard), working with B12, won the Nobel Prize in chemistry for outstanding achievements in the art of organic synthesis. 1981: K. Fukui (Kyoto) and R. Hoffman (Cornell), working with B12, won the Nobel Prize in chemistry for quantum mechanical studies of chemical reactivity. Sources of Vitamin B12 Mollusks (clams, oysters, mussels, etc) 3 ounces 84.1 micrograms Liver, beef, 1 slice 47.9 micrograms Trout, wild, 3 ounces 5.4 micrograms Salmon, 3 ounces 4.9 micrograms Trout, farmraised, 3 ounces 4.2 micrograms Beef sirloin, 3 ounces 2.4 micrograms Yoghurt 1.4 micrograms Milk, 1 cup 0.9 micrograms Pork, cured ham, canned, 3 ounces 0.6 micrograms Egg, hardboiled 0.6 micrograms Chicken breast, 1/2 breast 0.3 micrograms Vitamin B12 Recommended Daily Allowance Age RDA 0-6 months no RDA 7-12 months no RDA 1-3 years 0.9 micrograms 4-8 years 1.2 micrograms 9-13 years 1.8 micrograms 14 and older 2.4 micrograms Pregnancy 2.6 micrograms Lactation 2.8 micrograms REFERENCES HL Newbold, Mega-Nutrients, The Body Press, 1987. HL Newbold, Mega-Nutrients, The Body Press, 1987. Herbert V and Das KC. Folic acid and vitamin B12. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, Lea & Febiger, 1994:402-25. Doscherholmen A and others. Proc Soc Exp Biol Med 1975 Sep;149(4):987-90; DoscherholmenA and others. Br J Haematol 1976 Jun;33(2):261-72 Tucker KL and others. Am J Clin Nutr 2000;71:514-522 www.vegsoc.org/info/b12.html www.slowfood.com/img_sito/riviste/slow/EN/22/crudo.html. Reddy KP and others. J Dairy Sci 1976 Feb;59(2)191-5. Herbert V and Das KC. Folic acid and vitamin B12. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, Lea & Febiger, 1994:402-25. Dong A and Scott SC. Ann Nutr Metab 1982;26(4):209-16. Nature’s Way 1979;10:20-30. Herbert V. Am J Clin Nutr 1987;46:387-402. Brandt LJ and others. Ann Intern M 1977 Nov;87(5):546-51. Herbert V and Das KC. Folic acid and vitamin B12. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, Lea & Febiger, 1994:402-25. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academy Press. Washington, DC 1998; Snow CF. Arch Intern Med 1999;159:1289-98. Herbert V and Das KC. Folic acid and vitamin B12. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, Lea & Febiger, 1994:402-25. Cullen RW and Oace SM. J Nutr 1978 Apr;108(4):640-7. Louwan MWJ and others. Am J Clin Nutr 2002 Sep;72:762. Mitsuyama Y and Kogoh H. Japan J Neurol & Psychi 1988;42(1):65-71. www.johndommissemd.com/report4.html Tucker KL and others. Am J Clin Nutr 2000;71:514-522 McCaddon A and Kelly CL. Age and Aging, 1994 July;23:334-37 Van Goor and others. Age and Aging 1995;24:536-12 Healton EB and others. Medicine 1991;70:229-45 Martin DC and others. Journal of the American Geriatric Society 1992;40:168-72. Chao CL and others. American Journal of Cardiology 1999 Dec 1;84:1359-61. Hernandez BY and others. Cancer Causes Control 2003 Nov;14(9):859-70. Zhang SM and others. J Natl Cancer Inst 2003 Jul 16;95(14):1091; Choi SW. Nutr Rev 1999 Aug;57(8):250-3. Hultdin J and others. Int J Cancer 2005 Feb 20;113(5):819-24. http://www.news-medical.net/print_article.asp?id-213. http://www.annieappleseedproject.org/studofvitb12.html. Max Gerson, MD. A Cancer Therapy: Results of Fifty Cases. Totality Books, Del Mar, California, 1958. 1975. Kira J and others. Int Med 1994;33:82-6. Curtius H and others. Journal Neurological Trans 1982;55:301-8; Leeming R and others. Journal Mental Def Research 1982;26:21-5. Davidson S. J Flor Med Association 1954:15:717-20. Kumar S. Neurol India 2004 Mar;52(1):122-3. Dallosso H and others. Eur J Clin Nutr 2004 Jun 58(6):920-6. Bianchi A and others. Vitamin Horm 2004;69:297-312 Jaialudin MA. Methods Find Exp Clin Pharmacol 1995;17:539-544. Benito-Leon J and Porta-Etassam, J. New England Journal of Medicine 2000 342(13):981. Sandler B and Faragher B. Infertility 1984:7;133-8. Kumamoto Y and others. Acta Urol Japan 1988;34:1109-32. Bennett M. J Reprod Med 2001 Mar;46(3):209-12. Carmel R and others. N Engl J Med 1988;319:70-5. Tucker LK and others. J Bone Miner Res 2005 Jan;20(1):152-8. Melton ME and Kochran ML. Metabolism: Clin & Exp 1994 Apr;13(4):468-9. Palteil O and others. American Journal Hematology 1994;47:167-71. Garrison R and Somer E. The Nutrition Desk Reference, Chapter 5. Vitamin Research; Selected Topics. Keats Publishing, New Canaan, CT 1985, pp 93-4. Peisner B. Dtsch Med J. 1955 Aug 15;6(15-16):519-22; Neber H. Munch Med Wochenschr 1955 Aug 26;97(34):1102-3. Ruedemann R. AMA ARch Derm Syphilol 1954 Jun;69(6):738-9. Juhlin L and Olsson NJ. Act Derm Venereol 1997;77:460-462; Mori K and others. J Dermatol 2001 May;28(5):282-5. Bhatt HR and others. Lancet 1983;2:572 Reported in Body, Mind and the B Vitamins, Ruth Adams and Frank Murray, Larchmont Books, Los Angeles, CA. 1979. New Scientist, August 13, 1964; Larner AN. Int J Clin Pract 2004 Oct;58(10):977-8. Shemish A and others. American Journal of Otolarygol 1993;14:94-9; Am J Clin Nutr March 1999;69:564-71 Groenen PM and others. Am J Obstet Gynecol 2004 Jul;191(1):11-17. Henley S. Body Forum 1977 Jan 30;2(7):20; Sutterlin MW and others. Eur J Obstet Gynecol Repord Biol 2003 Mar 26;107(1):57-61; Lussana F and others. Thromb Res 2003;112(1-2):37-41 Dreizen S. Int J Vitam Nutr Res 1979;49(2):220-8. Tamura J and others. Clin Exp Immunol 1999 Apr;116(1):28-32. Anyanwi EC and others. Scientific World Journal 2004 Aug;4:736-45. Watson WP and others. Chem Res Toxicol 2004 Dec;17(12):1562-7. Jain ASC and Mukerji DP. J Indian Med Assoc 1960;35:502-5. Okawa M and others. Sleep 1990;13:1-23. This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Spring 2005. About the Authors Sally Fallon Morell is the author of Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats (with Mary G. Enig, PhD), a well-researched, thought-provoking guide to traditional foods with a startling message: Animal fats and cholesterol are not villains but vital factors in the diet, necessary for normal growth, proper function of the brain and nervous system, protection from disease and optimum energy levels. She joined forces with Enig again to write Eat Fat, Lose Fat, and has authored numerous articles on the subject of diet and health. The President of the Weston A. Price Foundation and founder of A Campaign for Real Milk, Sally is also a journalist, chef, nutrition researcher, homemaker, and community activist. Her four healthy children were raised on whole foods including butter, cream, eggs and meat. Mary G. Enig, PhD is an expert of international renown in the field of lipid biochemistry. She has headed a number of studies on the content and effects of trans fatty acids in America and Israel, and has successfully challenged government assertions that dietary animal fat causes cancer and heart disease. Recent scientific and media attention on the possible adverse health effects of trans fatty acids has brought increased attention to her work. She is a licensed nutritionist, certified by the Certification Board for Nutrition Specialists, a qualified expert witness, nutrition consultant to individuals, industry and state and federal governments, contributing editor to a number of scientific publications, Fellow of the American College of Nutrition and President of the Maryland Nutritionists Association. She is the author of over 60 technical papers and presentations, as well as a popular lecturer. Dr. Enig is currently working on the exploratory development of an adjunct therapy for AIDS using complete medium chain saturated fatty acids from whole foods. She is Vice-President of the Weston A Price Foundation and Scientific Editor of Wise Traditions as well as the author of Know Your Fats: The Complete Primer for Understanding the Nutrition of Fats, Oils, and Cholesterol, Bethesda Press, May 2000. She is the mother of three healthy children brought up on whole foods including butter, cream, eggs and meat.

University of Missouri Extension

MP906, New April 2009

Get your Gardeners' Welcome Packet to accompany this publication

The Gardeners' Welcome Packet is a set of documents that can be edited and revised by gardeners and garden leaders. It is available in RTF and PDF formats. The packet is intended to be a tool for organizing your garden, introducing new gardeners to the policies, procedures and people that keep the garden running smoothly, and keeping returning gardeners updated and involved. It is also intended to help gardeners find a clear and easy way to play an active role in the garden's management and upkeep. Although these written materials will not take the place of face-to-face communication with gardeners, they can provide a framework for improving communication and increasing involvement at your garden.

The Gardeners' Welcome Packet includes the following contents:

• Welcome to community gardening
• Community garden success and security
• Community garden job descriptions
• Roster and map
• Contact list and calendar
• Frequently asked questions
• Gardener guidelines
• Gardener application
• Planting, harvesting, composting, pests, disease and more

Gardeners' Welcome Packet

• Download a free PDF
• Download a free RTF

Community Gardening Toolkit

Bill McKelvey
MU Extension Associate
Healthy Lifestyle Initiative

What is a community garden?

Introduction
A community garden means many things to many people. For some, a community garden is a place to grow food, flowers and herbs in the company of friends and neighbors. For others, it's a place to reconnect with nature or get physical exercise. Some use community gardens because they lack adequate space at their house or apartment to have a garden. Others take part in community gardening to build or revitalize a sense of community among neighbors.

Community gardens also take many shapes and forms. From a 50-by-50-foot church garden that supplies a local food pantry with fresh produce to a vacant city lot divided into plots and gardened by neighbors, community gardens reflect the needs and the desires of people directly involved in their management and upkeep. As such, there are many, many ways to organize and manage a community garden.

Regardless of why people choose to take part in a community garden or how a garden is organized, the activity of gardening with others can be both rewarding and challenging. Our hope is that this guide will help you manage the challenges that come your way and experience the rewards of community gardening. This guide is intended to be a resource for gardeners, garden organizers, extension staff and other agency professionals who want to start a new community garden, enhance an existing garden or assist community members with starting and managing their own community garden.

Characteristics of neighborhood community gardens
This guide provides a framework for organizing and managing different types of community gardens with a primary focus on neighborhood community gardens, which typically share the following characteristics.

First, neighborhood community gardens are typically located on land that is divided into different plots for individual and family use. The land may be borrowed, rented or owned by the gardeners, and gardeners generally prepare, plant, maintain and harvest from their own plots. Gardeners and their family, friends and neighbors usually consume produce from the gardens rather than selling it. Gardeners often share tools, water and compost, along with seeds and plants.

Second, neighborhood community gardens are often organized and managed by the gardeners themselves, have one or more identified leaders responsible for managing the day-to-day activities of the garden and have some type of a garden committee to share in the work. Because community gardens come with a host of responsibilities that range from making plot assignments and keeping the grass mowed to resolving conflicts and enforcing the rules, things tend to run more smoothly when one or more people are in charge and gardeners themselves take an active role keeping the garden in shape.

Finally, in addition to occupying vacant neighborhood lots, neighborhood community gardens are sometimes found at churches, social service agencies and other nonprofit organizations, including food pantries and food banks. These gardens may involve both neighbors from the surrounding area and the members or clients of a particular agency or institution. They sometimes incorporate educational, job-training and entrepreneurial programming.

Other types of community gardens
In addition to the typical neighborhood community garden where plots are subdivided and cared for by individuals or families, community gardens exist in a variety of other forms to serve a number of functions. The examples below represent different types of community gardens that are distinguished in part by their purpose and participants.

• Youth/school gardens expose young people to gardening and nature, give them the opportunity to do some of their own gardening and/or educate them in a variety of subject areas. These gardens are typically associated with a formal or semi-formal program that incorporates classroom lessons with hands-on gardening activities. Gardens may be located on school grounds, at a community center, in neighborhoods or on other parcels of land.
• Entrepreneurial/job training market gardens are typically established by nonprofit organizations or other agencies to teach business or job skills to youth or other groups. They grow and sell the produce they raise. Proceeds from the sale of garden products are used to pay the participants for their work. Programs typically rely on outside sources of funding to offset costs.
• Communal gardens are typically organized and gardened by a group of people who share in the work and rewards. Plots are not subdivided for individual or family use. Produce is distributed among group members. Sometimes produce is donated to a local food pantry.
• Food pantry gardens may be established at a food pantry, food bank or other location. Produce is grown by volunteers, food pantry clients, or both and donated to the food pantry.
• Therapy gardens provide horticultural therapy to hospital patients and others. A trained horticulture therapist often leads programs and classes. Gardens may be located at hospitals, senior centers, prisons or other places. Demonstration gardens show different types of gardening methods, plant varieties, composting techniques and more.
• Demonstration gardens located at working community gardens are often open to the general public for display and classes. They may be managed and maintained by garden members or a participating gardening group such as extension Master Gardeners, community members who receive training in home horticulture and then serve as volunteers to educate the public about gardening.

*Adapted in part from: From Neglected Parcels to Community Gardens: A Handbook, Wasatch Community Gardens

Other gardens are distinguished more by their location and less by their purpose. These gardens may combine elements of a neighborhood community garden with other community garden models. Examples include, but are not limited to: public agency gardens, community center gardens, senior gardens, church gardens, apartment complex/public housing gardens and prison gardens.

Rural community gardens
Although community gardens are often associated with urban areas, they exist in many rural areas as well. However, because of the unique characteristics of rural places, they often take on different forms and serve different functions. Research conducted by Ashley F. Sullivan (1999) from the Center on Hunger and Poverty at Tufts University identified a number of ways in which rural community gardens differ from their urban counterparts. Her research uncovered different types of rural community gardens along with obstacles to community gardening in rural areas.

Sullivan identified seven different types of rural community gardens in her study. They included the following:

• Traditional neighborhood-type gardens with individual and family plots;
• Gardens that provide demonstration and education to gardeners at neighborhood gardens and home gardens;
• Communal gardens tended collectively with the produce going to a local food pantry;
• Educational gardens that offer classes to the public;
• School gardens that incorporate gardening and nutrition education;
• Community-assisted home gardens where an experienced gardener mentors novice gardeners in their home gardening efforts;
• Gardens affiliated with an existing agency, apartment complex or church.

Sullivan identified obstacles to community gardening in rural areas as well. Obstacles include a high rate of gardener and volunteer turnover, animosity between "outsiders" and community members, lack of gardening skills and lack of transportation.

Sullivan also offers recommendations for overcoming some of these obstacles:

• Do not assume that the traditional neighborhood community garden model will work in rural areas.
• During the planning stages, identify obstacles to starting a community garden in a rural area.
• Identify solutions to the obstacles.
• Respect the values of the community and incorporate those values into the garden's design.
• Be flexible when deciding how to organize a garden; incorporate different models into a plan to see which one works best.
• Help gardeners cultivate a sense of ownership for the garden.
• Take time to look at all of the factors that might hinder participation.
• Involve local organizations and businesses.

See the history of community gardening

Challenges
A discussion of starting and managing a community garden would be incomplete without a discussion of the challenges encountered by gardeners and garden organizers. Common challenges faced by most community garden groups include:

• Management
  Community gardens are management intensive. They demand patience, time and the capacity to work with and organize people and projects. They also typically require systems to enforce rules and resolve conflicts.
• Maintenance
  Community gardens are maintenance intensive. Grass will need to be mowed, equipment will need to be repaired, and plant debris will need to be composted, among other things.
• Participation
  From year to year, gardeners and garden leaders come and go from community gardens for a variety of reasons. Because of this, it can be challenging to maintain a sense of community and consistency at gardens.
• Theft and vandalism
  Theft and vandalism are commonplace at many community gardens. As a general rule, theft is the result of adult activity and vandalism is carried out by children.
• Gardening skills
  Many new and some returning gardeners don't know a lot about gardening. Gardeners who lack gardening skills and have poor gardening experiences may be more likely to give up.
• Leadership skills
  Many gardeners may not have the skills to take a leadership role at their respective garden.
• Services and supplies
  Plowing, tilling and the delivery of compost and mulch can be challenging services for gardeners to arrange for themselves.
• Water
  Most gardens need some way to irrigate fruits and vegetables during the summer. Finding a source of water can be challenging. Also, because most community gardens are located on borrowed land, installing a water hydrant may not be feasible or cost effective.
• Site permanency
  Most community gardens are located on borrowed land. This limits the amount of infrastructure that can be added to a particular site. It may also create an atmosphere of instability among gardeners since the garden could be lost at any moment.

See stories from experience

See the benefits of community gardening

Starting a community garden

Before getting into the nuts and bolts of starting a community garden, it's helpful to lay a foundation for the work at hand.

From the outset, it is essential to understand that community gardening is about more than growing food, flowers and herbs. It's also about interpersonal relationships, group dynamics, planning and organizing, group decision-making and the associated rewards and challenges that come with working with people. In short, community gardening is as much about "community" as it is "gardening."

If community is so important to community gardening, then how do we orient ourselves to the task of starting or enhancing a community garden?

The authors of the Growing Communities Curriculum (Abi-Nader et al., 2001) offer a set of suggestions developed by community gardening experts from across the country. These suggestions, written in the form of "core beliefs," can be used to guide the development of your community garden and provide a strong foundation for growth.

Taken as a whole, these core beliefs emphasize the importance of being inclusive, making room for diverse ideas and utilizing local assets when starting a community garden. They also demonstrate the importance of using a bottom-up or grassroots approach when developing a garden. As the authors have learned over the years, most successful community gardens are initiated, established and managed by the gardeners themselves. When gardeners have the opportunity to take ownership in a project, they are more likely to invest their time and effort in making the garden a success.

Additionally, keeping these suggestions in mind may help you overcome some of the challenges that arise when moving forward with a community garden project. For example, the people involved in your project will likely come from different backgrounds and have different ways of relating to each other and the project. They will bring their unique personalities, perceptions, knowledge, skills and experience to a group situation. They will have different ideas about how to accomplish a project. Some group members may learn faster than others. Some will be more pessimistic. Others will be more optimistic. Regardless of these differences, the group should be committed to remaining open and patient with all group members and creating the time and space to facilitate dialogue about the best way to accomplish the tasks at hand.

Five core beliefs of working in groups

• Core belief 1
  "There are many ways to start and manage a community garden." Although this may be a given, it helps to remember that community gardens can serve many purposes and take many forms.
• Core belief 2
  "In order for a garden to be sustainable as a true community resource, it must grow from local conditions and reflect the strengths, needs and desires of the local community." Assistance from people or organizations outside of the community can be helpful. However, those who will be using the garden should make most of the decisions about how the garden is developed and managed.
• Core belief 3
  "Diverse participation and leadership, at all phases of garden operation, enrich and strengthen a community garden." Gardens can be stronger when they are developed and led by people from different backgrounds.
• Core belief 4
  "Each community member has something to contribute." Useful skills and good suggestions are often overlooked because of how people communicate. People should be given a chance to make their own unique contributions to the garden.
• Core belief 5
  "Gardens are communities in themselves, as well as part of a larger community." This is a reminder to involve and be aware of the larger community when making decisions.

From idea to action — Ten steps to success

The Growing Communities Curriculum notes that community gardens generally start in one of the following two ways. Scenario one: One person or a small group of people has the idea to start a community garden. Scenario two: An outside group or local agency has the idea and land available to start a community garden.

Whether you are involved in a volunteer group or part of a local agency, the basic steps for moving from an idea to planting the first seed are the same. The following 10 steps can serve as your guide.

See role of an outside facilitator or community organization

Step 1
Talk with friends, neighbors and local organizations about your idea.
As you talk to people, collect names and numbers of those who are interested. If people voice opposition or concern, take note and be sure to address these concerns in future meetings. As a general rule, aim to find at least 10 interested individuals or families who want to be a part of the garden before moving to the next step.

Purpose, values, vision and action planning

Your first meeting may be an appropriate time to define your group's purpose, values and vision. This can help your group develop a common understanding of why you are embarking on a community garden project (purpose), the beliefs and principles you share that underlie your purpose (values) and the long-term goal or outcome you hope to achieve (vision).

At subsequent meetings, you may wish to draft an action plan to identify steps to take throughout the rest of your garden startup process. This can help your group get organized, stay focused and add a measure of accountability to your process.

The identified action steps can also be the basis for forming garden teams to handle various garden-related tasks.

*For more information, see Vision to Action: Take Charge Too, from the North Central Regional Center for Rural Development. To order a printed copy for $25, contact NCRCRD, Iowa State University, 107 Curtiss Hall, Ames, IA 50011-1050, or call 515-294-9768.

Step 2
Hold a meeting with anyone interested in the garden
The purpose of this meeting is to determine the feasibility of starting a garden, to brainstorm ideas and to address some basic questions. This meeting can be informal or formal, but at the very least, one person should be responsible for taking notes and sending them to the group after the meeting. Publicize the meeting to individuals, groups and relevant organizations using phone calls, personal visits, e-mails or fliers posted around your community.

See quetions to address at an initial meeting

Soil testing

Soil tests can usually be obtained through your local extension office. To search for an office in your area, go to the U.S. Department of Agriculture Cooperative State Research, Education and Extension Service. In Missouri, the MU Soil and Plant Testing Laboratory offers nutrient and heavy metal soil tests for gardens and lawns through the Columbia campus and local Extension offices.

Step 3
Find and evaluate potential garden sites
Get on your bike. Go out on foot. Tour the neighborhood with friends and family and talk to your neighbors. Be sure to consider churches, nonprofit agencies and businesses as potential partners. These groups may own land and have an interest in being a part of your garden.

See questions to help evaluate potential garden sites

Step 4
Identify local resources needed for starting a garden
Gardens can require a fair amount of tools, equipment, supplies, infrastructure, knowledge and other forms of support. Gardeners themselves can provide some resources. For other resources, it makes sense for the group to seek out and acquire materials in bulk or solicit donations and support from other groups.

See questions to identify local resources needed

Step 5
Hold a second meeting.
The purpose of this meeting is to discuss the notes from the previous meeting and hear reports from the people who volunteered to find and evaluate possible locations for a garden (Step 3) and identify local resources for starting a garden (Step 4). If you completed the Purpose, Values, Vision exercise, you may wish to revisit this document to see if people are still in agreement and to gain input from new group members.

If your group feels like the primary issues have been adequately addressed and enough people are committed to the project, you may be ready to evaluate and select one or more sites to pursue for your garden.

You may also be ready to elect your garden's leadership team. At the very least, you will need to have one or more garden co-leaders and two to three additional people to handle important tasks such as drafting and negotiating the lease agreement (Step 6), leading the planning and preparation of the site (Step 7 and Step 9), and drafting gardener guidelines and the gardener application (Step 8).

Asset-based community development

Rather than focus first on a community's needs and deficiencies, the asset-based community development approach takes stock of a community's capacity for change by identifying the "assets, skills and capacities of residents, citizens associations and local institutions" within a given community (Kretzmann and McKnight, 1993). For more information on this approach, check out Building Communities From the Inside Out by John P. Kretzman and John L. McKnight from your local library. Also, visit the Asset-Based Community Development Institute.

Step 6
Draft a lease agreement
It is in everyone's best interest to have a written agreement that outlines your group's and the landlord's obligations and responsibilities and includes a "hold harmless" clause that states that the landlord is not responsible if a gardener is injured on the property. Try to negotiate a lease that enables your group to use the land for at least three years.

See the sample permission for land use

Raised-bed gardening

There are a number of advantages to building and using raised beds. According to Christopher J. Starbuck, associate professor with MU Division of Plant Sciences, raised garden beds allow for better drainage, are easier to maintain, and can be used on sites with poor soil. Raised-bed gardening may also lead to higher yields and allow for an extended growing season. On the other hand, raised-bed gardens are typically more expensive to build than in-ground gardens because of the cost of materials, compost and soil. Also, where summers are hot, the soil in raised beds may have a tendency to dry out faster. For more information, see MU Extension Publication G6985, Raised-Bed Gardening.

Step 7
Develop a site plan
The plan for your garden can be as simple or elaborate as you choose. Consider including the following elements in your plan:

• The boundary of the lot
• The location and size of garden beds
• Any trees, shrubs or existing vegetation that will be kept
• Driveways, pathways and open spaces
• Compost bins
• A shed
• The location of the water source
• Common or shared garden areas such as perennial or herb beds, a row planted for donation purposes, a picnic table with chairs, or grassy areas
• Garden sign
• Garden name

Step 8
Establish gardener guidelines and draft the gardener application
Just as there are many types of community gardens, there are many types of gardener guidelines and gardener applications. Having clear guidelines for gardeners to follow and an application to collect their contact information will aid in your efforts to keep order among and stay in touch with gardeners.

For starters, let's look at some common issues that most gardener guidelines address.

• Application or membership fee. Is there a fee to garden? How much is the fee? Is there a sliding scale? When is the fee due?
• Plot maintenance. Is there an expectation that plots will be maintained to a certain standard? What happens if a plot is not maintained? Who decides?
• Garden maintenance. Are gardeners expected to volunteer for certain chores?
• Planting restrictions. Are there restrictions on which types of plants can be grown?
• End of the season. Do plots need to be cleaned by a certain date at the end of the season?
• Composting. Which materials may and may not be composted?
• Materials and tools. Are shared materials and tools available for gardeners to use? How should these items be handled and stored?
• Pesticides. Which pesticides are allowed?
• Other people's plots. How should gardeners treat and respect others' gardens?
• Water. Can the water be left on unattended?
• Pets and children.
• Alcohol and drugs.
• Unwanted activities. How should theft, vandalism and other unwanted activities be handled and reported?
• Violation of garden rules. What happens if a rule is violated?

For an exhaustive compilation of garden rules, click on "Community Garden Rules" at Gardening Matters.

See an example of gardener guidelines

As for gardener applications, most gardens collect the following information:

• Name, address, phone number and e-mail address
• Number and location of plot(s) assigned
• Total plot fee paid
• Sign up for a garden job/chore
• Request for help if the person is a new gardener
• Offer to help if the person is an experienced gardener
• Photo permission
• Phone and e-mail list permission
• Agreement to follow all of the garden rules
• Hold-harmless clause
• Signature and date

See an example of a gardener application

During the planning stage, it may be wise to treat these initial documents as drafts that will be revised by the gardening group after the first season. In addition, after your first season, it is strongly recommend that you create a relatively comprehensive set of written documents that explain how your garden operates and how gardeners can be involved. To aid your efforts in this process, a link to a downloadable Gardeners' Welcome Packet is included in this toolkit.

Step 9
Prepare and develop the site
Once you've held the meetings, gained commitments from a number of people, selected a location, identified and assembled the resources, drafted and signed the lease, established the garden rules and made the plans, it's time do the physical work of preparing and developing your community garden.

There are many ways to go about this, and much will depend on the condition of your site. Generally, groups will schedule regular workdays to take care of the initial tilling, trimming and building projects. It is helpful if one or more people can lead various projects and coordinate equipment, supplies and volunteers.

Step 10
Celebrate your success
Don't forget to take a step back and recognize your accomplishments. Hold a garden party and invite neighbors, local businesses and organizations. Show off the work you've done, and talk to people about your plans for the future. This is a great way to gain community support for your garden.

Additional information for local agencies interested in starting a community garden, or groups interested in involving an outside organization

As noted previously, community gardens are generally started by individuals or small groups of neighbors or an outside group or local agency. In the latter case, the process of starting a garden is very similar to the process outlined previously, with a few added twists.

First, an outside group or agency needs to be clear about its reasons for wanting to start a community garden. Just as a small group of neighbors should be clear about its purpose and vision for a gardening project, an outside group or local agency should take the time to define its own purpose and vision for the project.

Second, an outside group or agency needs to be clear about its role in the garden's establishment and management. What exactly does the group or agency expect to contribute to the project? Money, staff time, equipment, land, training, other resources? For how long?

Finally, it is very important that the outside group or local agency involve clients and potential gardeners from the beginning. All too often, outside groups or agencies develop well intentioned plans without engaging the people who will be affected by them.

Role of an outside facilitator or community organization
In some cases, a volunteer gardening group will enlist the help of a facilitator or community organ­ization who is not a part of the immediate group. Trained facilitators and organizers, such as university extension staff or other agency professionals, can assist groups as they work through the process of starting a community garden.

However, the garden group and the outside facilitator should be clear about their respective roles. The facilitator's job is to help move the group along and assist with the group process. It is not the facilitator's job to do the actual work of starting and managing the garden. According to Jack Hale, executive director of Knox Parks Educations in Hartford, Conn., facilitators and organizations should use the following guidelines (Growing Communities Curriculum, p. 58) when engaging with garden groups:

• Facilitators or organizations should only work with groups that have at least 10 committed gardeners. Expect half of these people to drop out before the project is completed.
• The gardening group should accomplish at least one task — locating potential garden sites, finding out who owns a particular site, checking for water, etc. — before the first meeting.
• At the first meeting, everyone should be assigned a job to complete before the second meeting.

Additional things to consider while getting started

Growing a garden
Your local extension office can provide an array of resources concerning horticulture, composting, food safety and preservation. To search for an office in your area, go to the U.S. Department of Agriculture Cooperative State Research, Education and Extension Service.

Creating a garden roster and map
As interest in your community garden begins to grow, it is essential to keep good records of interested gardeners, existing gardeners and plot assignments. Garden leaders will need to collect the names, addresses, phone numbers and e-mail addresses of individuals. They will also need to create a map of the garden, keep track of plot assignments and develop a system for contacting gardeners. All of this can be done with paper and pencil or you can use spreadsheets to create electronic documents.

Enhancing opportunities for success
New and returning gardeners may need support and encouragement to keep up with their garden plot for the entire season. Garden leaders can encourage gardeners to take the following steps to enhance their chances of success:

• Visit the garden two to three times a week during the growing season to keep from being overwhelmed by weeds, pests and disease.
• Attend scheduled meetings and workdays and volunteer for a committee to meet other gardeners and contribute to the garden.
• Make friends with other gardeners to share challenges, successes and gardening tips.
• Study, attend classes or participate in an extension Master Gardener program to learn more about gardening.

Security and personal safety
Theft and vandalism can be common occurrences at community gardens, regardless of the height or strength of your fence. The following tips are intended to help minimize theft and vandalism and keep gardeners safe while working at the garden.

• Know your neighbors.
  Learn the names and a little about your non-gardening neighbors. Share some extra produce. Take the time to visit with them about how the garden works if they're not familiar with it. You may be surprised to find that people just assume that they can take food from the garden. "Hey, it's for the community, right?"
• Harvest produce on a regular basis.
  Some thieves use the excuse that "a lot of food is going to waste" to justify taking food from a garden. During harvest season, let other gardeners know if you plan to be out of town for more than a few days. Gardeners can harvest for you and donate the food to a local pantry.
• Consider growing unpopular, unusual or hard-to-harvest varieties.
  Thieves generally go for easy-to-snatch things like tomatoes, peppers and corn.
• Grow more than you need.
• Put a border or fence around your garden or individual plots.
  Even a simple barrier can be a deterrent.
• Use common sense.
  Although your garden may be well lit by street lights, only garden during daylight hours. Garden in pairs or keep a cell phone nearby if it makes you feel more comfortable.
• Report theft, vandalism and unusual activities to garden leaders and the police.
  The more people you have looking out for the garden and talking about what's going on, the more success you'll have at being safe and curbing unwanted activities.

Additional tips can be found in the "Theft and vandalism" article at American Community Gardening Association.

Leadership
Leadership at a community garden is a vital part of any garden's ultimate success. While garden leaders may typically wear many different hats, their primary role is to help other gardeners find meaningful ways to be involved in the garden. All too often, garden leaders take on the responsibility of coordinating meetings and workdays, making plot assignments and drafting and enforcing rules when they could be enlisting the help of other garden members to do those and other jobs. Regardless, learning to be a leader takes time. It also requires the willingness and ability to lead by example. According to the Citizen's Handbook by Charles Dobson of the Vancouver Citizen's Committee, effective leaders are able to:

• Lead by example
• Delegate work
• Appreciate the contributions of others, regardless how large or small the contribution
• Welcome and encourage criticism
• Help people believe in themselves
• Articulate and keep sight of the higher purpose
• Avoid doing all of the work.

More specifically, effective community garden leaders are able to maintain frequent and regular contact and communication with gardeners and enlist the help of other gardeners with the following tasks:

• Forming a team or scheduling regular workdays to complete garden projects and maintain common areas
• Hosting community gatherings to involve neighbors and gardeners
• Planning winter or off-season activities or meetings
• Drafting and enforcing garden rules
• Seeking out funding sources
• Developing a garden budget
• Making sure that both gardeners and interested neighbors know how to become involved

Adapted from Great Garden Leader Practices, Hannah Reinhart and Lauren Maul, Gateway Greening, St. Louis

Making the garden accessible to all
Community gardens tend to attract a wide variety of people, including those with physical or other challenges. Because of this, it is helpful to think of ways to make your garden accessible to all gardeners. Building accessible raised beds for those who use wheelchairs or have trouble bending over is one way to make the garden more accessible. For more information, see MU Extension Publication G6985, Raised-Bed Gardening. Another great publication is Accessible Raised Beds, by the Community Action Coalition for South Central Wisconsin, Inc.

Donating food
Food banks, pantries and kitchens generally welcome donations of fresh produce from community gardeners. However, it is important to check with them before making a delivery to determine their hours of operation and their capacity to handle fresh fruits and vegetables. For a listing of organizations and agencies in your area that accept food donations, search the Internet or check your local phone book. To become involved in a national effort to increase fresh produce donations to food banks, pantries and kitchens coordinated by the Garden Writer's Association, check out the Plant a Row for the Hungry program.

Funding
Often, little money is needed to start a community garden. However, it is helpful to think about potential expenses and create a simple budget to have an idea of the amount of money or materials needed for your project. Often, gardeners can sustain the garden themselves. They can either provide their own equipment and supplies or they can pool their money to purchase items as a group. In other cases, gardeners may seek donations of money or materials from community members, local organizations or businesses. Partnering organizations can sometimes cover the cost of water, insurance and other supplies. A number of grant opportunities also exist. For an excellent article that covers fundraising for community gardens, see American Community Gardening Association. For information about funding, search the Web for "community garden grants."

See a sample community garden budget

Liability insurance for community gardens
In recent years, community gardens have come under increasing pressure to carry liability insurance. Although liability insurance can be quite expensive for individual gardens, larger organizations can often obtain policies for community gardens at a reasonable price or add them to an existing policy. For a more detailed discussion of this issue by Jack Hale, executive director of the Knox Parks Foundation, see the "Insurance for Community Gardens" article at American Community Gardening Association.

Starting a community gardening organization
Once your garden is up and running, you may be interested in exploring the possibility of starting an organization to support community gardening in your area if one doesn't already exist. For more information, see the "Setting Up a New Gardening Organization" article at American Community Gardening Association.

Policy and advocacy
There are many resources concerning policy and advocacy on the "Advocacy" page of the American Community Gardening Association.

In addition, check out American Community Gardening Association's Community Greening Review, Volume 10, 2000, titled Making policy: Steps beyond the physical garden. The publication includes information about how to craft and use policies to support community gardens. It also includes information about how to lobby government officials.

Also, an article from Legislation and Public Policy, Volume 3:351, titled Community development through gardening: State and local policies transforming urban open space, by Jane E. Schukoske. This scholarly article contains research about the value of community gardens, legal issues faced by gardens and an evaluation and summary of state and local ordinances concerning community gardens.

Evaluation
At some point, you may wish to evaluate your progress, either for your own benefit or to apply for a grant. A sample community garden evaluation form for adults and youth can be found under the "Sample Evaluation Tools" heading at the American Community Gardening Association.

Networking
To connect with other community gardeners in the United States and Canada, consider joining both the American Community Gardening Association and its e-mail discussion list.

See additional resources for community gardening and appendix of sample forms

MP906, new April 2009

Related MU Extension publications

• G6985, Raised-Bed Gardening
  http://extension.missouri.edu/publications/DisplayPub.aspx?P=G6985
• MP737, Garden 'n Grow: Leader Handbook
  http://extension.missouri.edu/publications/DisplayPub.aspx?P=MP737
• MP738, Garden 'n Grow: Gardener's Notebook
  http://extension.missouri.edu/publications/DisplayPub.aspx?P=MP738

Order publications online at http://extension.missouri.edu/explore/shop/ or call toll-free 800-292-0969.

The Four Cats

The 4 cats

A Little humor to brighten your day. It did mine.

The Four Cats

Four men were bragging about how smart their cats were.


The first man was an Engineer,
The second man was an Accountant,
The third man was a Chemist, and
The fourth man was a Government Employee.

To show off, the Engineer called his cat, 'T-square, do your stuff.'

T-square pranced over to the desk, took out some paper and pen and promptly drew a circle, a square, and a triangle.

Everyone agreed that was pretty smart.

But the Accountant said his cat could do better. He called his cat and said,
'Spreadsheet, do your stuff.'

Spreadsheet went out to the kitchen and returned with a dozen cookies. He divided them into 4 equal piles of 3 cookies.

Everyone agreed that was good.

But the Chemist said his cat could do better. He called his cat and said, 'Measure, do your stuff.'

Measure got up, walked to the fridge, took out a quart of milk, got a 10 ounce glass from the cupboard and poured exactly 8 ounces into the glass without spilling a drop.

Everyone agreed that was pretty good.

Then the three men turned to the Government Employee and said, 'What can your cat do?'

The Government Employee called his cat and said, 'CoffeeBreak, do your stuff.'

CoffeeBreak jumped to his feet.......

Ate the cookies........

Drank the milk.......

S**t on the paper.......

Screwed the other three cats.......

Claimed he injured his back while doing so........

Filed a grievance report for unsafe working conditions.......

Put in for Workers Compensation................and

Went home for the rest of the day on sick leave............

AND THAT, MY FRIEND IS WHY EVERYONE
WANT'S TO WORK FOR THE GOVERNMENT!!

Symptoms of a Stroke...

INFORMATION EVERYONE SHOULD KNOW........................
Blood Clots/Stroke - They Now Have a Fourth Indicator, the Tongue


I will continue to forward this every time it comes around!

My nurse friend sent this and encouraged me to post it and spread the word.
I agree.

If everyone can remember something this simple, we could save some folks.
Seriously..

Please read:

STROKE IDENTIFICATION:

During a BBQ, a friend stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics) .she said she had just tripped over a brick because of her new shoes..

They got her cleaned up and got her a new plate of food. While she appeared a bit shaken up, Ingrid went about enjoying herself the rest of the evening

Ingrid's husband called later telling everyone that his wife had been taken to the hospital - (at 6:00 pm Ingrid passed away.) She had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Ingrid would be with us today. Some don't die. they end up in a helpless, hopeless condition instead.

It only takes a minute to read this...

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke...totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

RECOGNIZING A STROKE

Thank God for the sense to remember the '3' steps, STR . Read and Learn!
Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.





STROKE:Remember the 1st Three Letters....S.T.R.

Now doctors say a bystander can recognize a stroke by asking three simple questions:

S *Ask the individual to SMILE.
T *Ask the person to TALK and SPEAK A SIMPLE SENTENCE (Coherently)
(i.e. It is sunny out today.)
R*Ask him or her to RAISE BOTH ARMS.

If he or she has trouble with ANY ONE of these tasks, call emergency numberimmediatelyand describe the symptoms to the dispatcher.

New Sign of a Stroke -------- Stick out Your Tongue

NOTE: Another 'sign' of a stroke is this: Ask the person to 'stick' out his tongue.. If the tongue is 'crooked', if it goes to one side or the other,that is also an indication of a stroke.

A cardiologist says if everyone who gets this e-mail sends it to 10 people; you can bet that at least one life will be saved.

I have done my part.

Where are the George Baileys?.

Don't ask, don't care.

Did anybody see the news today...who cares!