Increased dietary micronutrients decrease serum homocysteine concentrations in patients at high risk of cardiovascular disease Academic Article uri icon

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abstract

  • BACKGROUND: Elevated blood homocysteine is a risk factor for cardiovascular disease. A 5-micromol/L increase is associated with an approximately 70% increase in relative risk of cardiovascular disease in adults. For patients with established risk factors, this risk is likely even greater. OBJECTIVE: Effects of increased dietary folate and recommended intakes of vitamins B-12 and B-6 on serum total homocysteine (tHcy) were assessed in individuals at high risk of cardiovascular disease. DESIGN: This trial was conducted at 10 medical research centers in the United States and Canada and included 491 adults with hypertension, dyslipidemia, type 2 diabetes, or a combination thereof. Participants were randomly assigned to follow a prepared meal plan (PMP; n = 244) or a self-selected diet (SSD; n = 247) for 10 wk, which were matched for macronutrient content. The PMP was fortified to provide >/=100% of the recommended dietary allowances for 23 micronutrients, including folate. RESULTS: Mean folate intakes at 10 wk were 601 +/- 143 microgram/d with the PMP and 270 +/- 107 microgram/d with the SSD. With the PMP, serum tHcy concentrations fell from 10.8 +/- 5.8 to 9.3 +/- 4.9 micromol/L (P < 0.0001) between weeks 0 and 10 and the change was associated with increased intakes of folate, vitamin B-12, and vitamin B-6 and with increased serum and red blood cell folate and serum vitamin B-12 concentrations. tHcy concentrations did not change significantly with the SSD. CONCLUSIONS: The PMP resulted in increased intakes and serum concentrations of folate and vitamin B-12. These changes were associated with reduced serum tHcy concentrations in persons at high risk of cardiovascular disease.

authors

  • Chait, Alan
  • Malinow, M Rene
  • Nevin, David N
  • Morris, Cynthia D
  • Eastgard, Rebecca L
  • Kris-Etherton, Penny
  • Pi-Sunyer, F Xavier
  • Oparil, Suzanne
  • Resnick, Lawrence M
  • Stern, Judith S
  • Haynes, Robert Brian
  • Hatton, Daniel C
  • Metz, Jill A
  • Clark, Sharon
  • McMahon, Margaret
  • Holcomb, Scott
  • Reusser, Molly E
  • Snyder, Geoffrey W
  • McCarron, David A

publication date

  • November 1, 1999