Increased dietary micronutrients decrease serum homocysteine concentrations in patients at high risk of...

Area of Science:

• Cardiovascular Health
• Nutritional Science
• Biochemistry

Background:

• Elevated blood homocysteine is a significant risk factor for cardiovascular disease (CVD).
• A 5-micromol/L increase in homocysteine correlates with a 70% rise in CVD risk.
• This risk is amplified in individuals with pre-existing risk factors.

Purpose of the Study:

• To evaluate the impact of increased dietary folate and adequate vitamin B-12 and B-6 on serum total homocysteine (tHcy).
• To assess these effects in individuals at high risk for cardiovascular disease.

Main Methods:

• A 10-week randomized controlled trial involving 491 adults with hypertension, dyslipidemia, or type 2 diabetes.
• Participants were assigned to either a prepared meal plan (PMP) or a self-selected diet (SSD), matched for macronutrients.
• The PMP was fortified with 23 micronutrients, including folate, exceeding 100% of recommended dietary allowances.

Main Results:

• Participants on the PMP consumed significantly more folate (601 µg/d) compared to the SSD group (270 µg/d).
• Serum tHcy levels decreased significantly in the PMP group (from 10.8 to 9.3 µmol/L, P < 0.0001).
• This reduction was linked to increased folate, vitamin B-12, and B-6 intake and higher serum/red blood cell folate and serum vitamin B-12 levels.

Conclusions:

• A prepared meal plan significantly increased folate and vitamin B-12 intake and serum concentrations.
• These nutritional changes were associated with a significant reduction in serum homocysteine.
• Dietary fortification with folate and B vitamins may be a viable strategy to mitigate cardiovascular disease risk.