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Vitamins
Lowering High Homocysteine With Diet
Homocysteine Lowering with Folic Acid and B
Vitamins in Vascular Disease.
Folic acid is also abundant in certain Southern comfort foods, notably rice, black-eyed peas, and turnip greens, parbroiled rice and dried peas better than fresh, but fresh greens better than canned or frozen. Rice, black-eyed peas, lentils, and greens are relatively low in calories (provided they are not served with oil, butter, or salted pork), and very useful in
homocysteine-lowering prevention diet. Avoid Pork.
The CRP test is elevated
in these patients.
Vitamin B complex
The complex of B vitamins includes the following group of substances:
- B1 – thiamine
- B2 – riboflavin
- B3 – nicotinic acid
- B6 – pyridoxine
- B12 – cobalamin
- folate – folic acid.
The body requires relatively small amounts of vitamins B1, B2 and B3.
Vitamins B6 and B12 help the body to use folic acid and are vital nutrients in a range of activities, such as cell repair, digestion, the production of energy and in the immune system.
Vitamin B12 is also needed for the breakdown of fat and carbohydrate.
Deficiency of either vitamin will result in anemia.
Vitamin B6 is found in most foods, so deficiency is rare.
Vegetarians and B12
Vegetarians who eat eggs and dairy produce will get enough B12. Vitamin B12 deficiency can occur in vegans because all dietary sources are animal in origin.
The British Vegan Society recommends foods fortified with vitamin B12, such as:
- breakfast cereals
- yeast extract
- margarine
- soya powder and milk
- Plamil
- soya mince or chunks.
The best dietary sources of the B vitamins, especially B12, are:
- animal products (meat, poultry)
- yeast extracts (brewers' yeast, Marmite).
Other good sources include:
- asparagus, broccoli, spinach, bananas, potatoes
- dried apricots, dates and figs
- milk, eggs, cheese, yoghurt
- nuts and pulses
- fish
- brown rice, wheat germ, wholegrain cereals.
Dietary sources of vitamin B6 are similar to those for vitamin B12 and also include avocado, herring, salmon, sunflower seeds and walnuts.
Folic acid (folate)
Folic acid works closely in the body with vitamin B12. It is vital for the production of healthy blood cells.
Lack of folic acid is one of the main causes of anaemia, particularly in people whose diet is generally poor. Vitamins B6 and B12 help the body use folate, so are often given alongside folic acid supplements.
In pregnancy, low folate levels increase the risk of the baby's spinal cord system not developing completely (spina bifida). All women are now advised to take folic acid supplements in the first three months of pregnancy and ideally before conception occurs.
Folate occurs naturally in most foods but often in small amounts.
- Many food manufacturers now fortify white flour, cereals, bread, corn, rice and noodle products with folic acid.
- One serving of each enriched product will contribute about 10 per cent of the RDA for folic acid.
- Wholegrain products are not enriched because they already contain natural folate.
Liver contains the greatest amount of folic acid, with lower levels found in beef, lamb and pork and a range of green vegetables and citrus fruits.
Other sources of folate are dried beans, fresh orange juice, tomatoes, wheat germ (wholemeal bread and cereal) and wholegrain products (pasta and brown rice).
A study on lowering Homocysteine
N Engl J Med 2006;354
Background In observational studies, lower homocysteine levels
are associated with lower rates of coronary heart disease and
stroke. Folic acid and vitamins B6 and B12 lower homocysteine
levels. Methods We randomly assigned 5522 patients 55 years of
age or older who had vascular disease or diabetes to daily
treatment either with the combination of 2.5 mg of folic acid,
50 mg of vitamin B6, and 1 mg of vitamin B12 or with placebo for
an average of five years.
The primary outcome was a composite of
death from cardiovascular causes, myocardial infarction, and
stroke. Results Mean plasma homocysteine levels decreased by 2.4
micromol per liter (0.3 mg per liter) in the active-treatment
group and increased by 0.8 micromol per liter (0.1 mg per liter)
in the placebo group. Primary outcome events occurred in 519
patients (18.8 percent) assigned to active therapy and 547 (19.8
percent) assigned to placebo (relative risk, 0.95; 95 percent
confidence interval, 0.84 to 1.07; P=0.41). As compared with
placebo, active treatment did not significantly decrease the
risk of death from cardiovascular causes (relative risk, 0.96;
95 percent confidence interval, 0.81 to 1.13), myocardial
infarction (relative risk, 0.98; 95 percent confidence interval,
0.85 to 1.14), or any of the secondary outcomes. Fewer
patients assigned to active treatment than to placebo had a
stroke (relative risk, 0.75; 95 percent confidence interval,
0.59 to 0.97). More patients in the active-treatment group were
hospitalized for unstable angina (relative risk, 1.24; 95
percent confidence interval, 1.04 to 1.49). Conclusions
Supplements combining folic acid and vitamins B6 and B12 did not
reduce the risk of major cardiovascular events in patients with
vascular disease
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