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Better Health News and Comment

Heart Health for Any Budget
By Darin Ingels, ND

Healthnotes Newswire — Adding folic acid and vitamin B12 to your supplement regimen may be a cost-effective way to reduce blood levels of homocysteine, according to a study published recently in Journal of the American Medical Association.1

Over the last decade, homocysteine has been shown to be a significant risk factor for developing heart disease, and the risk of having a fatal heart attack increases as homocysteine levels rise. Several studies have shown that folic acid and vitamin B12 can lower elevated homocysteine levels to normal, an effect which might reduce one’s risk of heart problems.

Data from the well-known Framingham study indicate that homocysteine levels have been on the decline in the general population. This is partially due to the fact that since 1998, the FDA has required that all enriched grains produced in the United States contain 140 mcg of folic acid per 100 grams of grain, thereby increasing the folic acid content of most American’s diets. Researchers in this study used a complex statistical model, in combination with current health data, to predict how folic acid and vitamin B12 intake would affect homocysteine levels. The model looked at the effects of (1) fortification of grains and (2) taking a supplement of 1 mg of folic acid and 0.5 mg (500 mcg) of vitamin B12.

The results of the study indicated that consumption of fortified grains would reduce homocysteine levels on average by up to 11.9% in men and up to 9.8% in women. If folic acid and vitamin B12 supplements were added, homocysteine levels would fall even more dramatically. Men were predicted to have as much as a 27% decrease and women as much as a 24% decline. For both men and women, the higher the initial homocysteine levels, the greater the reduction after supplementing with folic acid and vitamin B12. The study also predicted that grain fortification with folic acid would decrease heart disease-related mortality by approximately 13% in men and 8% in women. In addition, compared with grain fortification alone, folic acid and vitamin B12 supplementation of individuals with established heart disease would prevent 27,000 heart attacks and more than 31,000 deaths per year related to heart disease in the United States. This would result in annual savings of over $2.4 billion, even after taking into account the cost of the supplements.

This study is significant in that it demonstrates that a relatively minor intervention could have a significant impact on the health of millions of Americans, while at the same time reducing the overall cost of health care. Heart disease continues to be the number one killer of Americans and accounts for a large proportion of healthcare-related expenses. A yearly supply of folic acid and vitamin B12 is estimated to cost about $20, which makes it affordable for most patients. It is possible that early intervention with folic acid and vitamin B12 could reduce the need for expensive procedures, such as heart bypass surgery, which may cost $60,000 or more.

One nutrient that was not evaluated by the researchers, but is relevant to the issue of homocysteine and heart disease, is vitamin B6 (pyridoxine). Studies have shown that vitamin B6, in conjunction with folic acid and vitamin B12, lowers homocysteine levels.2 3 Since vitamin B6 is readily available and inexpensive, it provides an additional cost-effective way for patients to lower high homocysteine levels.

1. Tice JA, Ross E, Coxson PG, et al. Cost-effectiveness of vitamin therapy to lower plasma homocysteine levels for the prevention of coronary heart disease. JAMA 2001;286:936–43.
2. Ubbink JB, Vermaak WJ, van der Merwe A, Becker PJ. Vitamin B-12, vitamin B-6 and folate nutritional status in men with hyperhomocysteinemia. Am J Clin Nutr 1993;57:47–53.
3. Ubbink JB, Vermaak WJ, van der Merwe A, et al. Vitamin requirements for the treatment of hyperhomocysteinemia in humans. J Nutr 1994;124:1927–33.

Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of Garlic and Cholesterol: Everything You Need to Know (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice in Westport, CT, where he specializes in environmental medicine and allergies. Dr. Ingals is a regular contributor to Healthnotes and Healthnotes Newswire.


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