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

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

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Background: Elevated blood homocysteine is a risk factor for cardiovascular disease. A 5-μmol/L increase is associated with an ≃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 μg/d with the PMP and 270 ±107 μg/d with the SSD. With the PMP, serum tHcy concentrations fell from 10.8 ±5.8 to 9.3 ± 4.9 μmol/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.

Original languageEnglish (US)
Pages (from-to)881-887
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Issue number5
StatePublished - Nov 1999

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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