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Association between B vitamin intake and plasma homocysteine concentration in the general Dutch population aged 20–65 y^1,2,3

¹ From the National Institute of Public Health and the Environment, the Department of Chronic Disease Epidemiology, Bilthoven, Netherlands, and the University Hospital St Radboud, the Laboratory of Pediatrics and Neurology, the University Hospital Nijmegen, Netherlands.

Background: An elevated plasma total homocysteine (tHcy) concentration is associated with an increased risk of cardiovascular diseases. Folate, riboflavin, vitamin B-6, and vitamin B-12 are essential in homocysteine metabolism.

Objective: The objective was to describe the association between dietary intakes of folate, riboflavin, vitamin B-6, and vitamin B-12 and the nonfasting plasma tHcy concentration.

Design: A random sample of 2435 men and women aged 20–65 y from a population-based Dutch cohort examined in 1993–1996 was analyzed cross-sectionally.

Results: Univariately, intakes of all B vitamins were inversely related to the plasma tHcy concentration. In multivariate models, only folate intake remained inversely associated with the plasma tHcy concentration. Mean plasma tHcy concentrations (adjusted for intakes of riboflavin, vitamin B-6, vitamin B-12, and methionine and for age, smoking, and alcohol consumption) in men with low (first quintile: 161 µg/d) and high (fifth quintile: 254 µg/d) folate intakes were 15.4 and 13.2 µmol/L, respectively; in women, plasma tHcy concentrations were 13.7 and 12.4 µmol/L at folate intakes of 160 and 262 µg/d, respectively. In men, the difference in the mean plasma tHcy concentration between men with low and high folate intakes was greater in smokers than in nonsmokers (2.8 compared with 1.6 µmol/L) and greater in nondrinkers than in drinkers of >2 alcoholic drinks/d (3.5 compared with 1.4 µmol/L). In women, the association between folate intake and plasma tHcy was not modified by smoking or alcohol consumption.

Conclusions: In this Dutch population, folate was the only B vitamin independently inversely associated with the plasma tHcy concentration. Changing dietary habits may substantially influence the plasma tHcy concentration in the general population.

Key Words: Folate • riboflavin • vitamin B-6 • vitamin B-12 • plasma homocysteine • population-based study • Netherlands

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