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Serum homocysteine is related to food intake in adolescents: the Child and Adolescent Trial for Cardiovascular Health ^1,2,3

¹ From the Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN (PLL, LMS, RVL, and LAL); the Clinical Research Program, Children's Hospital Boston, MA (HAF and SKO); the Department of Pediatrics, Harvard Medical School, Boston, MA (HAF and SKO); the New England Research Institutes, Watertown, MA (HAF and SKO); the University of Texas School of Public Health, Houston, TX (DHH); the Department of Biostatistics, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (LSW); and the University of California, San Diego, San Diego, CA (MG)

Background: An understanding of the relation in adolescents between serum homocysteine and foods rich in vitamin B-6, vitamin B-12, and folate is important because high homocysteine concentrations in childhood and adolescence may be a risk factor for later cardiovascular disease. However, little is known about the relation between food intake and homocysteine in adolescents.

Objective: Five years after national folic acid fortification of enriched grain products, cross-sectional relations between food intake and serum homocysteine concentrations were examined in 2695 adolescents [ age: 18.3 (range: 15–20) y] enrolled in the Child and Adolescent Trial for Cardiovascular Health.

Design: A nonfasting blood specimen was analyzed for serum homocysteine, folate, and vitamins B-6 and B-12. Dietary intake was assessed by using a food-frequency questionnaire. Multiple regression analyses were used to evaluate the relation of intakes of whole grains, refined grains, fruit, vegetables, dairy products, red and processed meats, and poultry with serum homocysteine concentrations after adjustment for demographic characteristics, lifestyle factors, and food intake.

Results: Serum homocysteine concentrations were lower with greater intakes of whole grains (P for trend = 0.002), refined grains (P for trend = 0.02), and dairy foods (P for trend <0.001); were higher with greater intake of poultry (P for trend = 0.004); and were not related to intakes of fruit, vegetables, or red or processed meat. After additional adjustment for serum B vitamins, the relations of serum homocysteine with most food groups were attenuated.

Conclusion: These observational findings suggest a beneficial effect of whole-grain, refined-grain, and dairy products on serum homocysteine concentrations in an adolescent population.

Key Words: Homocysteine • serum folate • cardiovascular disease • adolescents • food groups • whole grain