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Randomized Controlled Trial
. 2013 May 8;5(5):1531-43.
doi: 10.3390/nu5051531.

Homocysteine lowering by folate-rich diet or pharmacological supplementations in subjects with moderate hyperhomocysteinemia

Bruno Zappacosta  1 , Pierpaolo Mastroiacovo, Silvia Persichilli, George Pounis, Stefania Ruggeri, Angelo Minucci, Emilia Carnovale, Generoso Andria, Roberta Ricci, Iris Scala, Orazio Genovese, Aida Turrini, Lorenza Mistura, Bruno Giardina, Licia Iacoviello
Affiliations
Randomized Controlled Trial

Homocysteine lowering by folate-rich diet or pharmacological supplementations in subjects with moderate hyperhomocysteinemia

Bruno Zappacosta et al. Nutrients. .

Abstract

Background/objectives: To compare the efficacy of a diet rich in natural folate and of two different folic acid supplementation protocols in subjects with "moderate" hyperhomocysteinemia, also taking into account C677T polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene.

Subjects/methods: We performed a 13 week open, randomized, double blind clinical trial on 149 free living persons with mild hyperhomocyteinemia, with daily 200 μg from a natural folate-rich diet, 200 μg [6S]5-methyltetrahydrofolate (5-MTHF), 200 μg folic acid or placebo. Participants were stratified according to their MTHFR genotype.

Results: Homocysteine (Hcy) levels were reduced after folate enriched diet, 5-MTHF or folic acid supplementation respectively by 20.1% (p < 0.002), 19.4% (p < 0.001) and 21.9% (p < 0.001), as compared to baseline levels and significantly as compared to placebo (p < 0.001, p < 0.002 and p < 0.001, respectively for enriched diet, 5-MTHF and folic acid). After this enriched diet and the folic acid supplementation, Hcy in both genotype groups decreased approximately to the same level, with higher percentage decreases observed for the TT group because of their higher pre-treatment value. Similar results were not seen by genotype for 5-MTHF. A significant increase in RBC folate concentration was observed after folic acid and natural folate-rich food supplementations, as compared to placebo.

Conclusions: Supplementation with natural folate-rich foods, folic acid and 5-MTHF reached a similar reduction in Hcy concentrations.

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Figures

Figure 1
Figure 1
Folate intake through main food groups after supplementation, by treatment group.
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