Low-dose B vitamins supplementation ameliorates cardiovascular risk: a double-blind randomized controlled trial in healthy Chinese elderly
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We investigated whether daily supplementation with low-dose B vitamins in the healthy elderly population improves the Framingham risk score (FRS), a predictor of cardiovascular disease risk.
Between 2007 and 2012, a double-blind randomized controlled trial was conducted in a rural area of North China. In all, 390 healthy participants aged 60–74 were randomly allocated to receive daily vitamin C (50 mg; control group) or vitamin C plus B vitamins (400 µg folic acid, 2 mg B6, and 10 µg B12; treatment group) for 12 months. FRSs were calculated for all 390 subjects.
Folate and vitamin B12 plasma concentrations in the treatment group increased by 253 and 80 %, respectively, after 6 months, stopped increasing with continued supplementation after 12 months and returned to baseline levels 6 months after supplementation cessation. Compared with the control group, there was no significant effect of B vitamin supplementation on FRSs after 6 months (mean difference −0.38; 95 % CI −1.06, 0.31; p = 0.279), whereas a significant effect of supplementation was evident after 12 months (reduced magnitude 7.6 %; −0.77; 95 % CI −1.47, −0.06; p = 0.033). However, this reduction disappeared 6 months after supplementation stopped (−0.07; 95 % CI −0.80, 0.66; p = 0.855). The reduction in FRS 12 months after supplementation was more pronounced in individuals with a folate deficiency (10.4 %; −1.30; 95 % CI −2.54, −0.07; p = 0.039) than in those without (4.1 %; −0.38; 95 % CI −1.12, 0.36; p = 0.313). B vitamins increased high-density lipoprotein cholesterol by 3.4 % after 6 months (0.04; 95 % CI −0.02, 0.10; p = 0.155) and by 9.2 % after 12 months (0.11; 95 % CI 0.04, 0.18; p = 0.003). Compared with the control group, this change in magnitude decreased to 3.3 % (0.04; 95 % CI −0.02, 0.10; p = 0.194) 6 months after supplementation cessation.
Daily supplementation with a low-dose of B vitamins for 12 months reduced FRS, particularly in healthy elderly subjects with a folate deficiency. These reduced effects declined after supplementation cessation, indicating a need for persistent supplementation to maintain the associated benefits.
KeywordsB vitamins Cardiovascular disease risk Framingham risk score Prevention
Framingham risk score
Recommended dietary allowance
- 2.McCully KS (2007) Homocysteine, vitamins, and vascular disease prevention. Am J Clin Nutr 86:1563S–1568SGoogle Scholar
- 6.Armitage JM, Bowman L, Clarke RJ, Wallendszus K, Bulbulia R, Rahimi K, Haynes R, Parish S, Sleight P, Peto R, Collins R (2010) Effects of homocysteine-lowering with folic acid plus vitamin B12 vs. placebo on mortality and major morbidity in myocardial infarction survivors: a randomized trial. JAMA 303:2486–2494CrossRefGoogle Scholar
- 15.US Food and Drug Administration (2000) Letter regarding dietary supplement health claim for folic acid, vitamin B6, and vitamin B12 and vascular disease (Docket No. 99P-3029). http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm072865.htm#tab
- 16.US Food and Drug Administration (2001) Settlement reached for health claim relating B vitamins and vascular disease. http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm072855.htm
- 17.Elshorbagy AK, Oulhaj A, Konstantinova S, Nurk E, Ueland PM, Tell GS, Nygard O, Vollset SE, Refsum H (2007) Plasma creatinine as a determinant of plasma total homocysteine concentrations in the Hordaland Homocysteine Study: use of statistical modeling to determine reference limits. Clin Biochem 40:1209–1218CrossRefGoogle Scholar
- 19.National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2002) Third report of the National Cholesterol Education Program (NCEP) expert panel on detection E, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 106:3143–3421Google Scholar
- 25.Collaboration Homocysteine Lowering Trialists’ (2005) Dose-dependent effects of folic acid on blood concentrations of homocysteine: a meta-analysis of the randomized trials. Am J Clin Nutr 82:806–812Google Scholar
- 26.Ueland PM, Refsum H, Stabler SP, Malinow MR, Andersson A, Allen RH (1993) Total homocysteine in plasma or serum: methods and clinical applications. Clin Chem 39:1764–1779Google Scholar
- 27.Federation of American Societies for Experimental Biology (1984) Assessment of the folate nutritional status of the U.S. population based on data collected in the second National Health and Nutrition Examination Survey, 1976–1980. Federation of American Societies for Experimental Biology, Bethesda, MDGoogle Scholar
- 30.Vermeulen EG, Stehouwer CD, Twisk JW, van den Berg M, de Jong SC, Mackaay AJ, van Campen CM, Visser FC, Jakobs CA, Bulterjis EJ, Rauwerda JA (2000) Effect of homocysteine-lowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: a randomised, placebo-controlled trial. Lancet 355:517–522CrossRefGoogle Scholar
- 31.Morrison KM, Atkinson SA, Yusuf S, Bourgeois J, McDonald S, McQueen MJ, Persadie R, Hunter B, Pogue J, Teo K (2009) The Family Atherosclerosis Monitoring In early life (FAMILY) study: rationale, design, and baseline data of a study examining the early determinants of atherosclerosis. Am Heart J 158:533–539CrossRefGoogle Scholar
- 38.Crider KS, Zhu JH, Hao L, Yang QH, Yang TP, Gindler J, Maneval DR, Quinlivan EP, Li Z, Bailey LB, Berry RJ (2011) MTHFR 677C→T genotype is associated with folate and homocysteine concentrations in a large, population-based, double-blind trial of folic acid supplementation. Am J Clin Nutr 93:1365–1372CrossRefGoogle Scholar
- 39.Office of Dietary Supplements National Institutes of Health (2013) Dietary supplement fact sheet. http://ods.od.nih.gov/factsheets/list-all/