According to a recent cover story in Newsweek (August 11/97) most heart attack victims have normal cholesterol levels. Moreover, says reporter Geoffrey Cowley, there has been a steady decline in deaths from heart attacks despite the fact that cholesterol levels haven't changed much. "An avalanche of new studies show that an amino acid called homocysteine (pronounced HO-mo-SIS-teen) plays a critical role in destroying our arteries, perhaps as big a role as smoking and cholesterol."
Dr. Kilner McCully, a pathologist at the Veteran Affair's Medical Center in Providence, Rhode Island has conducted research on homocysteine for over 35 years. But due to the dominance of the "it's all cholesterol" school of thought, he's been like a voice crying in the wilderness. Now McCully's work has finally been vindicated in larger studies and McCully has just authored a book called, The Homocysteine Revolution (Keats, 1997).
Homocysteine is a sulphur containing byproduct of the essential amino acid methionine which is present in all protein. When methionine is broken down, it is converted to the free radical homocysteine. This free radical can cause damage to the arterial wall.
There are three ways you can get elevated homocysteine levels. The first is eating an excess of foods that contain methionine, which is plentiful in meat. The second is if you have a genetic defect that makes you unable to breakdown homocysteine. The third, and by far the most common, is if you have borderline vitamin deficiencies of three B-vitamins, folic acid, vitamin-B-12 and B-6.
A nutritional survey of older people conducted in Boston showed that most were deficient in not just one, but many nutrients. In the 60 to 69 year group, 65 percent were deficient in vitamin-D, 70 percent in folic acid, 70 percent in vitamin-B-12, 35 percent in calcium and 65 percent in zinc. B-6 deficiency was also widespread. Also as you age, the stomach makes less acid, and thus much less of the vitamins and minerals from our food are actually absorbed.
According to Dr. Jeffrey Blumberg, a senior scientist at Tufts University in Boston, homocysteine also functions like a brain toxin in the elderly. Elevated homocysteine levels, which are a sensitive indicator of deficiencies of vitamin-B-6, and folic acid, can trigger such neurological changes as a drop in alertness and memory ability as well as numbness and tingling in the legs.
Meanwhile, numerous studies have documented the link between hardening of the arteries and elevated homocysteine levels.
Dr. Jacob Selhub is the author of one of the recent studies on homocysteine published in the New England Journal of Medicine . Selhub and his colleagues in Norway found that even after adjusting for age, cholesterol and the amount of blockage already found in the heart arteries, high homocysteine levels were associated with a higher death rate from heart disease.
"A blood test for homocysteine costs about $25 to $40." said Selhub, "and high homocysteine is easy to treat by ensuring that patients get enough folic acid and vitamins B-6 and vitamin-B-12."
In fact, right now there's plenty you can do to assure a lower level of homocysteine. First eat a low fat high fibre diet with lots of fruits and vegetables. Second watch how you prepare your food especially vegetables which should be steamed or baked. The three B-vitamins are destroyed during food processing, and also by high heat and freezing.
Thirdly don't hesitate to take supplements if you are not getting your 5 to 7 daily servings of vegetables and fruits. Take at least 75mgs of vitamin-B-6, 100 micrograms of vitamin-B-12 and 400 micrograms of folic acid daily as a preventative measure. For very little money, and with no harmful side effects, you will be lowering your risk for heart disease and stroke, according to the latest evidence.
As Selhub puts it, "Do not wait for the Messiah, we recommend that you eat more vegetables, but if you can't do that take a vitamin pill."
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