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Probable benefits of increasing folic acid intakes. Lancet 355, 511–512 (Comment).īoushey CJ, Beresford SA, Omenn GS & Motulsky AG (1995): A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. 69, 315–321.īostom AG & Garber C (2000): Endpoints for homocysteine-lowering trials. 51, 691–697.īergami R, Maranesi M, Marchetti M, Sangiorgi Z & Tolomelli B (1999): Influence of Dietary N-3 polyunsaturated fatty acids on plasma lipemic effect of vitamin B6 deficiency. 33, 2657–2661.īates CJ, Mansoor MA, vanderPols J, Prentice A, Cole TJ & Finch S (1997): Plasma total homocysteine in a representative sample of 972 British men and women aged 65 and over. JAMA 279, 23–28.īang HO, Dyerberg J & Sinclair H M (1980): The composition of the Eskimo food in North Western Greenland. Thus, confirmation in large well-designed intervention trials is warranted.Īlbert CM, Hennekens CH, O’Donnell CJ, Ajani UA, Carey VJ, Willett WC, Ruskin JN & Manson JE (1998): Fish consumption and risk of sudden cardiac death.
Although these results are promising, they were produced in very small selective study populations. Furthermore, a human study indicated synergistic effects of folic acid (synthetic form of folate) and vitamin B 6 together with omega-3 fatty acids on the atherogenic index and the fibrinogen concentration. Nevertheless, animal studies clearly illustrate that vitamin B 6- as well as folate-metabolism are linked with those of long-chain omega-3 fatty acids. With respect to synergy between B-vitamins and omega-3 fatty acids, there is no evidence that fish oils have a tHcy-lowering effect beyond the effect of the B-vitamins. There are several pathways by which B-vitamins and omega-3 fatty acids may exert their protective effect on CVD, a common pathway is a beneficial effect on the endothelial function and hemostasis. In the future, intervention trials with hard end points and randomized double-blind placebo-controlled designs should be able to elucidate the causality problem. Yet, the lack of hard end points and/or appropriate study designs precludes a definitive conclusion about causality. The same is true for a higher intake of omega-3 fish fatty acids. The results of dietary intervention trials favor the hypothesis that higher intakes of B-vitamins (folate, vitamin B 6 and B 12), and subsequently lower total homocysteine (tHcy) concentrations, are causally associated with a decreased risk of vascular disease in patients with cardiovascular diseases (CVD).
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