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Nutritional advice to increase soluble fibre intake does not change plasma folate or homocysteine in men with angina: a randomised controlled trial

  • Pauline AL Ashfield-Watt (a1), Zoë E Clark (a1), Pat Breay (a1), Paul C Zotos (a1), Sara B Cale (a1), Michael L Burr (a1) and Ian FW McDowell (a1)...

Abstract

Objective:

To study the effect of advice to increase dietary soluble fibre, including fruit and vegetables, on plasma folate and homocysteine in men with angina.

Design:

Data were collected on a subset of subjects from the Diet and Angina Randomised Trial (DART II). In a randomised (2 × 2) factorial design, subjects received advice on either, neither or both interventions to: (1) increase soluble fibre intake to 8.0 g day−1 (fruit, vegetables and oats); (2) increase oily fish intake to 2 portions week−1. Those who received soluble fibre advice were compared with those who did not. Subjects were genotyped for C677T variant 5,10-methylenetetrahydrofolate reductase (MTHFR).

Setting/subjects:

Seven hundred and fifty-three male angina patients were recruited from general practice.

Results:

Plasma homocysteine concentrations were at the upper end of the normal range (median 11.5, 25% 9.4, 75% 14.0 μmol l−1). Baseline intake of fruit and vegetables was positively correlated with plasma folate (rs = 0.29, P < 0.01). Smokers had lower intakes of fruit and vegetables, lower plasma folate and higher homocysteine (all P < 0.01). Homozygotes for variant MTHFR had higher homocysteine concentrations at low plasma folate (P < 0.01). Reported intakes of fruit and vegetables and estimated dietary folate increased in the intervention group (ca. +75 g day−1, P < 0.01 and ca. +20 g day−1, P < 0.05, respectively). However, neither plasma folate (baseline/follow-up 4.5 vs. 4.4 μg l−1, P = 0.40) nor homocysteine (baseline/follow-up 11.7 vs. 11.7 μmol l−1, P = 0.31) changed.

Conclusions:

Plasma homocysteine, a cardiovascular risk factor, is influenced by MTHFR genotype, plasma folate and smoking status. Dietary advice successfully led to changes in fruit and vegetable intake, but not to changes in plasma folate or homocysteine, possibly because the fruits and vegetables that were chosen were not those richest in folate.

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Copyright

Corresponding author

*Corresponding author: Email mcdowell@cardiff.ac.uk

References

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1Ness, AR, Powles, JW. Fruit and vegetables, and cardiovascular disease: a review. Int. J. Epidemiol. 1997; 26: 113.
2Cummings, JH, Bingham, SA. Diet and the prevention of cancer. Br. Med. J. 1998; 317: 1636–40.
3Verhoef, P, Stampfer, MJ, Rimm, EB. Folate and coronary heart disease. Curr. Opin. Lipidol. 1998; 9: 1722.
4Kim, Y-I. Folate and carcinogenesis: evidence, mechanisms, and implications. J. Nutr. Biochem. 1999; 10: 6688.
5MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 1991; 338: 131–7.
6Boushey, CJ, Beresford, SA, Omenn, GS, Motulsky, AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA 1995; 274: 1049–57.
7Department of Health. Dietary Reference Values for Food Energy and Nutrients for the UK. Report on Health and Social Subjects No. 41. London: HMSO, 1991.
8Clark, ZE, Bowen, DJ, Whatley, SD, Bellamy, MF, Collins, PW, McDowell, IF. Genotyping method for methylenetetrahydrofolate reductase (C677T thermolabile variant) using heteroduplex technology. Clin. Chem. 1998; 44: 2360–2.
9Harmon, DL, Woodside, JV, Yarnell, JW, McMaster, D, Young, IS, McCrum, EE, Gey, KF, Whitehead, AS, Evans, AE. The common ‘thermolabile’ variant of methylene tetrahydrofolate reductase is a major determinant of mild hyperhomocysteinaemia. QJM 1996; 89: 571–7.
10Selhub, J, Jacques, PF, Wilson, PW, Rush, D, Rosenberg, IH. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA 1993; 270: 2693–8.
11Tucker, KL, Selhub, J, Wilson, PW, Rosenberg, IH. Dietary intake pattern relates to plasma folate and homocysteine concentrations in the Framingham Heart Study. J. Nutr. 1996; 126: 3025–1.
12Committee on Medical Aspects of Food Policy. Nutritional Aspects of Cardiovascular Disease. Report of the Cardiovascular Review Group. London: HMSO, 1994.
13World Health Organization (WHO). Diet, Nutrition and the Prevention of Chronic Diseases. Report of the WHO Study Group. Technical Report Series 797. Geneva: WHO, 1990.
14Kuo, K, Still, R, Cale, S, McDowell, I. Standardization (external and internal) of HPLC assay for plasma homocysteine. Clin. Chem. 1997; 43: 1653–5.
15Ho, Y, Ochiai, J, Saski, R, Suzuki, S, Kusuhara, Y, Morimitsu, Y. Serum concentrations of carotenoids, retinol and α-tocopherol in healthy persons determined by high performance liquid chromatography. Clin. Chim. Acta 1990; 194: 131–4.
16Still, RA, McDowell, IF. Clinical implications of plasma homocysteine measurement in cardiovascular disease. ACP Broadsheet No. 152: March 1998. J. Clin. Pathol. 1998; 51: 183–8.
17Nygard, O, Vollset, SE, Refsum, H, Brattstrom, L, Ueland, PM. Total homocysteine and cardiovascular disease. J. Intern. Med. 1999; 246: 425–54.
18Guttormsen, AB, Ueland, PM, Nesthus, I, Nygard, O, Schneede, J, Vollset, SE, Refsum, H. Determinants and vitamin responsiveness of intermediate hyperhomocysteinemia (> or =40 micromol/liter). The Hordaland Homocysteine Study. J. Clin. Invest. 1996; 98: 2174–83.
19Brattstrom, L, Wilcken, DE, Ohrvik, J, Brudin, L. Common methylenetetrahydrofolate reductase gene mutation leads to hyperhomocysteinemia but not to vascular disease: the result of a meta-analysis. Circulation 1998; 98: 2520–6.
20Kluijtmans, LA, Kastelein, JJ, Lindemans, J, Boers, GH, Heil, SG, Bruschke, AV, Jukema, JW, van den Heuvel, LP, Trijbels, FJ, Boerma, GJ, Verheugt, FW, Willems, F, Blom, HJ. Thermolabile methylenetetrahydrofolate reductase in coronary artery disease. Circulation 1997; 96: 2573–7.
21Jacques, PF, Sulsky, SI, Sadowski, JA, Phillips, JC, Rush, D, Willett, WC. Comparison of micronutrient intake measured by a dietary questionnaire and biochemical indicators of micronutrient status. Am. J. Clin. Nutr. 1993; 57: 182–9.
21Ashfield-Watt, PAL, Pullin, CH, Whiting, JM, Clark, ZE, Moat, SJ, Newcombe, RN, Burr, ML, Lewis, ML, Powers, HJ, McDowell, IFW. Methylenetetrahydrofolate reductase (C677T) genotype modulates blood folate and homocysteine responses to a folate rich diet or low dose folic acid supplement: a randomised controlled trial. Am. J. Clin. Nutr. 2001 [in press].
23Bingham, SA, Gill, C, Welch, A, Day, K, Cassidy, A, Khaw, KT, Sneyd, MJ, Key, TJA, Roe, L, Day, NE. Comparison of dietary assessment methods in nutritional epidemiology: weighed records v. 24h recalls, food-frequency questionnaires and estimated-diet records. Br. J. Nutr. 1994; 72: 619–43.
24Hu, FB, Rimm, E, Smith-Warner, SA, Feskanich, D, Stampfer, MJ, Ascherio, A, Sampson, L, Willett, WC. Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am. J. Clin. Nutr. 1999; 69: 243–9.
25Hu, FB, Rimm, EB, Stampfer, MJ, Ascherio, A, Spiegelman, D, Willett, WC. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am. J. Clin. Nutr. 2000; 72: 912–21.
26Brouwer, IA, van Dusseldorp, M, Thomas, CM, Duran, M, Hautvast, JG, Eskes, TK, Steegers-Theunissen, RP. Low-dose folic acid supplementation decreases plasma homocysteine concentrations: a randomised trial. Am. J. Clin. Nutr. 1999; 69: 99104.
27Cuskelly, GJ, McNulty, H, Scott, JM. Effect of increasing dietary folate on red-cell folate: implications for prevention of neural tube defects. Lancet 1996; 347: 657–9.
28Brouwer, IA, van Dusseldorp, M, West, CE, Meyboom, S, Thomas, CM, Duran, M, het Hof, KH, Eskes, TK, Hautvast, JG, Steegers-Theunissen, RP. Dietary folate from vegetables and citrus fruit decreases plasma homocysteine concentrations in humans in a dietary controlled trial. J. Nutr. 1999; 129: 1135–9.
29Ministry of Agriculture, Fisheries and Food (MAFF)/Royal Society of Chemistry (RSC). Cereals and Cereal Products. Third Supplement McCance & Widdowson's The Composition of Foods, 4th ed. London: RSC, 1988.
30Ashfield-Watt, PAL, Knowles, RM, Cale, SB, Payne, N, McDowell, IFW. A folate enriched diet lowers plasma homocysteine in patients with hyperlipidaemia: a randomised controlled trial. Br. J. Cardiol. 2001; 8: 2835.
31Department of Health. Folic Acid and the Prevention of Disease. Report of the Committee on Medical Aspects of Food and Nutrition Policy. Report on Health and Social Subjects No. 50. London: The Stationery Office, 2001.

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Nutritional advice to increase soluble fibre intake does not change plasma folate or homocysteine in men with angina: a randomised controlled trial

  • Pauline AL Ashfield-Watt (a1), Zoë E Clark (a1), Pat Breay (a1), Paul C Zotos (a1), Sara B Cale (a1), Michael L Burr (a1) and Ian FW McDowell (a1)...

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