Synergy of genes and nutrients: the case of homocysteine.
OBJECTIVE
Folic acid is now considered an important functional food component: it lowers potentially toxic homocysteine, prevents birth defects and modulates the risk of several cancers. The complexity of interactions involved, however, means we still have much to learn about the role of folate and homocysteine in both health and disease.


RESULTS
This review examines the emergence of homocysteine as a public health issue, and places this in context by exploring recent developments in the field of homocysteine as a vasculo, neuro and embryotoxic thiol. The paper also examines the homocysteine nexus in relation to mood disorders and cancer. It ends with an assessment of the issues associated with government-mandated folate fortification.


CONCLUSIONS
Folate fortification as a population measure may mask B12 deficiency, affect antiepileptic drug seizure control, and influence the genetic selection of a potentially deleterious genotype, albeit over a number of generations. It is likely that only large studies with a comprehensive battery of endpoints that fully address the complexity of nutrient-gene and gene-gene interactions will be able to answer all the necessary questions fully.
Lucock
Mark D
MD
School of Environmental and Life Sciences, University of Newcastle, PO Box 127, Brush Road, Ourimbah, NSW 2258, Australia. Mark.Lucock@newcastle.edu.au
D005492:Folic Acid / Q000097:blood* / Q000378:metabolism; D005527:Food, Fortified / Q000009:adverse effects; D006710:Homocysteine / Q000097:blood* / Q000378:metabolism; D006801:Humans; D020138:Hyperhomocysteinemia / Q000235:genetics* / Q000517:prevention & control; D019964:Mood Disorders / Q000517:prevention & control; D009369:Neoplasms / Q000517:prevention & control; D011634:Public Health; D012641:Selection, Genetic; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis; D014803:Vitamin B Complex / Q000097:blood*
D006710:Homocysteine; D014803:Vitamin B Complex; D005492:Folic Acid