title: Homocysteine lowering by folate-rich diet or pharmacological supplementations in subjects with moderate hyperhomocysteinemia.
abstract: OBJECTIVE
  To compare the efficacy of a diet rich in natural folate and of two different folic acid supplementation protocols in subjects with "moderate" hyperhomocysteinemia, also taking into account C677T polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene.
  
  
  METHODS
  We performed a 13 week open, randomized, double blind clinical trial on 149 free living persons with mild hyperhomocyteinemia, with daily 200 μg from a natural folate-rich diet, 200 μg [6S]5-methyltetrahydrofolate (5-MTHF), 200 μg folic acid or placebo. Participants were stratified according to their MTHFR genotype.
  
  
  RESULTS
  Homocysteine (Hcy) levels were reduced after folate enriched diet, 5-MTHF or folic acid supplementation respectively by 20.1% (p < 0.002), 19.4% (p < 0.001) and 21.9% (p < 0.001), as compared to baseline levels and significantly as compared to placebo (p < 0.001, p < 0.002 and p < 0.001, respectively for enriched diet, 5-MTHF and folic acid). After this enriched diet and the folic acid supplementation, Hcy in both genotype groups decreased approximately to the same level, with higher percentage decreases observed for the TT group because of their higher pre-treatment value. Similar results were not seen by genotype for 5-MTHF. A significant increase in RBC folate concentration was observed after folic acid and natural folate-rich food supplementations, as compared to placebo.
  
  
  CONCLUSIONS
  Supplementation with natural folate-rich foods, folic acid and 5-MTHF reached a similar reduction in Hcy concentrations.
authors.affiliation: Department of Laboratory, Foundation of Research and Care, John Paul II, Catholic University of Sacred Heart, Campobasso 86100, Italy. bzappacosta@rm.unicatt.it
authors.forename: Bruno
authors.initials: B
authors.lastname: Zappacosta
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Mastroiacovo
authors.forename: Silvia
authors.initials: S
authors.lastname: Persichilli
authors.forename: George
authors.initials: G
authors.lastname: Pounis
authors.forename: Stefania
authors.initials: S
authors.lastname: Ruggeri
authors.forename: Angelo
authors.initials: A
authors.lastname: Minucci
authors.forename: Emilia
authors.initials: E
authors.lastname: Carnovale
authors.forename: Generoso
authors.initials: G
authors.lastname: Andria
authors.forename: Roberta
authors.initials: R
authors.lastname: Ricci
authors.forename: Iris
authors.initials: I
authors.lastname: Scala
authors.forename: Orazio
authors.initials: O
authors.lastname: Genovese
authors.forename: Aida
authors.initials: A
authors.lastname: Turrini
authors.forename: Lorenza
authors.initials: L
authors.lastname: Mistura
authors.forename: Bruno
authors.initials: B
authors.lastname: Giardina
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
mesh_terms: D000328:Adult; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D005838:Genotype; D006710:Homocysteine / Q000097:blood* / Q000235:genetics; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000178:diet therapy* / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D008875:Middle Aged; D011110:Polymorphism, Genetic; D012720:Severity of Illness Index; D013763:Tetrahydrofolates / Q000235:genetics / Q000494:pharmacology / Q000627:therapeutic use; D014803:Vitamin B Complex / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D013763:Tetrahydrofolates; D006710:Homocysteine; C013123:5,10-methylenetetrahydrofolic acid; D014803:Vitamin B Complex; D005492:Folic Acid; D042965:Methylenetetrahydrofolate Reductase (NADPH2); C005984:5-methyltetrahydrofolate