Nutrition Hotline
By Suzanne Havala Hobbs, DrPH, MS, RD
QUESTION: “Do vegetarian diets affect homocysteine levels and risk for heart disease?”
ANSWER: High levels of plasma homocysteine, a condition referred to as hyperhomocysteinemia, are a risk factor for heart disease. Homo-cysteine is an amino acid that the body can make for itself, so it’s not required in the diet. Therefore, this is not a case in which too much of a nutrient is consumed, causing the increased levels. Instead, deficiencies in vitamin B12, B6, and/or folate are associated with this condition. Although more evidence and studies are required, some researchers have concluded that high homocysteine levels may be as important as blood cholesterol levels in predicting the risk of coronary artery disease. The three vitamins—B12, B6, and folate—are important components in some amino acid biochemical pathways, some of which are associated with cardiovascular functions. If these pathways are inhibited due to deficiencies in one or more of these vitamins, the amino acid homocysteine will build up, causing hyperhomocysteinemia. One way to help prevent hyperhomocysteinemia is to meet the recommended intakes of vitamin B12, vitamin B6, and folate by maintaining a healthy diet. Some easy ways to obtain vitamin B12 from non-animal sources are through fortified soymilk, nutritional yeast with vitamin B12 (such as Red Star Vegetarian Support Formula), or a dietary supplement. Vegans can get plenty of vitamin B6 from fortified cereals, beans, bananas, spinach, tomato juice, fortified oatmeal, and many other foods. Foods containing folate include green leafy vegetables, fortified cereals or oatmeal, orange juice, peanuts, and whole wheat bread. If you are concerned about your risk for coronary artery disease and want to check your homocysteine status, a simple blood test can be performed by your doctor. A homocysteine level lower than 12µmol per liter is generally considered ideal, while levels greater than 15µmol per liter are considered high.
Contributed by Erin M. Crandell, VRG Intern and University of Michigan MPH and RD Candidate. Reviewed by Suzanne Havala Hobbs.
Lower your homocysteine level by increasing the size and frequency of servings of fruits and vegetables. Adult men and women should aim for at least 400 micrograms (mcg) of folate each day.
| Source of Folic Acid | Amount | Folic Acid |
|---|---|---|
| Brown lentils | 1 cup, cooked | 358 mcg |
| Chickpeas | 1 cup, cooked | 282 mcg |
| Asparagus | 1 cup, cooked | 262 mcg |
| Spinach | 1 cup, cooked | 262 mcg |
| Black beans | 1 cup, cooked | 256 mcg |
| Bran Flakes | 1 cup, cooked | 200 mcg |
| Baked Beans | 1 cup, cooked | 122 mcg |
| Papaya | 1 medium | 116 mcg |
| Cheerios | 1 cup | 100 mcg |
| Raisin Bran | 1 cup, cooked | 100 mcg |
| Broccoli | 1 cup, cooked | 78 mcg |
| Orange Juice | 8 ounces | 75 mcg |
