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Diet therapy

Homocysteine and cardiovascular disease: folate to the rescue!

Raised homocysteine levels are now thought to be causally related to heart disease, not just a disease marker as previously thought.

Homocysteine is a product of our metabolic system and is derived from certain amino acids such as methionine, which originates most commonly from meat and dairy products.

Homocysteine levels

Even a moderately elevated blood homocysteine level has been associated with a higher risk for cardiovascular disease.

An increase in blood homocysteine of 20% has been associated with a:

  • 16% increased risk of cardiovascular disease
  • 25% increased risk of stroke
  • 25% increased risk of deep vein thrombosis

Lifestyle and Nutritional factors hold important roles with respect to levels of blood homocysteine. Factors which increase homocysteine levels are:

  • Increased body mass index (BMI) and obesity
  • Increased glucose and triglyceride levels
  • Low level of physical fitness
  • Excess consumption of coffee and alcohol


Dietary folate is the only factor found to reduce homocysteine concentrations. Intervention studies involving folate have demonstrated associated risks are reversible with an intake of only 0.8 mg folate daily. Vitamin B6 and B12 are also involved as cofactors in homocysteine metabolism, however only folate has a direct effect on key metabolic pathways which help to prevent the build up of homocysteine.

The New Zealand Recommended Daily Intake for folate is 200 micrograms per day for all adults, with the exception of women planning to become pregnant or those who already are as requirements are further increased to 400 micrograms. Folate is widely distributed in food, especially in green leafy vegetables, legumes and liver. Fruit, nuts, seeds and fortified breakfast cereals are also good sources of folate.

If you have any concerns regarding heart disease, diabetes and stroke, or are planning a family, contact Lea Stening Health today to further discuss your nutritional and health needs.

About the author View all

Lea Stening

Lea is one of New Zealand’s leading paediatric dietitians and also specialises in Sports Nutrition. She has specialised in Paediatric Nutrition for 31 years and in 1985 was the first paediatric dietitian to enter private practice in New Zealand. Lea helps families through her private consultations, public lectures, newspaper and magazine articles as well as television and radio interviews. Read more »

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