Multivitamin/mineral supplementation improves plasma B-vitamin status and homocysteine concentration in healthy older adults consuming a folate-fortified diet

Elevated homocyspeine has been identified as an independent risk factor for cardiovascular and cerebrovascular disease. Although multivitamin use has been associated with low plasma homocysteine concentrations in several obse rvational studies, no clinical trials have been conducted using multivitami n/mineral supplements to lower homocysteine. We determined whether a multiv itamin/mineral supplement formulated at about 100% Daily Value will further lower homocysteine concentration and improve B-vitaman status in healthy o lder adults already consuming a diet fortified with folic acid. In this ran domized, double-blind, placebo-controlled trial, 80 free-living men and wom en aged 50-87 y with total plasma homocysteine concentrations of greater th an or equal to8 mu mol/L received either a multivitaman/mineral supplement or placebo for 56 d while consuming their usual diet. After the 8-wk treatm ent, subjects taking the supplement had significantly higher B-vitamin stat us and lower homocysteine concentration than controls (P < 0.01). Plasma fo late, pyridoxal phosphate (PLP) and vitamin B-12 concentrations were increa sed 41.6, 36.5 and 13.8%, respectively, in the supplemented group, whereas no changes were observed in the placebo group. The mean homocysteine concen tration decreased 9.6% in the supplemented group (P < 0.001) and was unaffe cted in the placebo group. There were no significant changes in dietary int ake during the intervention, Multivitamin/mineral supplementation can impro ve B-vitamin status and reduce plasma homocysteine concentration in older a dults already consuming a folate-fortified diet.