REDUCT OF PLASMA HOMOCYST(E)INE LEVELS BY BREAKFAST CEREAL FORTIF W/ FOLIC ACID

美国食品和药物管理局（FDA）建议， 谷类食品中添加叶酸， 先天性神经管缺陷 补充叶酸 降低血浆同型半胱氨酸或血浆总同型半胱氨酸， 在动脉闭塞性疾病中经常升高， 叶酸强化可以降低血浆同型半胱氨酸 程度. 为了验证这一假设，我们评估了早餐的影响， 强化了三种水平叶酸的谷物，还含有 维生素B6和B12的推荐膳食摄入量， 随机、双盲、安慰剂对照、交叉试验，75例 患有冠心病的男性和女性。 血浆叶酸 血浆同型半胱氨酸水平随年龄的增加而增加， 早餐谷物中叶酸的含量。 第127章提供粮食？G 叶酸的每日摄入量，接近每日摄入量的增加， 由于FDA的富集政策，增加了血浆叶酸 降低30.8%（P=0.045），但血浆同型半胱氨酸仅降低3.7% （P= 0.24）。 然而，谷物提供499和665？叶酸摄入量 血浆叶酸水平分别提高64.8%（P< 0.001）和105.7%（P= 0.001）， 血浆同型半胱氨酸水平降低11%（P< 0.001）。 和14.0%（P= 0.001）。 叶酸强化谷物 有可能增加血浆叶酸水平， 血浆同型半胱氨酸水平。 需要进一步的临床试验， 确定叶酸强化是否可以预防血管 疾病 在此之前，我们的研究结果表明， 强化水平高于FDA推荐的水平， 有正当理由 资助通用米尔斯出版物Malinow MR，Duell PB， 赫斯DL，安德森PH，克鲁格WD，菲利普森BE，格拉克曼RA，块PC， 厄普森BM。 早餐降低血浆同型半胱氨酸水平 叶酸强化谷物对冠心病患者的影响 疾病 N Engl J Med 338：1009-1015，1998.

The Food and Drug Administration (FDA) has recommended that cereal-grain products be fortified with folic acid to prevent congenital neural-tube defects. Since folic acid supplementation reduces plasma homocyst(e)ine, or plasma total homocysteine, which is frequently elevated in arterial occlusive disease, we hypothesized that folic acid fortification might reduce plasma homocyst(e)ine levels. To test this hypothesis, we assessed the effects of breakfast cereals fortified with three levels of folic acid, and also containing the recommended dietary allowances of vitamins B6 and B12, in a randomized, double-blinded, placebo-controlled, cross-over trial in 75 men and women with coronary artery disease. Plasma folic acid increased and plasma homocyst(e)ine decreased proportionately with the folic acid content of the breakfast cereal. Cereal providing 127 ?g of folic acid daily, approximating the increased daily intake that may result from the FDA=s enrichment policy, increased plasma folic acid by 30.8% (P=0.045) but decreased plasma homocyst(e)ine by only 3.7% (P= 0.24). However, cereals providing 499 and 665 ?g folic acid daily increased plasma folic acid by 64.8% (P< 0.001) and 105.7% (P= 0.001), respectively, and decreased plasma homocyst(e)ine by 11% (P< 0.001) and 14.0% (P= 0.001), respectively. Cereal fortified with folic acid has the potential to increase plasma folic acid levels and reduce plasma homocyst(e)ine levels. Further clinical trials are required to determine whether folic acid fortification may prevent vascular disease. Until then, our results suggest that folic acid fortification at levels higher than that recommended by the FDA may be warranted. FUNDING General Mills PUBLICATIONS Malinow MR, Duell PB, Hess DL, Anderson PH, Kruger WD, Phillipson BE, Gluckman RA, Block PC, Upson BM. Reduction of plasma homocyst(e)ine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease. N Engl J Med 338:1009-1015, 1998.