Dr. McCully’s B vitamin recipe

Why do some people die from heart attacks when their blood cholesterol is normal? They’ve never smoked a cigarette, are thin as a rake, exercise regularly, take vitamin E and C and don’t suffer from diabetes, hypertension or other cardiac risk factors. Evidence is mounting that the culprit may be increased amounts of homocysteine in the blood. Ah, what sweet revenge for Dr. Kilmer McCully.

In 1968, Dr. Kilmer McCully was a pathologist at Harvard’s prestigious Massachusetts General Hospital. He was performing an autopsy on a two-month-old boy who had died of a rare generic disease: homocystinuria, a condition causing high levels of homocysteine to accumulate in the blood. McCully noted that the infant’s arteries were hardened and clogged, identical to older patients with advanced vascular disease.

Dr. McCully made a reasonable assumption that homocysteine might be related to coronary heart disease. But he was young and his older colleagues scoffed at his theory. For sticking to his guns he was finally asked to find a position elsewhere.

Now, 14 years later, several world studies have confirmed there is a possible link between increased levels of homocysteine and vascularisease.

Homocysteine is a waste product of protein metabolism. It’s the task of three B vitamins, B6, B12 and especially folic acid, to remove homocysteine from the blood. The evidence linking homocysteine to vascular disease is not conclusive, but a study conducted in nine European countries should make everyone take notice.

The results showed that elevated blood levels of homocysteine for both men and women can raise the risk of heart disease as much as smoking a pack of cigarettes a day, having a high blood pressure of 160/95, or an elevated blood cholesterol.

A recent report in the Journal of the American Medical Association revealed that high homocysteine levels are not only associated with coronary heart disease. Nine of 11 studies showed increased homocysteine was related to higher incidence of stroke. And all nine studies found a relationship between increased homocysteine and arterial disease of the legs.

Other evidence abounds. For instance, the Nutrition Canada Survey found that Canadians with lowest levels of folic acid in the blood had a 69 per cent greater risk of death from coronary heart disease (CHD). A study in the journal Circulation even found a link between high homocysteine and CHD in young women, a group in which heart disease is rare.

The scary conclusion? Those who had the highest elevated levels of homocysteine had double the risk of heart disease.

While it’s not certain how high blood levels of homocysteine trigger heart disease, it’s believed that homocysteine injures the inner endothelial lining of the arteries. This sets the stage for both clogging of the artery and increased risk of blood clot.

So what should we do? One could wait for more proof. But being tardy about getting sufficient amounts of B vitamins might result in a needless heart attack.

One in five adults has homocysteine levels high enough to increase the risk of heart disease. It’s also estimated that 88 per cent of North Americans consume less than the recommended 400 micrograms of folic acid.

The most sensible approach is to ensure an adequate dietary intake of B vitamins. Folic acid is present in green leafy vegetables, fruits, wheat germ, brewers yeast, dried beans, peas and liver. Vitamin B6 is also present in green leafy vegetables, along with fish, meat, poultry, whole grain cereals, nuts. Dairy products, eggs, meat and fish are rich in B12.

If you have a diet deficient in these vitamins it’s wise to take a multivitamin supplement. Dr. Meir Stampfer, a world authority on vitamins, believes the dosages found in typical multivitamins are acceptable.