Serum homocysteine is related to food intake in adolescents: the Child and Adolescent Trial for Cardiovascular Health1–3

Background: An understanding of the relation in adolescents be-tween serum homocysteine and foods rich in vitamin B-6, vitamin B-12, and folate is important because high homocysteine concen-trations in childhood and adolescence may be a risk factor for later cardiovascular disease. However, little is known about the relation between food intake and homocysteine in adolescents. Objective: Five years after national folic acid fortification of en-riched grain products, cross-sectional relations between food intake and serum homocysteine concentrations were examined in 2695 adolescents [x age: 18.3 (range: 15–20) y] enrolled in the Child and Adolescent Trial for Cardiovascular Health. Design: A nonfasting blood specimen was analyzed for serum ho-mocysteine, folate, and vitamins B-6 and B-12. Dietary intake was assessed by using a food-frequency questionnaire. Multiple regres-sion analyses were used to evaluate the relation of intakes of whole grains, refined grains, fruit, vegetables, dairy products, red and pro-cessed meats, and poultry with serum homocysteine concentrations after adjustment for demographic characteristics, lifestyle factors, and food intake. Results: Serum homocysteine concentrations were lower with greater intakes of whole grains (P for trend 0.002), refined grains (P for trend 0.02), and dairy foods (P for trend 0.001); were higher with greater intake of poultry (P for trend 0.004); and were not related to intakes of fruit, vegetables, or red or processed meat. After additional adjustment for serum B vitamins, the relations of serum homocysteine with most food groups were attenuated. Conclusion: These observational findings suggest a beneficial ef-fect of whole-grain, refined-grain, and dairy products on serum ho-mocysteine concentrations in an adolescent population. Am