B vitamins may reduce osteoporosis fractures

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B vitamins may reduce osteoporosis fractures

Folic acid helps lower homocysteine levels, studies find

The Associated Press

Updated: 8:46 p.m. ET May 12, 2004

Folate and other B vitamins seem even more of a wonder drug than anyone

suspected: Already known to prevent severe birth defects and heart attacks, they

may also ward off broken bones from osteoporosis, two major studies suggest.

The findings underscore doctors' longstanding recommendation that people take

multivitamins. They could also further support the government's decision to

require bread and cereal makers to fortify their products with folate, also

known as folic acid.

B vitamins are known to reduce levels of homocysteine, an amino acid already

linked, at high levels, to an increased risk of heart attacks, strokes and

Alzheimer's disease. Now research shows high levels of homocysteine at least

double the risk of osteoporosis-related fractures.

A report from Holland found that the risk of such fractures was twice as high in

men and women with homocysteine levels in the top 25 percent, compared with

those with lower levels. Similarly, a U.S. study found the risk nearly

quadrupled in the top 25 percent of men and nearly doubled in the top 25 percent

of women, compared with the 25 percent with the lowest levels.

" The basic way to keep your homocysteine down in a healthy range is to have

plenty of B vitamins, " said Dr. P. Kiel, senior author of the U.S. study

and director of medical research at Hebrew Rehabilitation Center for Aged

Research and Training Institute in Boston.

The studies were reported in Thursday's New England Journal of Medicine.

Reducing the risk of broken bones

Kiel said a standard multivitamin, taken once a day, would bring a person's

homocysteine levels below the danger point. Foods naturally rich in B vitamins

and calcium - including dairy products, broccoli and other green, leafy

vegetables, carrots, avocados, cantaloupes, apricots, almonds and peanuts - can

also reduce the risk of broken bones.

Since 1998, when the U.S. government began requiring that folate be added to

bread, cereal and other flour products, the resulting drop in Americans'

homocysteine levels has been credited with preventing about 48,000 deaths from

heart attacks and strokes each year. Also, severe brain and spinal birth defects

have dropped 27 percent - the strategy's original purpose.

Researchers say it is unclear why the same benefit with fractures has not yet

been documented. There is also uncertainty as to how homocysteine levels affect

bone strength. The prevailing theory is that it interferes with crucial chemical

bonds within the bones.

Experts say it is too soon to recommend routine testing of homocysteine levels,

which can cost from $100 to $200. That is partly because the new studies do not

actually prove that high homocysteine levels - rather than some other factors -

cause weaker bones.

Kiel's research examined 825 men and 1,174 women, aged 59 to 91, who were part

of the Framingham Heart Study, which since 1948 has been studying heart disease

risk factors in residents of the Boston suburb. Homocysteine levels in blood

samples taken from the patients between 1979 and 1982 were later measured, and

the patients were followed for 12 to 15 years to see how many had hip fractures.

Hip fractures are the leading cause of elderly people being forced into nursing

homes; they lead to death within a year for about 20 percent of patients,

because of infections and other complications, said Dr. Felicia Cosman, clinical

director of the National Osteoporosis Foundation.

A 'wake-up call to eat better'

Among the study participants with the highest homocysteine levels, men were

about four times more likely to fracture a hip and women about twice as likely,

compared with the 25 percent with the lowest levels.

" This should be another wake-up call to eat better, when you're older,

especially, " Kiel said.

Kiel said the highest homocysteine levels would result in about 9 extra hip

fractures per 100 men and 9.5 extra fractures per 100 women over 14 years, the

average time the patients were studied.

The report from Erasmus Medical Center in Holland analyzed data from two

studies, one in Rotterdam and one in Amsterdam, involving a total of 2,406

people age 55 or older. Those with the highest levels were 1.9 times more likely

than the others to suffer osteoporosis-related fractures.

Research reports since at least 1985 have hinted at a relationship between

homocysteine and osteoporosis, said Dr. Todd Stitik, associate professor of

physical medicine and rehabilitation at University of Medicine and Dentistry of

New Jersey-Newark.

" This is providing more pieces to that puzzle, " he said.

Stitik said that starting a healthier lifestyle even before middle age can head

off problems.

Besides taking a multivitamin with folate, vitamin B12 and vitamin B6, he

recommends plenty of walking or other weight-bearing exercise and eating foods

rich in B vitamins.

© 2004 The Associated Press. All rights reserved. This material may not be

published, broadcast, rewritten or redistributed.

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