Heart-stopper

Homocysteine is an artery damaging amino acid building blocks of protein produced by the body during the breakdown of another amino acid, methionine. Deficiency of certain vitamins or genetic defects allows build up of homocysteine levels. This makes homocysteine an independent risk factor in cardiovascular diseases8212;on a par with high blood cholesterol and smoking. The risk is particularly high among Indians.

Normal homocysteine levels are below 10 micromol/litre in adults and below 5 micromol/litre in children. People with homocysteine levels above 12 have double the risk of heart attack. High homocysteine levels can injure the lining of blood vessels, increase the production of muscle cells surrounding vessels and promote blood clots and plaque formation.

High homocysteine levels could be due to genetic or nutritional factors. However, nutritional factors appear to be more important, especially among Indians. High homocysteine levels are related to low levels of folic acid and vitamin B6 and B12. Dietary factors and the destruction of the nutrient content of food through processing and prolonged cooking appear to be the major factors for high levels of homocysteine among Indians. Other factors include heavy intake of alcohol and coffee, and smoking. Smoking increases a person8217;s homocysteine levels, and thus the risk of heart attack, by 12 times. Some other conditions that increase homocysteine include gene mutations, kidney disease and certain medications.

Watch what you eat
Include foods rich in folic acid, and vitamins B6 and B12 in your diet. Spinach, leafy greens, romaine lettuce, broccoli, asparagus, beans, peanuts, orange juice, wheat germ, liver, sunflower seeds, sprouts, pulses, cabbage, cauliflower and enriched grain products can check homocysteine. It has been reported that folate supplements can reduce coronary artery disease by 16 per cent and stroke by 24 per cent. In fact, following the 8216;folic acid fortification program8217;, which began in India in 1998, homocysteine levels among Indians have declined by 50 per cent. Folate must be taken in combination with vitamin B12 because an excess of folate can mask vitamin deficiency.

Vitamin B12, a vitamin commonly found only in animal foods like low-fat dairy, eggs, meat, poultry and fish, helps control homocysteine levels. By that logic, vegetarians may be at risk for low vitamin B12 levels. But a recent study in India stated that more than 70 per cent of both vegetarians and non-vegetarians had high levels of homocysteine.

Natural sources of vitamin B6 include whole grains, fish, poultry, meat, nuts, sunflower seeds and bananas. Preliminary studies indicate that w-3 fatty acids containing fish oils can lower homocysteine levels by 50 per cent. Other good sources for omega 3 fats include soy, tofu, walnuts, fenugreek seeds, flaxseeds, canola oil, mustard oil and fatty fish like hilsa, salmon, black pomfret, sardines etc.

Those who do not eat abundant fresh vegetables and fruits daily should consider vitamin supplements under professional supervision. Try to include 6-8 servings of vegetables and fruits 1 serving=1/2 cup every day. It is important to eat fresh fruits and lightly cooked or raw vegetables. If vegetables must be cooked, they should be done in minimum water, steamed, stir-fried or cooked in the microwave oven.
The writer is a former senior nutritionist at Escorts. She heads the Centre of Dietary Counselling and also runs a health food store. She feels that for complete well-being, one should integrate physical, mental and spiritual health. According to her: 8220;To be healthy should be the ultimate goal for all.8221;