By Stephenie Karony

Wednesday, August 18, 1999

Keep an eye on levels
of homocysteine

Question: I've been hearing that something called homocysteine is a risk factor in heart disease. What is homocysteine and how is it related to heart disease?

Answer: Homocysteine has been getting a lot of press lately. It made the headlines about four years ago when a study in the New England Journal of Medicine reported that people with elevated homocysteine levels were nearly five times as likely to die of heart disease than those with normal levels.

This remained the case even after taking into account other risk factors such as high cholesterol, high blood pressure and smoking.

Current data suggests that 20 percent of all heart disease cases are associated with high homocysteine levels. What we know now is that homocysteine is also linked to depression and some cancers.

Exactly what is homocysteine? It's a substance produced by our bodies when we metabolize methionine, an amino acid found in protein-rich foods.

If we allow homocysteine to accumulate in the bloodstream, above normal levels, it can damage the lining of the arteries and accelerate blood clotting.

So how do we prevent this from occurring? By making sure we eat enough vitamin B6, B12, and folic acid (folate). These B vitamins convert homocysteine into other amino acids, and this prevents homocysteine from accumulating in our bloodstream, which reduces our risk of developing heart disease.

How are homocysteine and depression related?

According to a Harvard study, 15 percent to 40 percent of depressed adults also have low levels of folic acid in their systems and higher than normal levels of homocysteine.

The researchers that carried out this study speculate that the elevated homocysteine levels caused by a low intake of B vitamins may have a toxic effect on nerve cells, possibly leading to depression.

In regards to cancer, it appears to work like this: When the body has an adequate supply of B vitamins, it has lower levels of homocysteine in the blood. This seems to protect the DNA from the damage that can cause cancer.

If you have a family history of heart disease, depression, or cancer, or have any known risk factors for these disorders, a homocysteine test is clearly warranted.

There is some debate over what constitutes an optimal homocysteine level. Check with your doctor.

To keep homocysteine in check, eat a well-balanced diet, eat plenty of vitamin B enriched foods and eat at least 400 micrograms of folate a day.

Folate-rich foods include orange juice, beans, lentils, asparagus, spinach, peanuts, broccoli and citrus fruits.

Q: My aerobics instructor introduced a new way to do an abdominal crunch, where you lie on your back with your legs straight, toes pointed inward. Is there any advantage to doing it this way over the traditional crunch with the knees bent?

A: No, in fact doing any abdominal exercise with the legs straight is unsafe because it places more stress on the lower back.

I recommend always keeping the knees bent when doing ab exercises. Bent knees tilt the pelvis in such a way that there is less stress on the lower back and more on the abdominal muscles, where it's supposed to be.

Stephenie Karony is a certified health
and fitness instructor, a personal trainer and the author of
"Body Shaping with Free Weights." Send questions to her at
P.O. Box 262, Wailuku Hi. Her column appears on Wednesdays.

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