August 2, 2004
The vitamin B substance folic acid (Vitamin B9) may be able to counteract osteoporosis. This is concluded by an American and a Dutch population study, which were simultaneously publisized in the medical magazine The New England Journal of Medicine.
Folic acid prevents neural tube defect (spina bifida) which is a serious and relatively frequent congenital malformation. Moreover, it is assumed that the vitamin counteracts coronary thrombosis, strokes, and other sequelae from atherosclerosis. Folic acid deficiency is quite widespread. One of the results of folic acid deficiency is that the blood level of the amino acid homocysteine is raised to abnormal high levels.
In the Netherlands, a group of 2,406 people above the age of 55 located in Rotterdam and Amsterdam were followed over a period of up to nine years.
In the American study which was part of the well-known Framingham study, 1,999 elderly people participated and were followed for 15 years. In addition to fractures, a large number of other significant factors in the development of osteoporosis were registered: Smoking habits, age, height and weight, consumption of coffee and alcohol, calcium- and vitamin D intake, oestrogen supplements, etc.
The two studies demonstrated that a high level of homocysteine was linked to an increased risk of suffering hip fractures. Both studies showed that people who belong to the top 25% with regards to high homocysteine levels in their blood have twice as large a risk of breaking their hip as the ones who have much lower levels of homocysteine.
Several conditions point towards a cause and effect relationship here. For example, it was statistically rejected that the risk was related to and biased by other known causes of osteoporosis, such as smoking, a lack of dietary calcium, etc.
It is also known that osteoporosis is a pronounced phenomenon in the hereditary disease homocystinuria in which the levels of homocysteine are particularly high. Finally, it has been demonstrated in laboratory experiments that homocysteine weaken the cross-links in the wickerwork of connective tissue around which the bones are built.
According to the Dutch results, a high level of homocysteine – and thereby a resulting lack of folic acid – might be the cause of approximately 19% of all hip fractures!
By: Vitality Council
1. Van Meurs Joyce B J et al. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 2004;350:2033-41.
2. Mc Lean Robert R et al. Homocysteine as a predictive factor for hip fracture in older persons, N Engl J Med 2004;350:2042-9.
3. (Editorial) Raisz LG. Homocysteine and osteoportic fractures – culprit or bystander? N Engl J Med 2004;350:2089-90.