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Author(s): Ruo Zhang [sup.1] , Leqian Guo [sup.2] , Doudou Zhao [sup.3] , Pengfei Qu [sup.3] , Shaonong Dang [sup.4] [sup.5] , Hong Yan [sup.4] [sup.5] [sup.6] Author Affiliations: (1) [...], Background/Objectives The effect of dietary folate intake or folic acid (FA) supplementation during pregnancy on neonatal congenital heart defects (CHDs) remains inconclusive. There are limited data about non-folate-B-vitamin intake and the risk of CHDs. Furthermore, few studies have investigated dietary B-vitamin intake and B-vitamin supplement use simultaneously in relation to the risk of CHDs. This study aimed to explore the associations between maternal folate, vitamin B.sub.6, and vitamin B.sub.12 intake (dietary intake, total intake from diet and supplements); B-vitamin supplement use during pregnancy; and the risk of CHDs using the propensity score matching (PSM) method. Methods We conducted a case-control study and included 760 cases and 1600 controls in Shaanxi Province, China. Diet, supplement use and other information were collected through a questionnaire interview. By using the 1:2 ratio PSM method, 396 cases were matched with 792 controls. Conditional logistic regression was used to investigate the associations between maternal B-vitamin intake and supplement use during pregnancy and CHDs. Results Higher maternal dietary and total intake of folate and vitamin B.sub.12 were associated with reduced risk of CHDs, and the tests for linear trend were significant. Compared with non-users, maternal FA + VB.sub.6 + VB.sub.12 containing supplement use during pregnancy (OR 0.61, 95%CI 0.40-0.94), FA supplement use during pregnancy (OR 0.70, 95%CI 0.50-0.98) and in the first trimester (OR 0.62, 95%CI 0.46-0.85) were associated with a lower risk of CHDs. Conclusions The findings of this study suggest that a higher intake of folate and vitamin B.sub.12 during pregnancy reduces the risk of CHDs.

Deficiencies of the vitamins folate, [B.sub.12], and [B.sub.6] are associated with neurological and psychological dysfunction and with congenital defects. In the elderly, cognitive impairment and incident dementia may be related to the high prevalence of inadequate B vitamin status and to elevations of plasma homocysteine. Plausible mechanisms include homocysteine neurotoxicity, vasotoxicity, and impaired S-adenosylmethionine-dependent methylation reactions vital to central nervous system function. In light of this, it is imperative to find safe ways of improving vitamin B status in the elderly without exposing some individuals to undue risk. doi: 10.1111/j.1753-4887.2010.00346.x

Introduction Self-administered food frequency questionnaires (FFQs) are the most economical method to estimate dietary intake of foods or nutrients in large-scale epidemiological studies. However, FFQs are prone to both systematic [...], Background/Objectives: B vitamins have been implicated in major chronic diseases but results have been inconsistent. This study evaluated the accuracy of dietary intakes of folate, vitamin B12, riboflavin and vitamin B6 as measured by the Northern Sweden Food Frequency Questionnaire (FFQ) against repeated 24-h recalls (24HR) and plasma levels, taking into consideration the MTHFR 677C>T polymorphism. Subjects/Methods: B vitamin intakes assessed by a semi-quantitative FFQ designed to measure the intake over the previous year were compared with those from 10 24HR, as well as to plasma levels of folate and vitamin B12, in randomly selected men (n = 96) and women (n = 99) aged 30-60 years. FFQ-based B-vitamin intakes were also compared with plasma levels of B-vitamins and with MTHFR 677C4T genotype in 878 men, aged 40-61 years. Results: Intakes of vitamins B12 and riboflavin were similar, whereas folate and B6 intakes were 16-27% higher, as estimated by FFQ versus 24HR. Spearman correlation coefficients between the two methods ranged from 0.31 to 0.63 (all P [less than or equal to]0.002), and were lowest for vitamin B12. Intakes estimated by FFQ were correlated with plasma levels, but coefficients were lower (range: 0.13-0.33), particularly for vitamin B12 in men (0.15-0.18). Folate intake was not correlated with plasma levels in subjects with the MTHFR 677 T/T genotype. Conclusions: The validity of the Northern Sweden FFQ for assessing B vitamin intake is similar to that of many other FFQs used in large-scale studies. The FFQ is suitable for ranking individuals by intake of folate, riboflavin, vitamin B6 and to a lesser extent vitamin B12. European journal of Clinical Nutrition (2010) 64, 905-913; doi: 10.1038/ejcn.2010.80; published online 26 May 2010 Keywords: folate; vitamin B; validity; food frequency questionnaire; 24-h recall; MTHFR

A study was conducted to evaluate the efficacy of vitamin B in slowing the progression of diabetic nephropathy as well as prevent vascular complications. Results indicated that high doses of vitamin B did significantly reduce such complications.

Due to the increased immune activation in the intestinal tract of people with celiac disease, the digestive and absorptive processes of those affected may be compromised. Individuals with celiac disease [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2009.05.011 Byline: Mary E. Keith, Natalie A. Walsh, Pauline B. Darling, Stacy A. Hanninen, Subarna Thirugnanam, Howard Leong-Poi, Aiala Barr, Michael J. Sole Abstract: The impact of heart failure and its treatment on specific nutrient requirements is unknown. Furthermore, depletion of water-soluble B vitamins that play key roles in the production of cellular energy in patients with heart failure can contribute to depletion of energy reserves observed in the failing heart. A cross-sectional study recently reported that approximately one third of hospitalized patients with heart failure had tissue levels suggestive of thiamin deficiency (vitamin B-1). Riboflavin (vitamin B-2) and pyridoxine (vitamin B-6) are similar to thiamin in that they are water-soluble, subject to renal excretion, have limited tissue storage, and are dependent on intake. Therefore, it was hypothesized that the status of these B vitamins may also be adversely affected by heart failure. As a result, the prevalence of patients at risk of vitamin B-2 (erythrocyte glutathione reductase activity coefficient [greater than or equal to]1.2) and B-6 deficiency (plasma B-6 [less than or equal to]20 nmol/L) was determined in a cross-section of 100 patients hospitalized with heart failure between April 2001 and June 2002 as well as in a group of volunteers without heart failure. Twenty-seven percent of patients with heart failure had biochemical evidence of vitamin B-2 deficiency, while 38% had evidence of B-6 deficiency. These prevalence rates were significantly higher than those observed in the volunteers without heart failure (2% and 19%, respectively; P[less than or equal to]0.02). Use of common B-vitamin-containing supplements by patients with heart failure did not significantly reduce deficiency rates in comparison with those who did not use supplements (B-2 P=0.38 or B-6 P=0.18)). Finally, while 80% of patients with heart failure took diuretics, neither the dose nor the duration of furosemide use was related to the presence of either B-2 or B-6 deficiency. Given the physiologic importance of these vitamins, further investigations aimed at determining the effect of heart failure on specific nutrient requirements as well as the safety and efficacy of B-vitamin supplementation are warranted. Article History: Accepted 26 January 2009

Elevated circulating total homocysteine (tHcy) concentrations are related to increased risk for cardiovascular disease. Folic acid fortification resulted in a significant decrease in circulating tHcy in the United States. In the post-folic acid fortification period, associations between plasma tHcy and demographic, health, and lifestyle factors and B vitamin status were investigated. Data from the 3 recent NHANES cycles (1999-2004) were used to study the associations among plasma tHcy and sex, race/ethnicity, age, BMI, blood pressure (BP), serum creatinine, serum cotinine, vitamin/mineral supplement use, and folate and cobalamin status in 16,254 persons (8329 men, 7925 women). Multivariate-adjusted plasma tHcy was ~9.7% higher in men than in women (P < 0.0001), ~5.3% higher in non-Hispanic whites than in non-Hispanic blacks (P < 0.0001), -64.5% higher in individuals aged [greater than or equal to] 60 y than in individuals aged < 20 y (P < 0.0001), and -5% higher in supplement nonusers than in supplement users (P < 0.0001). Persons in the 4th quartile for serum creatinine, serum cotinine, systolic BP, and serum methylmalonic acid (MMA) had ~36.1, ~13.4, ~5.6, and ~16.2%, respectively, higher tHcy than those in the 1st quartile (P < 0.0001). Plasma tHcy was inversely associated with serum folate (P < 0.0001), RBC folate (P < 0.0001), and serum cobalamin (P < 0.0001). In the post-folic acid fortification period, sex, race/ethnicity, age, systolic BP, supplement use, RBC folate, and serum creatinine, cotinine, folate, and cobalamin are significant determinants of plasma tHcy. Serum MMA was strongly associated with plasma tHcy. J. Nutr. 139: 345-352, 2009.

Mycobacterium tuberculosis is predicted to subsist on alternative carbon sources during persistence within the human host. Catabolism of odd- and branched-chain fatty acids, branched-chain amino acids, and cholesterol generates propionyl-coenzyme A (CoA) as a terminal, three-carbon ([C.sub.3]) product. Propionate constitutes a key precursor in lipid biosynthesis but is toxic if accumulated, potentially implicating its metabolism in M. tuberculosis pathogenesis. In addition to the well-characterized methylcitrate cycle, the M. tuberculosis genome contains a complete methylmalonyl pathway, including a mutAB-encoded methylmalonyl-CoA mutase (MCM) that requires a vitamin [B.sub.12]-derived cofactor for activity. Here, we demonstrate the ability of M. tuberculosis to utilize propionate as the sole carbon source in the absence of a functional methylcitrate cycle, provided that vitamin [B.sub.12] is supplied exogenously. We show that this ability is dependent on mutAB and, furthermore, that an active methylmalonyl pathway allows the bypass of the glyoxylate cycle during growth on propionate in vitro. Importantly, although the glyoxylate and methylcitrate cycles supported robust growth of M. tuberculosis on the [C.sub.17] fatty acid heptadecanoate, growth on valerate ([C.sub.5]) was significantly enhanced through vitamin [B.sub.12] supplementation. Moreover, both wild-type and methylcitrate cycle mutant strains grew on [B.sub.12]-supplemented valerate in the presence of 3-nitropropionate, an inhibitor of the glyoxylate cycle enzyme isocitrate lyase, indicating an anaplerotic role for the methylmalonyl pathway. The demonstrated functionality of MCM reinforces the potential relevance of vitamin [B.sub.12] to mycobacterial pathogenesis and suggests that vitamin [B.sub.12] availability in vivo might resolve the paradoxical dispensability of the methylcitrate cycle for the growth and persistence of M. tuberculosis in mice.

Objective The purpose of this study was to determine if nonsupplementing older women (aged [greater than or equal to] 55 years) with rheumatoid arthritis had higher plasma homocysteine and lower B-vitamin status compared to healthy controls. Elevated plasma homocysteine, a risk factor for cardiovascular disease, may help explain why individuals with rheumatoid arthritis have an increased risk of cardiovascular disease. Methods Older, free-living women were classified as rheumatoid arthritis (n=18) or healthy control (n=33). Participants were not using B-vitamin supplements. Fasting blood samples were measured for pyridoxal 5'phosphate (PLP) (the metabolically active coenzyme form of vitamin B-6), folate, red blood cell folate, vitamin B-12, transcobalamin II, homocysteine, C-reactive protein, and lipid concentrations. Participants completed 7-day weighed food records, the Stanford Health Assessment Questionnaire (HAQ), and a visual analog pain scale. Results PLP concentrations were lower in the rheumatoid arthritis vs healthy control participants (4.93[+ or -]3.85 vs 11.35 [+ or -] 7.11 ng/mL [20 [+ or -] 16 vs 46 [+ or -] 29 nmol/L]; P<0.01) whereas plasma homocysteine was higher in the rheumatoid arthritis group (1.63 [+ or -] 0.74 vs 1.15 [+ or -] 0.38 mg/L [12.1 [+ or -] 5.5 vs 8.5 [+ or -] 2.8 [micro]mol/L]; P=0.02). Red blood cell folate concentrations were lower in the rheumatoid arthritis vs healthy control participants [414[+ or -]141 vs 525[+ or -]172 ng/mL [938[+ or -]320 vs 1,190[+ or -] 390 nmol/L]; P=0.02). No significant differences were found for plasma folate, vitamin B-12, and transcobalamin II. An inverse correlation was found between PLP concentrations and the HAQ disability index (r=-0.37; P<0.01). A positive correlation was found between homocysteine concentrations and the HAQ disability index (r=0.36; P=0.01). Total cholesterol and low-density lipoprotein cholesterol levels were lower in the rheumatoid arthritis group (cholesterol 191[+ or -]43 vs 218[+ or -]33 mg/dL [4.95[+ or -] 1.11 vs 5.65[+ or -]0.85 mmol/L]; P=0.02; low-density lipoprotein cholesterol 110[+ or -]36 vs 137[+ or -]29 mg/dL [2.85[+ or -]0.93 vs 3.55[+ or -]0.75 mmol/L]; P<0.01). No significant differences were seen between groups for protein (g/day), fat (g/day), cholesterol (mg/day), folate ([micro]g/day), vitamin B-12 ([micro]g/day), and vitamin B-6 (mg/day) dietary intakes. Conclusions Poor vitamin B-6 status and elevated plasma homocysteine concentrations were seen in older women with rheumatoid arthritis compared to healthy controls and may contribute to their increased risk of cardiovascular disease.

THE MAJORITY OF premature infants, especially very low birth weight (birth weight < 1500 g) infants, receive ≥ 1 red blood cell transfusion for anemia of prematurity during their first [...], OBJECTIVES. Erythropoietin is frequently administered to premature infants to stimulate erythropoiesis. The primary goal of erythropoietin therapy is to reduce transfusions, but the efficacy of erythropoietin has not been convincingly demonstrated in this regard. The aim of this trial was to investigate whether combined administration of vitamin [B.sub.12], folic acid, iron, and erythropoietin could decrease transfusion requirements in extremely low birth weight infants. PATIENTS AND METHODS. In a randomized, controlled trial, extremely low birth weight infants with a birth weight ≤ 800g and a gestational age ≤ 32 weeks were randomly assigned to a group receiving combination treatment or a control arm. RESULTS. The treatment increased levels of folate in red blood cells, vitamin [B.sub.12], ferritin, transferrin receptor levels in plasma, and reticulocyte counts. The proportion of infants requiring no transfusions was lower in the treatment group (38%) as compared with controls (5%). The treatment group and the need for mechanical ventilation were independent predictors of the number of transfusions in multiple regression analysis. Cox regression analysis indicated that combined therapy resulted in a 79% risk reduction for any transfusion. CONCLUSION. Combined treatment with erythropoietin, intravenous iron, folate, and vitamin [B.sub.12] during the first weeks reduces the need for transfusion in extremely low birth weight infants. Key Words folate, vitamin [B.sub.12], erythropoietin, iron, ELBW infant, transfusions Abbreviations RBC--red blood cell GA--gestational age ELBW--extremely low birth weight TFR--transferrin receptor CI--confidence interval IRF--immature reticulocyte fraction MCV--mean corpuscular volume ROP--retinopathy of prematurity

A study was conducted to assess whether supplementation reduced the risk of major cardiovascular events in patients with vascular disease. It was found that supplements combining folic acid and vitamins B(sub 6) and B(sub 12) did not reduce the risk of major cardiovascular events in patients with vascular disease.

Cysteine synthesis from homocysteine is catalyzed by two pyridoxal 5'-phosphate (PLP)-dependent enzymes. This suggests that vitamin B-6 status might affect cysteine and glutathione homeostasis, but it is unclear whether this occurs in humans. We assessed the effects of vitamin B-6 status on static and kinetic parameters of cysteine and glutathione metabolism in healthy female (n = 5) and male (n = 4) volunteers (20-30 y) before and after 4 wk of dietary vitamin B-6 restriction ( KEY WORDS: * cysteine * glutathione * human * transsulfuration * vitamin B-6

To identify existing dietary patterns and examine associations between these patterns and plasma homocysteine and B vitamin concentrations in an urban Chinese population living in Beijing (n = 119), dietary information was collected with a food frequency questionnaire designed for this population. Plasma homocysteine and B vitamin concentrations were examined. Food group variables, expressed as percentages of total energy intake, were entered into cluster analysis to define three distinct dietary pattern groups. The prevalence of high homocysteine (>11 [micro]mol/L for women and 12 [micro]mol/L for men), was 31.9%; of low folate ( KEY WORDS: * dietary patterns * homocysteine * B vitamin * cluster analysis * Chinese

Because of limited available information, the Estimated Average Requirement (EAR) and Recommended Dietary Allowance (RDA) of vitamin B-6 for adolescents were recently estimated by extrapolation from adult values. To determine vitamin B-6 requirements and to provide recommendations for intakes, vitamin B-6 intake, nutritional status and anthropometry were studied in 134 healthy adolescents (63 boys and 71 girls) aged 13-15 y in Tainan, Taiwan. Direct and indirect vitamin B-6 indicators were measured in plasma, erythrocytes and urine. The anthropometric data of the adolescents in this study were similar to those of the first Nutrition and Health Survey in Taiwan (NAHSIT), conducted from 1993 to 1996, showing the normal growth and development of this adolescent group. All subjects had plasma pyridoxal-5'-phosphate (PLP) concentrations [greater than or equal to] 20 nmol/L, indicating an adequate vitamin B-6 status. The mean dietary vitamin B-6 intakes of boys and girls were 1.04 [+ or -] 0.24 and 0.83 [+ or -] 0.26 mg/d, respectively. Vitamin B-6 status indicators, including plasma PLP, erythrocyte alanine activity coefficient (EALT-AC), aspartate aminotransferase activity coefficient (EAST-AC) and urinary 4-pyridoxic acid (4-PA), were correlated with vitamin B-6 intake (r = 0.84, -0.84, -0.77 and 0.86, respectively, P < 0.01). Adequate values of plasma PLP ([greater than or equal to] 20 nmol/L), EALT-AC (3.0 [micro]mol/d) were used to determine the EAR according to the Dietary Reference Intake committee methodology. The present study suggests that vitamin B-6 EAR (RDA) for adolescent boys and girls aged 13-15 y are 1.07 (1.28) and 0.90 (1.08) mg/d, respectively. J. Nutr. 133: 3191-3194, 2003. KEY WORDS: * vitamin B-6 * nutritional status * Estimated Average Requirement * Recommended Dietary Allowance * adolescent

Peripheral arterial disease (PAD) causes morbidity and is associated with mortality. B vitamin intake has been inversely associated with coronary heart disease, but their effects on PAD are not known. We examined prospectively the relationships between dietary folate, vitamin B-6 and B-12 and PAD risk in 51,529 male U.S. health professionals, aged 40 to 75 y, who answered a detailed 131-item questionnaire to assess diet and vitamin supplement use. The study population consisted of 46,036 men free of PAD, cardiovascular disease and diabetes at baseline followed for 12 y during which we documented 308 incident PAD cases. For every 400 [micro]g/d increment of folate intake, the multivariate adjusted PAD risk decreased by 21% [relative risk (RR) = 0.79, 95% CI 0.64-0.96]. Men in the top category of folate intake (median = 840 [micro]g) were at 33% lower risk of PAD than men in the bottom category (median = 244 [micro]g) (RR = 0.67, 95% CI 0.45-0.96, P-value, test for trend = 0.03) after multivariate adjustment. There were weak inverse associations between intake of vitamin B-6 and PAD risk (RR = 0.70, 95% CI 0.48-1.02, P-value, test for trend = 0.06) and B-12 (RR = 0.77, 95% CI 0.54-1.11, P-value, test for trend = 0.12). These results suggest that higher consumption of folate may contribute to the prevention of PAD. KEY WORDS: * folate * peripheral arterial disease * vitamin B-6 * vitamin B-12 * homocysteine

The prevalence of vitamin B-12 deficiency increases with age, probably resulting from malabsorption of food-bound B-12 secondary to gastric atrophy. On the basis of this assumption, the Institute of Medicine (IOM) recommends those aged >50 y consume crystalline vitamin B-12. There is limited information on the prevalence of gastric atrophy in the elderly and whether the IOM recommendation would be effective. The objective of this study was to assess predictors of vitamin B-12 status and their interactions in free-living elderly. Individuals (n = 57) with deficient plasma vitamin B-12 (p-B12 < 148 pmol/L) were compared with 68 individuals with marginal p-B12 (148-221 pmol/L) and 52 with normal p-B12 (>221 pmol/L) in a cross-sectional sample (n = 1546) of elderly (>60 y) Latinos in California. Associations were examined among p-B12 and serum gastrin, vitamin B-12 intake from food and crystalline sources, and medications that putatively affect vitamin B-12 absorption. Serum gastrin was elevated, indicating gastric atrophy, in 48% of participants with deficient p-B12, 23% with marginal p-B12 and 21% of normal p-B12 participants, and was a significant predictor of deficient p-B12 and high plasma homocysteine (p-tHcy). Median total vitamin B-12 intake exceeded recommendations and was similar among status groups. Crystalline vitamin B-12 intake in the normal p-B12 group was higher than in the deficient p-B12 group (P < 0.01), and tended to be higher than the marginal group (P = 0.07). When serum gastrin was elevated, p-B12 was predicted by crystalline vitamin B-12, but not by intake of vitamin B-12 from food. Elevated serum gastrin was highly prevalent and predicted vitamin B-12 depletion. Crystalline vitamin B-12 intake predicted p-B12 in individuals with elevated serum gastrin, supporting IOM recommendations to increase consumption of crystalline vitamin B-12. KEY WORDS: * vitamin B-12 * homocysteine * dietary intake * serum gastrin * elderly

Byline: MieczysAaw Litwin (1), Mahmoud Abuauba (1), Zbigniew T. Wawer (2), Ryszard Grenda (1), Tomasz Kuryt (2), Ewa Pietraszek (2) Keywords: KeywordsaHyperhomocysteinemia; Chronic renal failure; Folate; Vitamin B12; Sulfur amino acids; Hypermethioninemia Abstract: We examined the plasma profile of sulfur amino acids (SAA) in patients with chronic renal failure (CRF) and looked for any correlation with serum folate (FA) and/or vitamin B.sub.12. Group 1 comprised 9 patients with CRF and glomerular filtration rate (GFR) &gt 20 ml/min per 1.73 m.sup.2, 9 patients with GFR&lt 20 ml/min per 1.73 m.sup.2 comprised group 2, and 14 patients on hemodialysis group 3. The control group comprised 16 healthy children. Homocysteine (Hcy), methionine (Met), cysteine (Cys), and serine (Ser) were measured with gas chromatography. FA and vitamin B.sub.12 were measured using enzymatic immunoassay. Median SAA concentrations were significantly lower in controls than in the three groups of patients. Hcy concentrations were 0.8 Aumol/l in controls versus 5 Aumol/ (group 1), 9 Aumol/l (group 2), and 20 Aumol/l (group 3). Met concentrations were 26 Aumol/l in controls versus 26 Aumol/l (group 1), 66 Aumol/l (group 2), and 281 Aumol/l (group 3). Cys concentrations were 10 Aumol/ in controls versus 98 Aumol/l (group 1), 54 Aumol/l (group 2), and 122 Aumol/l (group 3). Ser concentrations were 88 Aumol/ in controls versus 153 Aumol/l (group 1), 239 Aumol/l (group 2), and 240 Aumol/l (group 3). The median concentrations of FA were lower in controls than in groups 2 and 3: 5.5 ng/ml versus 8 ng/ml and 15 ng/ml, respectively. Vitamin B.sub.12 concentrations did not differ between groups. Vitamin levels did not correlate with SAA. The only difference between patients with Hcy levels in the lower and upper quartile was in Met concentration (38 vs. 263 Aumol/l, P&lt 0.02) and GFR (P&lt 0.01). In conclusion, patients with CRF had higher SAA concentrations than healthy children. FA concentrations are higher in CRF patients than in healthy children but did not correlate with concentrations of SAA. Author Affiliation: (1) Department of Dialysis and Kidney Transplantation, The Children&apos;s Memorial Health Institute, Al. Dzieci Polskich 20, 04-736 Warsaw, Poland e-mail: mieczyk@zigzag.pl Tel.: +48-022-8151540, Fax: +48-022-8151540, PL (2) Department of Laboratory Diagnostics, The Children&apos;s Memorial Health Institute, Warsaw, Poland, PL Article note: Received: 3 January 2000 / Revised: 21 September 2000 / Accepted: 11 October 2000

Introduction The study of nutritional status of elderly people is of particular importance, as they are at greater risk of malnutrition [1] and at the same time have an increased [...]

In the 20th century, the United States witnessed a steady and dramatic increase in the prevalence of coronary heart disease (CHD), with CHD ranking as the leading cause of death [...]

Results of a study to establish the efficacy of Vitamin B supplementation in slowing cognitive decline in individuals with Alzheimer's disease revealed no benefits of Vitamin B. There is need for further research to try and establish some benefit of Vitamin B.

Clinical trials by National Health and Nutrition Examination Surveys are made to assess the potential impact of nutritional intervention with folic acid and vitamin B, and to know the risk of increasing cardiovascular diseases on fortification of vitamin B. The study reveals that vitamin B fortification may not reduce cardiovascular disease.