Dietary strategies to treat hyperhomocysteinaemia based on the biochemistry of homocysteine: a review

Hyperhomocysteinaemia is implicated in various diseases, including cardiovascular disease and cancer. Several conditions influence the concentration of homocysteine (Hcy), including demographic, genetic and lifestyle factors. With regard to the latter, dietary components may be manipulated as Hcy can be remethylated to methionine by folate, or metabolised by other one-carbon nutrients, such as betaine and its precursor, choline. This metabolic interplay enables the nutritionist or dietitian to be able to lower Hcy concentrations cost-effectively by tailoring an individual’s diet, or by food enrichment and fortification strategies. Evidence supports the safety and benefits of Hcy reduction by simple dietary intervention. B vitamins, and betaine and choline intake lower Hcy, whereas methionine and certain beverages (coffee, tea and alcohol) increase it. Therefore, dietary determinants of Hcy raise the prospect of a simple, inexpensive and safe means of treating and/or preventing diseases contingent on this sulphur- containing protein. Keywords: alcohol, B vitamins, coffee, homocysteine, lipotropics, te

The association between calf circumference and appendicular skeletal muscle mass index of black urban women in Tlokwe City

Background: Sarcopenia, the loss of muscle mass and strength, is associated with adverse health outcomes. Calf circumference (CC) has been proposed as a surrogate measure of muscle mass in the elderly; however, ethnic/sex specific cut-off values remain to be established.Objective: A study was undertaken to investigate the relationship between CC and appendicular skeletal muscle mass (ASM), and the ASM index (ASMI), as well as to determine whether CC could be used to diagnose sarcopenia.Methods: This was a cross-sectional study of 247 older black women living from Tlokwe, South Africa. ASM was measured using dual-energy X-ray absorptiometry, and the ASMI was calculated. Receiver operator characteristics curves and maximum Youden index were applied to identify a CC cut-off point for sarcopenia according to low gait speed (< 0.8 m/s), low hand-grip strength (< 16 kg) and low ASMI using a South African cut-off point for sarcopenia (ASMI < 4.94 kg/m2).Results: A strong positive correlation between CC and ASMI (r = 0.84, p < 0.001) was observed. The CC to predict low hand-grip strength was 34.3 cm and 37.8 cm for low gait speed. A CC of 29.9 cm was indicative of sarcopenia. The area under the curve for all outcomes was > 0.60.Conclusion: A CC of 30 cm is proposed as a simple and inexpensive way to predict, screen or diagnose sarcopenia in black women in low-resource health settings. An accessible, inexpensive screening or diagnostic tool could facilitate timely interventions and prevention.Keywords: gait speed, geriatric, hand-grip strength, muscle strength, sarcopeni

Trust in financial services: the influence of demographics and dispositional characteristics

So far, very little attention has been paid to examining consumer perceptions of trust from an interdisciplinary perspective. The purpose of this study is to examine how consumer trusting belief and disposition to trust within the financial services sector vary on the basis of individual demographic differences in trust. The research provides new insights into how consumers with higher dispositional trust have higher institutional trust and higher trusting belief and how consumers’ trusting belief significantly differs according to their demographic background in terms of age, marital status, ethnicity and gross annual income. The findings offer useful insights for the managers in financial institutions to carefully consider the impact of the influence of these individual differences on consumer behaviour in order to serve the needs of consumers in their target market and be able to design financial products and develop trust building strategies to attract and retain them. They also call for the action of the regulators and the financial institutions to play their part in building strong institutional systems that contribute to engendering higher levels of consumer trust

Gene–environment and gene–gene interactions of specific MTHFR, MTR and CBS gene variants in relation to homocysteine in black South Africans

The methylenetetrahydrofolate reductase (MTHFR), cystathione-beta-synthase (CBS) and methionine synthase (MTR) genes interact with each other and the environment. These interactions could influence homocysteine (Hcy) and diseases contingent thereon. We determined single nucleotide polymorphisms (SNPs) within these genes, their relationships and interactions with total Hcy concentrations within black South Africans to address the increased prevalence of diseases associated with Hcy. The MTHFR 677 TT and MTR 2756 AA genotypes were associated with higher Hcy concentrations (16.6 and 10.1 mu mol/L; p <0.05) compared to subjects harboring the MTHFR 677 CT/CC and the MTR 2756 AG genotypes (10.5, 9.7 and 9.5 mu mol/L, respectively). The investigated CBS genotypes did not influence Hcy. We demonstrated interactions between the area of residence and the CBS T833C/844ins68 genotypes (p = 0.005) so that when harboring the wildtype allele, rural subjects had significantly higher Hcy than their urban counterparts, but when hosting the variant allele the environment made no difference to Hcy. Between the CBS T833C/844ins68 or G9276A and MTHFR C677T genotypes, there were two-way interactions (p = 0.003 and = 0.004, respectively), with regard to Hcy. Subjects harboring the MTHFR 677 TT genotype in combination with the CBS 833 TT/homozygous 844 non-insert or the MTHFR 677 IF genotype in combination with the CBS 9276 GA/GG displayed higher Hcy concentrations. Therefore, some of the investigated genotypes affected Hcy; residential area changed the way in which the CBS T833C/844ins68 SNPs influenced Hcy concentrations highlighting the importance of environmental factors; and gene-gene interactions allude to epistalic effects. (C) 2013 Elsevier B.V. All rights reserved

Interactions between C-reactive protein genotypes with markers of nutritional status in relation to inflammation

Inflammation, as indicated by C-reactive protein concentrations (CRP), is a risk factor for chronic diseases. Both genetic and environmental factors affect susceptibility to inflammation. As dietary interventions can influence inflammatory status, we hypothesized that dietary effects could be influenced by interactions with single nucleotide polymorphisms (SNPs) in the CRP gene. We determined 12 CRP SNPs, as well as various nutrition status markers in 2010 black South Africans and analyzed their effect on CRP. Interactions were observed for several genotypes with obesity in determining CRP. Lipid intake modulated the pro-inflammatory effects of some SNPs, i.e., an increase in both saturated fatty acid and monounsaturated fatty acid intake in those homozygous for the polymorphic allele at rs2808630 was associated with a larger increase in CRP. Those harboring the minor alleles at rs3093058 and rs3093062 presented with significantly higher CRP in the presence of increased triglyceride or cholesterol intake. When harboring the minor allele of these SNPs, a high omega-6 to -3 ratio was, however, found to be anti-inflammatory. Carbohydrate intake also modulated CRP SNPs, as HbA1C and fasting glucose levels interacted with some SNPs to influence the CRP. This investigation highlights the impact that nutritional status can have on reducing the inherent genetic susceptibility to a heightened systemic inflammatory state

Low vitamin D status is associated with reduced muscle mass and impaired physical performance in frail elderly people

Background/Objectives: Serum 25-hydroxyvitamin D (25(OH)D) status has been associated with muscle mass, strength and physical performance in healthy elderly people. Yet, in pre-frail and frail elderly people this association has not been studied. The objective of this study was to explore the association between vitamin D intake and serum 25(OH)D status with muscle mass, strength and physical performance in a pre-frail and frail elderly population. Subjects/Methods: This cross-sectional study included 127 pre-frail and frail elderly people in The Netherlands. Whole body and appendicular lean mass (ALM) (dual energy X-ray absorptiometry), leg strength (one repetition maximum), handgrip strength and physical performance (short physical performance battery) were measured, and blood samples were collected for the assessment of serum 25(OH)D status (liquid chromatography-tandem mass spectrometry). In addition, habitual dietary intake (3-day food records) and physical activity data (accelerometers) were collected. Results: In total, 53% of the participants had a serum 25(OH)D level below 50¿nmol/l. After adjustment for confounding factors, 25(OH)D status was associated with ALM (ß=0.012, P=0.05) and with physical performance (ß=0.020, P0.05). Conclusion: In this frail elderly population, 25(OH)D status is low and suggests a modest association with reduced ALM and impaired physical performance. In addition, vitamin D intake tended to be associated with impaired physical performance. Our findings highlight the need for well-designed intervention trials to assess the impact of vitamin D supplementation on 25(OH)D status, muscle mass and physical performance in pre-frail and frail elderly peopl

The contribution of genetic and environmental factors to changes in total and ¿’ fibrinogen over 5 years

Introduction Increased fibrinogen is associated with cardiovascular disease risk. It is, however, not known to what extend environmental and genetic factors and/or their interaction influence changes in total and ¿’ fibrinogen over time. We aimed to determine how variation within the fibrinogen gene as well as environmental factors influence the change in total and ¿’ fibrinogen over time, and also whether gene-environment interactions influence total and ¿’ fibrinogen on a cross-sectional and prospective level in Africans. Materials and methods This prospective study consisted of 2010 participants at baseline and 1288 participants at follow-up (5 years). Results The gene–environment interactions that were associated with fibrinogen concentration on a cross-sectional level were: FGA 2224 G>A (rs2070011) with age (p = 0.005), FGB Arg448Lys (rs4220) with HIV status (p A (rs1800791) with HbA1c (p = 0.01). The only factor that independently influenced the change in total fibrinogen levels over time, was baseline CRP (p T (rs2066865) was the only single nucleotide polymorphism that independently influenced the change in fibrinogen ¿’ levels over time (p = 0.02). Only the FGG 9340 T>C (rs1049636) with HbA1c interaction was found to predict change in total fibrinogen concentrations over time (p = 0.005). Conclusions Gene-environment interactions influenced fibrinogen levels cross-sectionally and also mediated changes in levels over time

Genetic polymorphisms influencing total and gamma ' fibrinogen levels and fibrin clot properties in Africans

Clinical epidemiolog

Nutritional Genetics: The Case of Alcohol and the MTHFR C677T Polymorphism in relation to homocysteine in a Black South African Population

Background/Aims: It is unknown whether the effect of alcohol consumption on homocysteine (Hcy) is modulated by the methylenetetrahydrofolate reductase (MTHFR) C677T. We explored this hypothesized effect by analyzing cross-sectional data of 1,827 black South Africans. Methods: Total Hcy concentrations were determined by fluorescence polarization immunoassay and the genotype through polymerase chain reaction-based RFLP analysis. Results: Subjects harboring the 677 TT genotype had the highest Hcy. Among subjects harboring the 677 CC genotype, men had higher Hcy (p = 0.04). Age and gamma-glutamyltransferase (GGT) correlated best (r = 0.26 and r = 0.27; p 0.05) for Hcy concentrations; however, an interaction was determined for GGT and the MTHFR genotype (p = 0.02). Age, GGT, gender, MTHFR and vitamin B6 explained 16.8% of the variation in Hcy (p <0.01). Conclusion: The determined interactions might result in differences in the risk conveyed through Hcy with regard to disease development in those with unfavorable GGT concentrations