B12 and Heart Disease

Vegans have heart attacks.  This may be a little unfamiliar to read, but not entirely untrue.  The science of nutrition has focused its attention on the role animal fats and high glycemic index diets have on heart disease in the general population.  We have come to associate heart attacks and strokes as meat-eating problems.  In fact, going veggie is often the lifestyle treatment of choice for victims of cardiovascular disease.  But vegans don’t get off scot-free.

The concern with veganism and heart disease, as well as a host of other diseases, seems to be in the disrupted metabolism of an essential amino acid called methionine resulting in what is referred to as hyperhomocysteinemia or too much homocysteine in the blood.  Homocysteine is an amino acid whose metabolism from methionine requires folic acid and vitamin B12 and vitamin B6.  These vitamins are very important for proper and ideal health and often require vigilance in the vegetarian community.  We commonly associate B vitamins with the nervous system, but their relationship with almost all of our organ systems is much more intimate.  As it seems, much of this relationship has to do with homocysteine.

Our understanding of homocysteine has not yet been able to reveal whether its increase is a cause for certain common diseases or if it is merely a byproduct of the disease process itself.  However, disturbed methionine/homocysteine metabolism is implicated in congenital heart disease, cleft lip and palate, late pregnancy complications, neurodegenerative and psychiatric diseases, dementia, osteoporosis, and cardiovascular disease.  Studies indicate that homocysteine and/or its derivatives are considered especially toxic to the cardiovascular system.

We have identified different degrees of hyperhomocysteinemia.  The severe kind is generally associated with genetic deficiencies or mutations that govern enzyme functioning related to homocysteine.  A milder version is seen in folate and B12 deficiencies, usually noted in fasting conditions or vegetarianism/veganism.  Experimental evidence suggests that higher blood levels may result in actual physical changes to our blood vessels.  The more homoscysteine in our blood the more sustained injury to artery walls, greater increase in inflammation around arteries, constriction of arteries, plaque build-up and blood clot formation.  All of these mechanisms are the same by which heart disease happens in meat-eating populations, yet the cause may be completely different.  What is believed to happen is homocysteine produces free radicals that oxidize other cells and tissues in our bodies.  Put in another way, it produces particles that rust away our insides and have a special affinity for our blood vessels and blood clotting.  Imagine a damaged blood vessel supplying a vital part of our body with vital nutrients like a rusty clogged pipe not letting blood get to its destination.  Often the destination is our heart or brain resulting in a heart attack or stroke, respectively.  Recent epidemiological studies conclude that vegetarians present significantly higher homocysteine levels and lower vitamin B12 levels than non-vegetarians.  Also, in some studies, vegetarians have been found to suffer in greater numbers from diseases like dementia and pregnancy related concerns.  Also, Overall mortality rates between vegetarians and non-vegetarians are roughly similar.  Paying closer attention to B vitamin consumption may prove to benefit longevity of life and quality of life for vegetarians even further.  If the solution is in part or entirely lies with our consumption of B vitamins, then we can safely say we will be only improving our well-being and preventing future occurrence of disease.

Vegetarians and vegans who eat food fortified with vitamins B12, B6 and folic acid probably don’t have much to worry about in the way of homocysteine or heart disease.  Still, we eat in a world of convenient foods devoid of any nutritive value and eating fortified foods or supplementing is a constant reminder for many people.  This is another reminder.  As a vegetarian or vegan it is imperative that we be cognizant of our daily dietary needs to be our best selves.  I believe that when we know better, we do better.  Ensuring simple daily measures such as including B vitamins enables us to live to be our best and prevent the worst. Consult a qualified healthcare practitioner at evolve to learn more and to get a fresh perspective.

Dr. Bobby Parmar
Naturopathic Physician

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