For many years doctors have known that people with very high levels of homocysteine in their blood often develop severe osteoporosis early in life. As homocysteine levels rise above 9 mg/dl the risk of heart attacks, strokes and developing Alzheimer’s disease goes up. There is already more than enough reason to take steps to lower the homocysteine level in the blood if it is moderately elevated, but until the results of a new study were published in the New England Journal of Medicine in May there was no good evidence that lower homocysteine levels might also prevent damage to the bones leading to hip fractures.

Hip fractures are the number-one cause of elderly people being forced into nursing homes. Researchers in Holland found that the people in a test group whose homocysteine levels were in the top 25% were twice as likely to suffer a hip fracture as those whose homocysteine levels were in the bottom 25% of the group. The authors of this study conclude, “An increased homocyteine level appears to be a strong and independent risk factor for osteoporotic fracture in older men and women.”1Supplements of folic acid, vitamin B-6, vitamin B-12 and either choline and/or betaine can lower elevated homocysteine levels. By contrast diets high in fatty meats and particularly processed meats like hot dogs, sausages, bologna and pepperoni markedly increase the level of homocysteine in the blood. Fasting homocyteine levels tend to be elevated in people who eat fewer whole grains, fruits, vegetables and nonfat dairy products.There is already convincing evidence that lowering high cholesterol levels reduces the risk of osteoporosis and hip fractures. This new data demonstrates a strong connection between modestly elevated homocysteine levels and an increased risk in hip fractures, which provides another reason to discourage Americans from following diets high in protein, salt and animal fats and low in fruits, vegetables, whole grains and legumes.  By James Kenney, PhD, RD, LD, FACN 1. N Engl J Med 2004;350:2033-41