Low levels of vitamin B12 are associated with an increased risk of cardiovascular disease, but taking vitamin B12 supplements has not been consistently shown to prevent heart attacks or other cardiovascular events, according to a recent scientific review published in the Nutrition Journal.
The review indicates that the strongest evidence of a potential benefit relates to taking a group of B12 vitamins together to prevent stroke, especially in people who live in areas where folic acid is not added to food compulsory.
The researchers relied on laboratory studies, population research, and clinical trials to evaluate the role of vitamin B12 in cardiovascular health, and the extent to which its supplements can provide protection from it.
How does vitamin deficiency affect the heart?
Vitamin B12 is found naturally in animal foods, such as meat, fish, eggs, and dairy products. It plays an important role in the formation of blood cells and nerve functions. It also helps the body regulate some vital processes related to DNA and the breakdown of fats and amino acids.
When the vitamin is deficient, levels of homocysteine and methylmalonic acid rise in the body. The review explains that high homocysteine may negatively affect the lining of blood vessels, contributing to their damage and the accumulation of plaques associated with atherosclerosis.
Studies on animals have shown an increase in the accumulation of these plaques with high levels of homocysteine, and studies in women after menopause have monitored a link between its high level and poor blood vessel function.
Also, low vitamin B12 is associated with some electrical indicators in the heart that may indicate increased susceptibility to heart rhythm disorders, but these results do not prove that people who suffer from vitamin deficiency are actually more susceptible to these disorders.
Despite these potential biological explanations, the clinical significance of the effect of vitamin deficiency on blood vessels and the heart remains unresolved.
What do studies say about supplements?
Previous studies have indicated an association between low levels of vitamin B12 and stroke, heart failure, atherosclerosis, and death. One study also found that high levels of methylmalonic acid in heart failure patients were associated with an increased risk of death from any cause.
But clinical trial results did not provide similar evidence of the effectiveness of supplements in preventing heart disease.
Two studies tested combinations that combined folic acid and vitamin B12, and vitamin B6 was added to them in some treatment groups. Although these interventions reduced homocysteine levels by about 27 percent in one study, they did not consistently reduce heart attacks or deaths from cardiovascular disease, according to the Medical News website, which is interested in news of scientific studies.
In contrast, the HOPE-2 study recorded a decrease in stroke cases among participants who took B vitamins. The results of the NORVIT study also indicated the possibility of harmful effects when using the three vitamins together.
A Cochrane review that included more than 71,000 participants concluded that there is no tangible benefit for these supplements in preventing coronary artery disease.
When the trial results were combined, treatments that combined B vitamins to lower homocysteine were associated with a relative reduction in stroke cases of about 10 percent. This percentage rose to between 30 and 35 percent in a sub-analysis that included people living in areas where folic acid is not mandatory added to food.
But most of these studies tested a combination of vitamins, so the potential benefit cannot be attributed to vitamin B12 alone.
Who is most at risk of vitamin B12 deficiency?
The review identifies several categories that warrant attention to their vitamin levels:
- The elderly: The risk of deficiency increases with age due to decreased stomach acid and poor absorption of the vitamin, but experiments have not proven that taking its supplements provides clear protection for the heart in this group.
- Vegetarians: The risk of vitamin deficiency increases in those who do not eat animal products, and this may be accompanied by high levels of homocysteine. Deficiency can be corrected using supplements.
- Those who have undergone obesity surgery: Surgery may lead to poor absorption of the vitamin, and its reserve in the liver can delay the onset of deficiency symptoms for years, making long-term follow-up necessary.
- Chronic kidney disease patients: They may suffer from high homocysteine levels, and they can be reduced with B12 and folate supplements, but trials have not proven that this reduces cardiovascular events. Treatment of confirmed deficiency remains necessary, especially if it is associated with anemia.
- Pregnant women: Low levels of the vitamin are linked to preeclampsia, gestational diabetes, and low birth weight, as well as the possibility of later metabolic problems in children. Supplements can improve maternal vitamin levels, but evidence of their effect on infant neurodevelopment is still limited and inconsistent.
The review also indicates that significantly high levels of vitamin B12 are associated with increased death rates, but researchers believe that this is an indicator of other diseases.
Should I take supplements to protect the heart?
The review concludes that low vitamin B12 is associated with a higher risk of cardiovascular disease, but current evidence does not prove that taking supplements alone prevents these diseases.
Treating the deficiency remains necessary because of the proven benefits it brings to blood and nervous system health, while the clearest indications for stroke prevention are limited to taking formulas that combine B vitamins in specific population groups.
Researchers call for further studies to determine which groups may benefit from supplements, and to develop evaluation methods that combine blood test results, nutritional status, and genetic factors.
A recent research review published in the journal Brain Medicine showed that creatine, which is today one of the most widely used nutritional supplements in the world, may be useful in treating depression. While its benefits in enhancing strength and athletic performance are supported by scientific evidence, it is increasingly being recommended for its potential role in supporting mental health.
Dr. Zudin Butochiri, Professor of Intensive Care Medicine at Queen Mary University of London, wrote in an article published on Friday on the Conversation website, commenting on the results of this research review: “After creatine was a nutritional supplement whose use was mostly limited to those obsessed with fitness, today it has become one of the most widely used nutritional supplements in the world,” noting that there are many reasons that make it appear to be beneficial for our brains and our mental health.
He explained that creatine is a compound that the body produces naturally, and is also found in meat, whether white or red, and some types of fish, such as salmon, tuna, and herring. Creatine acts as a source of energy. It mainly helps in supplying the muscles with energy during physical activity. Most creatine is stored in the muscles, while small amounts are found in the brain, which is one of the body's most energy-consuming organs. Although it constitutes only 2 percent of the total body weight, it consumes 20 percent of the body's energy.
When energy levels in the brain decrease, it may affect the biochemicals that control mood, Bhuttocheri wrote. It is also thought that low brain energy may contribute to various mental health problems, including depression, bipolar disorder, and schizophrenia. Research has found that people with depression may have low levels of creatine in the frontal part of the brain, a key area associated with mood regulation. For this reason, the idea has been proposed that creatine may be useful in treating some psychological disorders, including depression.
Depression and creatine
According to the article, 40 years ago, scientists discovered a relationship between suicidal thoughts and low levels of creatine in the body. Since then, numerous studies have been conducted to examine the link between creatine levels and mental health. Large-scale studies have found that people who consume larger amounts of creatine have lower rates of mental health-related diseases.
As Bhuttocheri explained, research has also shown that teens with unresponsive depression who took creatine supplements alongside their usual medications saw an improvement in their mood.
To obtain a clearer picture of the benefits of creatine for mental health, this systematic review was conducted, which included 5 trials in which 238 patients participated.
According to the article, two of these trials showed a benefit, while the other three trials showed no positive results.
Bhuttocheri cautions that it is important to note that all studies that have explored the benefits of creatine for mental or cognitive health have been small-scale. So there is still no conclusive scientific evidence.
He explained that we do not yet know the appropriate dose or the ideal duration for taking it. A person may need a higher dose of creatine for a longer period than they would if they were taking it for fitness purposes only. This is because creatine does not easily move into the brain. Therefore, it is necessary to determine the appropriate dose for the brain and ensure its safety, stressing that at the present time, the best option remains to ensure obtaining a sufficient amount of creatine through following a balanced diet.
European researchers have created a personal index that provides an accurate picture of individuals' metabolism, by analyzing the chemicals that the body produces to perform its functions, starting in middle age.
Joris Delen, from the Leiden University Medical Center in the Netherlands, presented this indicator during the “FAPESP” week held in the Netherlands from October 27 to 29.
The new index is a general marker of health in midlife, allowing early detection of people on the path to healthy aging, and those most at risk of functional decline.
Delin pointed out that there is a noticeable disparity between countries in the number of years during which people enjoy good health after the age of 65, explaining that this disparity is linked to a group of factors, most notably the social and economic situation, educational level, lifestyle, and genetic factors.
Studies conducted in various countries indicate that about 60 percent of people over the age of 65 currently suffer from two or more chronic medical conditions.
Measuring biological aging
Given the inability to measure biological aging directly, the team, which included scientists from the Max Planck Institute for the Biology of Aging in Cologne, Germany, decided to look for answers in blood samples from 44,000 volunteers, who were followed over several years in 12 studies conducted across Europe. Through careful blood tests, the researchers measured more than 200 biochemicals, including levels of fats, sugars and indicators of inflammation.
During the research period, 5,500 deaths were recorded among volunteers. By analyzing the blood of these individuals, researchers identified substances that are warning biomarkers of increased risk of death. The team also established direct cooperation with researchers from Brazil to improve the results of this indicator.
According to the researchers, the tool was updated in three stages, so that it now focuses on only 10 indicators that doctors are accustomed to evaluating.
According to the researchers, the new version has proven more effective in predicting heart and metabolic diseases, such as diabetes, heart attacks, and strokes.
Because this score reflects the general functional state of the body, it is associated with various measures of healthy aging, such as cognitive function, lung capacity, and hand grip strength, which reflect overall muscle function.
To test the possibility of modifying this indicator through practical procedures, scientists subjected groups of volunteers to lifestyle changes and muscle-strengthening programmes. The results showed that these interventions led to noticeable improvements, especially among individuals considered less healthy.
In this high-risk group, behavioral changes and exercise led to significant reductions in fasting blood insulin levels and blood triglyceride levels, as well as improved body composition.
Delin said: “When we analyzed the change in the group’s results, we did not notice a clear change; “But when we divided individuals according to their initial scores, we found that the lifestyle intervention was particularly effective in those whose scores were less than zero, that is, people who were less healthy to begin with.”
The group's analyzes revealed that the metabolic outcome is determined 40 percent by genetic factors, and 60 percent by lifestyle and environmental factors. Among the behaviors analyzed, smoking emerged as a negative factor with a significant impact on the metabolic outcome. On the other hand, increasing regular physical activity reduced the risk and improved the outcome.
