- Email: [email protected]
Assessment of Plasma Homocysteine and Vitamin B-6 Status in Women with Rheumatoid Arthritis
APPLICATION
Assessment of Plasma Homocysteine and Vitamin B-6 Status in Women with Rheumatoid Arthritis WHAT ARE THE IMPLICATIONS OF THIS STUDY FOR NUTRITION PROFESSIONALS? The link between rheumatoid arthritis, cardiovascular disease, and serum levels of folate, vitamin B-12, and vitamin B-6 has been pretty well established. What remains unclear is whether serum levels of these nutrients in patients with rheumatoid arthritis are related to inadequate dietary intake or abnormal metabolic consequences. This is the first study to carefully examine the relationship between plasma homocysteine and folate and vitamins B-12 and B-6, comparing objective serum data with subjective dietary food records (1). This research adds to the body of evidence supporting a role for the food and nutrition professional in assisting patients with rheumatoid arthritis. HOW SHOULD THESE FINDINGS BE APPLIED TO NUTRITION PRACTICE OR THE DIETITIAN? What Are the Implications for Nutrition Assessment (How Could It Change What You Currently Do?) If they are not already doing so, and in consultation with the physician, food and nutrition professionals should assess B-vitamin status (both dietary intake and serum values) and plasma total homocysteine concentrations in their patients with rheumatoid arthritis. Authors further recommend that health care providers consider folic acid supplements if the patient is using methotrexate to manage his or her disease.
This article was written by Kimberly Thedford, MS, RD, Associate Editor of the Journal. doi: 10.1016/j.jada.2008.01.027
454
March 2008 Volume 108 Number 3
What Types of Nutrition Diagnosis Would Likely Be Associated with These Research Findings? This research is specific to older women who are diagnosed with rheumatoid arthritis. These women may have an altered metabolism of vitamin B-6. What Interventions Might You Consider Changing Based on these Research Findings? The food and nutrition professional will want to assure that the patient has adequate intake of vitamins B-6 and B-12 and folic acid. Existing evidence does not support intakes above the recommended levels. What Are the Implications for What You Might Monitor and Evaluate to Determine Whether Your Nutrition Care Was Successful? The food and nutrition professional will want to evaluate and monitor B-vitamin status and plasma total homocysteine concentrations. WHAT ELSE NEEDS TO BE DONE IN THIS AREA OF RESEARCH? The authors recommend additional research to explore the impact of B-6 supplementation on plasma homocysteine concentrations in older women with rheumatoid arthritis. Such research could address whether supplements, fortified foods, or natural sources offer the best results. In addition, the recommended dosage is also of interest. Reference 1. Woolf K, Manore MM. Elevated plasma homocysteine and low vitamin B-6 status in nonsupplementing older women with rheumatoid arthritis. J Am Diet Assoc. 2008;108:443-453.
Assessment of Plasma Homocysteine and Vitamin B-6 Status in Women with Rheumatoid Arthritis WHAT ARE THE IMPLICATIONS OF THIS STUDY FOR NUTRITION PROFESSIONALS? The link between rheumatoid arthritis, cardiovascular disease, and serum levels of folate, vitamin B-12, and vitamin B-6 has been pretty well established. What remains unclear is whether serum levels of these nutrients in patients with rheumatoid arthritis are related to inadequate dietary intake or abnormal metabolic consequences. This is the first study to carefully examine the relationship between plasma homocysteine and folate and vitamins B-12 and B-6, comparing objective serum data with subjective dietary food records (1). This research adds to the body of evidence supporting a role for the food and nutrition professional in assisting patients with rheumatoid arthritis. HOW SHOULD THESE FINDINGS BE APPLIED TO NUTRITION PRACTICE OR THE DIETITIAN? What Are the Implications for Nutrition Assessment (How Could It Change What You Currently Do?) If they are not already doing so, and in consultation with the physician, food and nutrition professionals should assess B-vitamin status (both dietary intake and serum values) and plasma total homocysteine concentrations in their patients with rheumatoid arthritis. Authors further recommend that health care providers consider folic acid supplements if the patient is using methotrexate to manage his or her disease.
This article was written by Kimberly Thedford, MS, RD, Associate Editor of the Journal. doi: 10.1016/j.jada.2008.01.027
454
March 2008 Volume 108 Number 3
What Types of Nutrition Diagnosis Would Likely Be Associated with These Research Findings? This research is specific to older women who are diagnosed with rheumatoid arthritis. These women may have an altered metabolism of vitamin B-6. What Interventions Might You Consider Changing Based on these Research Findings? The food and nutrition professional will want to assure that the patient has adequate intake of vitamins B-6 and B-12 and folic acid. Existing evidence does not support intakes above the recommended levels. What Are the Implications for What You Might Monitor and Evaluate to Determine Whether Your Nutrition Care Was Successful? The food and nutrition professional will want to evaluate and monitor B-vitamin status and plasma total homocysteine concentrations. WHAT ELSE NEEDS TO BE DONE IN THIS AREA OF RESEARCH? The authors recommend additional research to explore the impact of B-6 supplementation on plasma homocysteine concentrations in older women with rheumatoid arthritis. Such research could address whether supplements, fortified foods, or natural sources offer the best results. In addition, the recommended dosage is also of interest. Reference 1. Woolf K, Manore MM. Elevated plasma homocysteine and low vitamin B-6 status in nonsupplementing older women with rheumatoid arthritis. J Am Diet Assoc. 2008;108:443-453.