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Fortified food increase heart disease risk

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Fortifying foods such as flour, cereal and oats with niacin (vitamin B3) could be causing heart disease—the very thing the practice is supposed to be preventing.

Food manufacturers add niacin to their produce to help lower cholesterol levels, but researchers have discovered a mechanism from an excess of the nutrient that triggers cardiovascular disease.

When we have too much niacin in our body, we produce a pathway, called 4PY, that helps break down the nutrient—but it also causes vascular inflammation that damages blood vessels and increases the risk of stroke and heart attack.

If niacin is a good thing, we are having too much of it, say researchers at the Cleveland Clinic, who have discovered the damage caused by 4PY pathways.  They studied the heart health of a group of volunteers, 25 percent of whom had excess levels of niacin and, as a result, also had high 4PY activity.

Lead researcher Dr Stanley Hazen likened the process to multiple taps pouring water into a bucket.  “Once the bucket is full, it begins to spill over, and the body needs to process that spillover and produces other metabolites, including 4PY,” he explained.

Food manufacturers in the US and around 50 other countries are mandated to add niacin to food such as flour, cereals and oats to prevent diseases that are related to nutritional deficiency, and to lower levels of the so-called ‘bad’ LDL cholesterol.  Niacin is also in over-the-counter remedies, and so it’s easy for people to have an excess of the nutrient.

People should be changing their diet and focus on fruit and vegetables and less on produce that has high levels of carbohydrates—and governments should review their policy on niacin-fortification, Hazen added.

References
Nature Medicine, 2024; 30: 424; doi: 10.1038/s41591-023-02793-8
Article Topics: food, heart disease
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