Association of dietary protein intake and coffee consumption with serum homocysteine concentrations in an older population

Rachael Z. Stolzenberg-Solomon, Edgar R. Miller, Maureen G. Maguire, Jacob Selhub, Lawrence J. Appel

Research output: Contribution to journalArticlepeer-review

123 Scopus citations


Background: Elevated blood concentrations of total homocysteine (tHcy) have been implicated in the pathogenesis of atherosclerotic cardiovascular disease. Previous studies identified suboptimal nutritional status and dietary intake of folate, vitamin B-6, and vitamin B-12 as determinants of elevated tHcy. Objective: We identified other nutritional factors associated with tHcy in 260 retired schoolteachers in the Baltimore metropolitan area. Design: We performed observational analyses of baseline and 2-4-mo follow-up data collected in a study designed to test the feasibility of conducting a large-scale clinical trial of vitamin supplements by mail. The study population consisted of 151 women and 109 men with a median age of 64 y. At baseline, each participant completed a food-frequency questionnaire. At follow-up, fasting serum tHcy was measured. Results: In multivariable linear regression and generalized linear models, there was an independent, inverse dose-response relation between dietary protein and ln tHcy (P = 0.002) and a positive, significant dose-response relation between coffee consumption and ln tHcy (P for trend = 0.01). Other significant predictors of ln tHcy were creatinine (positive; P = 0.0001) and prestudy use of supplemental B vitamins (inverse; P = 0.03). In stratified analyses restricted to persons receiving standard multivitamin therapy, the association of ln tHcy with dietary protein and coffee persisted. Conclusions: These results support the hypothesis that increased protein intake and decreased coffee consumption may reduce tHcy and potentially prevent atherosclerotic cardiovascular disease and other disease outcomes.

Original languageEnglish (US)
Pages (from-to)467-475
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Issue number3
StatePublished - Mar 1999


  • Coffee
  • Creatinine
  • Diet
  • Elderly
  • Folic acid
  • Homocysteine
  • Observational study
  • Protein
  • THcy
  • Vitamin B- 12
  • Vitamin supplements

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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