The epidemiology of homocysteine levels is explored from the experience of large scale population-based samples. Higher levels in adults have been associated consistently with lower levels of the B group vitamins—folate, vitamin B6 and vitamin B12. The most consistent associations have been described for lower folate intake and lower folate levels in the blood, and approximately 20–30 percent of the adult U.S. population may be affected. Fortification of the U.S. food supply, originally announced in 1996, promises to lead to greater intakes of folate and a reduced prevalence of elevated homocysteine levels in the adult population. Fortified cold cereals, multivitamins and orange juice are important sources of folate intake in men and women and appear to account for approximately 40 percent of folate consumed.

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