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- Excess niacin breakdown products have been associated with an increased risk of cardiovascular events such as heart attack and stroke.
- Niacin, or vitamin B3, is necessary for a healthy nervous system. Most people get enough from their diet.
- Bread, flour, and other foods are fortified with niacin. But researchers say this may need to be reconsidered in light of new findings.
For decades, the U.S. food industry has added niacin, also known as vitamin B3, to bread, flour, and corn products to prevent pellagra, a disease caused by a deficiency of this nutrient.
The program has been so successful that pellagra is now virtually unknown in the country, except in some extremely food insecure populations.
Preventing deficiencies is good, but a new study was published on February 19th.
In this study, the researchers focused specifically on a metabolic byproduct of excess niacin known as 4PY.
The researchers did not aim to investigate niacin’s role in cardiovascular disease. Instead, they sought to determine why some people still have cardiovascular events despite being treated for other risk factors, such as diabetes and high cholesterol.
Their initial study found that 4PY, whose full name is N1-methyl-4-pyridone-3-carboxamide, is a potential marker of cardiovascular risk in the blood. Researchers tracked this compound and found excess niacin.
The results showed that participants in the quarter with the highest 4PY levels had an approximately two-fold increased risk of major adverse cardiovascular events, such as heart attack or stroke, compared to participants in the quarter with the lowest 4PY levels. found.
Put another way, “one in four people in our cohort exhibits high levels of 4PY, putting them at significantly increased risk for adverse cardiovascular events,” says the Cleveland Clinic’s Lerner Research Cardiovascular Research Institute. -Stanley Hazen, Ph.D., director of metabolic science and study author, said: the Ohio lab told Healthline.
Researchers claim that 4PY increases cardiovascular risk through inflammation within blood vessels, known as vascular inflammation.
Because niacin has the ability to lower low-density lipoprotein (LDL or “bad”) cholesterol and triglycerides and raise high-density lipoprotein (HDL or “good”) cholesterol, it was It was used as a treatment to prevent vascular disease. A type of cholesterol-lowering statin.
However, some studies have shown that taking niacin does not reduce the risk of cardiovascular disease events, and combining it with statins provides no additional benefit. One study even found that niacin use may slightly increase the risk of early death.
In addition to this, the results of a new study suggest that excess niacin may negate some of the benefits of small amounts of niacin, including:
“Niacin was previously prescribed as a cholesterol-lowering drug, but its use fell out of favor after studies did not find as many benefits for cardiovascular health as originally thought.” said Dr. Chen-Han Chen, an interventional cardiologist and physician. Director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, California.
Chen was not involved in this research.
“this [new] “This study will put another nail in the coffin for the use of niacin in heart disease,” he told Healthline.
However, Professor Chen cautioned that more research is needed to understand the relationship between differences in excess niacin levels and cardiovascular disease, particularly in people taking niacin supplements.
To avoid deficiency, adults need:
By comparison, therapeutic levels of niacin (such as the amount used in clinical trials to lower cholesterol) are more along the lines of 1,500 to 2,500 milligrams per day, the researchers wrote.
People taking prescription or over-the-counter niacin products were excluded from the analysis, Hazen said. Therefore, the main source of niacin for participants is food.
The researchers did not have data on how much niacin the participants were getting in their diet. However, Dr. Hazen says that ingesting excessive amounts of niacin, or related compounds such as nicotinamide adenine dinucleotide, nicotinic acid, and nicotinamide riboside, all increase levels of 4PY and another breakdown product, 2PY. pointed out that it had been shown previously.
In this study, 2PY, also known as N1-methyl-2-pyridone-5-carboxamide, was not associated with inflammation or an increased risk of cardiovascular disease events.
According to the 2017-2020 National Health and Nutrition Examination Survey (NHANES), Americans tend to consume more than enough niacin to prevent deficiency, consuming an average of 37 milligrams of niacin per day. . Additionally, the authors note that the study showed that less than 4% of adults reported consuming less than 15 milligrams per day.
So while most Americans get enough niacin in their diets, and some of it comes from fortified foods, that may need to be reconsidered in light of new findings, Hazen said. thinking.
“The main conclusion is not that we should completely stop taking niacin; that is not a realistic approach,” he said in the release. “Given these findings, there will be a debate as to whether continuing mandates to fortify flour and grains with niacin in the United States are justified.”
Chen warns people who regularly take niacin supplements, especially those at high risk for cardiovascular disease. If you are considering taking niacin or related products, you should first consult your doctor.
“However, given niacin’s ubiquity in the food chain, it may be more difficult to avoid niacin-fortified foods,” he says. Therefore, “niacin fortification may need to be considered at a higher level as a matter of public policy.”
Researchers found that people with high amounts of excess niacin breakdown products had a higher risk of serious adverse cardiovascular events, such as heart attack and stroke.
Researchers say this breakdown product, known as 4PY, works through inflammation within blood vessels, increasing the risk of cardiovascular disease.
Further research is needed to understand the association between different levels of excess niacin and the risk of cardiovascular disease events. Researchers are calling for a reconsideration of fortifying foods with niacin.
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