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How Your Daily Diet Could Impact Your Heart’s Health

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Recent research published in Nature Medicine has unveiled a potential risk associated with elevated levels of niacin, a crucial B vitamin, indicating a link to heart disease through inflammation and vascular damage.

According to the study’s senior author, Dr. Stanley Hazen, about 25% of Americans surpass the recommended daily allowance of niacin, which is found abundantly in various foods such as meat, fish, nuts, and fortified cereals and breads. The suggested daily intake stands at 16 milligrams for men and 14 milligrams for non-pregnant women.

Dr. Hazen, chair of cardiovascular and metabolic sciences at the Cleveland Clinic’s Lerner Research Institute, warns against niacin supplements, suggesting that excessive intake could elevate the risk of cardiovascular disease.

Historically, niacin fortification in flour, grains, and cereals dates back to the 1940s after the discovery that insufficient niacin levels could lead to pellagra, a potentially fatal condition. While once prescribed to improve cholesterol levels before the advent of statins, niacin supplements are now cautioned against due to emerging health concerns.

To identify potential risk factors for heart disease, Hazen and his team conducted a comprehensive study analyzing blood samples from over 1,100 patients and subsequent validation studies involving more than 3,000 adults. The research unveiled a breakdown product of niacin, known as 4PY, which was found to predict future cardiovascular risks including heart attack, stroke, and mortality.

Furthermore, experiments conducted on mice demonstrated increased inflammation in blood vessels upon injection with 4PY, reinforcing the association between niacin and vascular damage.

Dr. Robert Rosenson, director of metabolism and lipids at the Mount Sinai Health System, considers the findings both fascinating and significant, envisioning the possibility of developing medications to mitigate blood vessel inflammation and reduce the likelihood of major cardiovascular events.

Rosenson advocates for a reconsideration of niacin usage in food products, emphasizing the need to moderate its inclusion. He underscores the potential consequences of excessive niacin intake, suggesting that too much of the vitamin could have adverse effects.

Dr. Amanda Doran, an assistant professor of medicine at the Vanderbilt University Medical Center, highlights the study’s innovative approach in combining clinical data, genetic analysis, and animal experimentation. She acknowledges the surprising revelation regarding niacin’s pro-inflammatory properties and underscores the potential implications for future research and therapeutic interventions.

The newfound understanding of niacin’s role in heart disease could pave the way for novel strategies to address blood vessel inflammation and mitigate cardiovascular risks. Doran expresses optimism about the prospects of identifying therapeutic targets to combat heart disease based on this groundbreaking research.

As scientists delve deeper into the mechanisms underlying heart disease, the identification of niacin as a potential risk factor offers new avenues for exploration and intervention. The study’s multidisciplinary approach underscores the complexity of cardiovascular health and the importance of continued research to advance preventive and therapeutic strategies.

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