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To the Editor: Dr Albert and colleagues¹ found that a combination of oral folic acid, vitamin B₆, and vitamin B₁₂ did not reduce total cardiovascular events among high-risk women after 7.3 years of treatment and follow-up despite significant homocysteine lowering. However, almost 70% of their cohort had folate concentrations greater than 7 ng/mL before supplementation (to convert folate to nmol/L, multiply by 2.266), suggesting that their prospective study was not performed in a folate-deficient population. In addition, the study population consisted of health professionals, a group at a relatively low risk of folate deficiency.

We have shown that Kazakhstan, located in Central Asia, might be a folate-deficient area.² The traditional food of the Kazakh people consists mainly of meat; intake of vegetables tends to be low, especially in rural areas, owing to inadequate distribution. Screening folate concentrations in 50 healthy Kazakh adults were low in 82% of participants, whereas . . . [Full Text of this Article]

Ainur Akilzhanova, MD, PhD
Department of Molecular Pathology

Noboru Takamura, MD, PhD
takamura@nagasaki-u.ac.jp
Department of Radiation Epidemiology

Shunichi Yamashita, MD, PhD
Department of Molecular Medicine
Nagasaki University Graduate School of Biomedical Sciences
Nagasaki, Japan

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