Folic and Vitamin B-6 may together help reduce heart disease in the elderly, a new study suggests. Scientists at the University of Ulster, led by Dr. McKinley, investigated the homocysteine-lowering effect of vitamin B-6, which was found in previous studies, they claimed, to have an uncertain benefit when used alone as a supplement. They studied 22 elderly participants, aged 63-80, recruited from the community surrounding the University of Ulster and none were currently taking B-vitamin supplements. Before starting the vitamin B-6 intervention, all subjects achieved repletion in riboflavin and folic acid, first receiving riboflavin (1.6 mg/d) for 12 weeks, followed by a combination of folic acid (400 µg/d) and riboflavin (1.6 g/d) for an additional 6 weeks. Riboflavin and folate supplementation continued throughout the vitamin B-6 phase of the study. In a randomised, double-blind trial, they were assigned to receive either vitamin B-6 (1.6 mg/d) supplementation, or a placebo for 12 weeks. Dietary intake and compliance with the vitamin B-6 supplementation were closely monitored throughout the study. The initial folate supplementation produced a significant decline in serum homocysteine levels. The participants had reached a "folate plateau" prior to the start of the B-6 intervention, as evidenced by a lack of any change in homocysteine in the placebo group. In response to vitamin B-6 alone, homocysteine concentrations were reduced by an additional 7.5%. The authors suggest that the effect of vitamin B-6 may have been missed in previous studies due to suboptimal folate status in the study population. If this hypothesis is correct, the effect of vitamin B-6 supplementation may be significant only after accounting for the homocysteine-lowering response to folate. Full findings are published in the American Journal of Clinical Nutrition.