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Nutritional Epidemiology

Long-Term Garlic or Micronutrient Supplementation, but Not Anti-Helicobacter pylori Therapy, Increases Serum Folate or Glutathione Without Affecting Serum Vitamin B-12 or Homocysteine in a Rural Chinese Population^1–4,

⁵ Key Laboratory of Carcinogenesis and Translation Research (Ministry of Education), Department of Epidemiology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Hai-dian District, Beijing 100036, P.R. China; ⁶ Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD 20892; ⁷ Linqu Public Health Bureau, Linqu, Shandong 262600, China; ⁸ Westat Co., Rockville, MD 20850; and ⁹ Information Management Services, Rockville, MD 20852

The effects of a 7.3-y supplementation with garlic and micronutrients and of anti-Helicobacter pylori treatment with amoxicillin (1 g twice daily) and omeprazole (20 mg twice daily) on serum folate, vitamin B-12, homocysteine, and glutathione concentrations were assessed in a rural Chinese population. A randomized, double-blind, placebo-controlled, factorial trial was conducted to compare the ability of 3 treatments to retard the development of precancerous gastric lesions in 3411 subjects. The treatments were: 1) anti-H. pylori treatment with amoxicillin and omeprazole; 2) 7.3-y supplementation with aged garlic and steam-distilled garlic oil; and 3) 7.3-y supplementation with vitamin C, vitamin E, and selenium. All 3 treatments were given in a 2³ factorial design to subjects seropositive for H. pylori infection; only the garlic supplement and vitamin and selenium supplement were given in a 2² factorial design to the other subjects. Thirty-four subjects were randomly selected from each of the 12 treatment strata. Sera were analyzed after 7.3 y to measure effects on folate, vitamin B-12, homocysteine, and glutathione concentrations. Regression analyses adjusted for age, gender, and smoking indicated an increase of 10.2% (95%CI: 2.9–18.1%) in serum folate after garlic supplementation and an increase of 13.4% (95%CI: 5.3–22.2%) in serum glutathione after vitamin and selenium supplementation. The vitamin and selenium supplement did not affect other analytes and the amoxicillin and omeprazole therapy did not affect any of the variables tested. In this rural Chinese population, 7.3 y of garlic supplementation increased the serum folate concentration and the vitamin and selenium supplement increased that of glutathione, but neither affected serum concentrations of vitamin B-12 or homocysteine.

^* To whom correspondence should be addressed. E-mail: weichengyou{at}yahoo.com.

Manuscript received 17 April 2008. Initial review completed 12 May 2008. Revision accepted 15 October 2008.

Published online 3 December 2008.