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It is noteworthy that gene-nutrient interactions, especially between the C677T mutation of the MTHFR gene and folate status and perhaps between heterozygosity for CBS defect and folate status (Lentz et al, 2000), could be involved in the onset of hyperhomocysteinemia

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This approach should ideally complement other measures, which include maximising treatment benefits while minimising harms, increasing accessibility, enhancing health literacy and overcoming physicianpatient barriers