Use Folic Acid to Reduce Heart Disease, Say Experts

November 25, 2006 - The scientific evidence is strong enough to justify using folic acid as a cheap and simple way of reducing heart disease and strokes, say researchers in this week’s British Medical Journal (BMJ).

Debate continues over whether raised homocysteine levels in the blood (an amino acid implicated in the development of arterial disease) causes heart disease and stroke, and whether folic acid, which lowers homocysteine, will help reduce the risk of these disorders.

(Read more about folate and folic acid below this news report.)

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So heart expert, Dr David Wald and colleagues set out to clarify the issue. They examined all the evidence from different studies to see whether raised homocysteine is a cause of cardiovascular disease.

Some studies looked at homocysteine and the occurrence of heart attacks and strokes in large numbers of people (cohort studies), some focused on people with a common genetic variant which increases homocysteine levels to a small extent (genetic studies), while others tested the effects of lowering homocysteine levels (randomized controlled trials).

The cohort studies and genetic studies yielded similar results, indicating a protective effect from lower homocysteine levels, even though they did not share the same sources of possible error. The randomized trials were too small to be conclusive although their results were consistent with the expected protective effects of folic acid.

The conclusion that homocysteine is a cause of cardiovascular disease explains the observations from all the different types of study, even if the results from one type of study are, on their own, insufficient to reach that conclusion, say the authors.

Since folic acid reduces homocysteine concentrations, it follows that increasing folic acid consumption will reduce the risk of heart attack and stroke.

They therefore take the view that the evidence is now sufficient to justify action on lowering homocysteine concentrations, although the position should be reviewed as evidence from ongoing clinical trials emerges.

Editor's Notes:

Source: The debate on folic acid, homocysteine and cardiovascular disease: examination of the evidence BMJ Volume 333 pp 1114-7

>> Click here to view paper.

>> Click here to view full contents for this week's print journal.

About Folate (Folacin, Folic Acid)

Ohio State University Extension Fact Sheet

This fact sheet is one in a series containing information to help you select foods that provide adequate daily amounts of vitamins, minerals, and dietary fiber. Following these guidelines will put your diet in accordance with the Dietary Guidelines for Americans, which focus on nine general topics:

● Adequate nutrients within calorie needs
● Weight management
● Physical activity
● Food groups to encourage: fruits and vegetables, whole grains, and nonfat or low-fat milk and milk products
● Fats
● Carbohydrates
● Sodium and potassium
● Alcoholic beverages
● Food safety

What is “a good food source”?

A good food source of folate contains a substantial amount of folate in relation to its calorie content and contributes at least 10 percent of the U.S. Recommended Daily Allowance (RDA) for folate in a selected serving size. The U.S. RDA for folate is 400 micrograms per day. The U.S. RDA given is for adults (except pregnant or lactating women) and children over 4 years of age.

The U.S. RDA for folate is the amount of the vitamin used as a standard in nutrition labeling of foods. This allowance is based on the 1968 RDA for 24 sex and age categories set by the Food and Nutrition Board of the National Academy of Sciences. The 1989 RDA for folate has been set at 180 micrograms per day for women 19 to 50 years of age and 200 micrograms for men 19 to 50 years of age.

Where do we get folate?

More than one-third of the folate in the American diet is provided by fruits and vegetables. Grain products contribute a little more than one-fifth and legumes, nuts, and seeds contributed a little less than one-fifth. Foods that contain small amounts of folate but are not considered good sources can contribute significant amounts of folate to an individual’s diet if these foods are eaten often or in large amounts.

Why do we need folate?

Folate, a water-soluble vitamin, helps the body form red blood cells and aids in the formation of genetic material within every body cell.

Functions of Folate

● Plays a role in reducing blood homosysteine levels
● Formation of red blood cells
● Protein metabolism
● Cell growth and division
● Prevention of neural tube defects and anencephaly
— To prevent these defects adequate folate should be obtained in the first month of pregnancy
— All neural tube defects occur between the 17th and 30th days following conception.

Do we get enough folate?

According to recent surveys of the U.S. Department of Agriculture (USDA), the average intake of folate by nonpregnant women and men 19 to 50 years of age met their RDA for folate.

Where can I find folate in the food guidance system?

Grains
● Fortified breakfast cereal
● Whole wheat products

Meat and Beans
● Liver
● Eggs
● Beans
● Sunflower seeds

Vegetables—Excellent Source!
● Asparagus
● Leafy green vegetables

Fruits
● Oranges
● Strawberries
● Cantaloupes and other melons

Milk, Yogurt, Cheese, Fats, Oils, and Sweets are poor sources of folate!