Folic Acid prevents heart disease.
WHAT THEY’RE SAYING
Folic acid reduces the risk of heart disease by decreasing the amount of homocysteine (an amino acid) in the blood.
WHAT WE KNOW
Although for years folic acid supplementation has been recommended for pregnant women or women who plan to become pregnant, research is starting to shed a new light on its importance in everyone’s diet. The mechanism behind folic acid’s heart promoting qualities deals with its reduction of the amino acid homocysteine in the blood.
Homocysteine is not derived from food, but converted in the body from another amino acid called methionine. Methionine can be found in sesame seeds, Brazil nuts, fish, meats, cereal grains and some other plant seeds. Most fruits, vegetables and legumes contain very little methionine.
Too much homocysteine is related to a higher risk of coronary heart disease, stroke and peripheral vascular disease (fatty deposits in peripheral arteries). Evidence suggests that homocysteine may promote atherosclerosis (fatty deposits in blood vessels) by damaging the inner lining of arteries and promoting blood clots; however, a causal link hasn’t been established.
Folic acid and other B vitamins, particularly vitamins B-6 and B-12, help break down homocysteine in the body. Homocysteine levels in the blood are also strongly influenced by diet and genetic factors.
HOW DO WE KNOW THIS?
In a randomized trial of folic acid supplementation, a study concluded that a daily 0.8 mg dosage of folic acid appears necessary to achieve the maximum reduction in serum homocysteine level in the population studied. The study also stated that current U.S. food fortification levels will achieve only a small proportion of the achievable homocysteine reduction.¹
A 2006 study published by the New England Journal of Medicine reported that giving vitamins (folic acid, B6, and B12) to reduce homocysteine levels may not quickly offer benefit but a significant 25% reduction in homocysteine levels was found. While this study did not conclude that supplementation with folic acid and other B vitamins reduced the risk for stroke and other major cardiovascular disease, the reduction in homocysteine levels was of importance.²
A 2010 study published by the Journal of Renal Nutrition sought to assess whether the use of folic acid vitamin supplements reduced cardiac and stroke mortality in hemodialysis patients. The study found that the consumption of higher than the standard 1 mg prescribed dose of folic acid was not beneficial in reducing cardiac or stroke mortality in these patients. Similarly, the consumption of less than the standard dose was not associated with an increase in either cardiac or stroke mortality.³
Bottom line? Several studies have been done on the effects of folic acid and homocysteine. However, no conclusive decision or new recommendations have been made at this time.
A well-balanced diet is the key to not only cardiovascular health, but your health in general. Think of your body as a finely-tuned machine that needs the right ingredients (vitamins and minerals from foods) to work efficiently. A deficiency in one vitamin or mineral can affect multiple systems in the body and stop them from working as effectively as they should. This is why a diet rich in fruits and vegetables, which contain a wide variety of vitamins and minerals, is crucial!
The American Heart Association has not called hyperhomocysteinemia (high homocysteine level in the blood) a major risk factor for cardiovascular disease and does not recommend a widespread supplementation of folic acid and vitamin B supplementation. The current recommendation for folic acid is 0.4 mg daily. Sources: leafy green vegetables, legumes, whole grains, nuts, liver and oranges.
Overall, a diet rich in fruits and vegetables, whole grain and low-fat dairy products is the best way to protect your heart. Supplements should only be used when the diet doesn’t provide enough; however, they can’t mimic the full beneficial effects of real food.
¹ Wald, D. S, et al. "Randomized Trial of Folic Acid Supplementation and Serum Homocysteine Levels." Archives of Internal Medicine 161 (2001): 695-700.
² Lonn, E., S. Yusuf, M.J. Arnold, P. Sheridan, J. Pogue, M. Micks, M.J. McQueen, J. Probstfield, et al. "Homocysteine Lowering with Folic Acid and B Vitamins in Vascular Disease." New England Journal of Medicine 356 , no. 15 (2006): 1567–77.
³ Leung, June, Brett Larive, Johanna Dwyer, Patricia Hibberd, Paul Jacques, William Rand. "Folic Acid Supplementation and Cardiac and Stroke Mortality among Hemodialysis Patients." Journal of Renal Nutrition 10 (2010):1053-59.