Cardiovascular disorders continue to have a high morbidity and mortality in North America. Even though doctors advocate exercise, discontinuation of smoking, and better control of blood pressure and blood sugars, the majority of patients remain non-compliant. Many individuals continue to consume a vast number of health supplements including vitamins to reduce their risk of heart disease.
Many consumers are convinced that eating certain health supplements can prevent illness. One of these supplements that is widely promoted to prevent heart disease is folic acid. Fortification of foods with folic acid was started nearly 15 years ago to reduce neural tube defects. This is now a universal policy all over the world.
There are many health professionals who recommend that patients consume folic acid as a preventive aid against atherosclerosis. Now there is a study from Holland which is a big blow to the proponents of folic acid. This large clinical trial failed to show any benefit of folic acid in reduction of cardiac disease.
The study concluded that despite a considerable increase in folate concentrations and a reduction in total homocysteine concentrations, 3-y folic acid supplementation did not slow down atherosclerotic progression or arterial stiffening.
The study looked at whether folic acid supplements could help prevent atherosclerotic plaques in elderly individuals who had high homocysteine levels but had not yet developed atherosclerosis. After daily consumptions of folic acid (800 mcg/day) for more than 3 years, there was no difference in atherosclerotic plaques between individuals who took the supplement and those who did not.
These novel findings indicate that folic acid does not prevent slowing down of atherosclerotic plaques. To ensure that there were no problems with under dosing, individuals in the trials were given twice the recommended daily dose of folic acid (800mcg/day).
For the consumer, it is important to understand that folic acid is essential to the diet and if you follow the instructions on the label, there should be no harm in taking supplements. However, for those who take folic acid in the belief that it will prevent heart disease, this appears to be a false notion.
Sources:
1. Effect of 3 y of folic acid supplementation on the progression of carotid intima-media thickness and carotid arterial stiffness in older adults.
http://www.ajcn.org/content/93/5/941.abstract?sid=ba9ac823-6d6c-43bd-a93e-78e20041f796
2. Martí-Carvajal AJ, Solà I, Lathyris D, Salanti G Homocysteine lowering interventions for preventing cardiovascular events. http://www2.cochrane.org/reviews/en/ab006612.html
3. Bazzano L, Reynolds K, Holder K, et al.: Effect of folic acid supplementation on risk of cardiovascular diseases: A meta-analysis of randomized controlled trials. JAMA 296: 2720–2726, 2006.
http://docnews.diabetesjournals.org/cgi/ijlink?linkType=ABST&journalCode=jama&resid=296/22/2720
4. Wald D, Wald N, Morris J, et al.: Folic acid, homocysteine, and cardiovascular disease: Judging causality in the face of inconclusive trial evidence, BMJ 333:1114–1117, 2006
http://www.ncbi.nlm.nih.gov/pubmed/17124224
Reviewed June 8, 2011
Edited by Alison Stanton