Are you getting enough folate?
In yesterday’s e-Alert (“Laughing Matter” 8/9/04), I told you about a study that jumped to the dubious conclusion that folate may create problems for patients who have undergone angioplasty to open a narrowed artery for a stent implant. But any implication that folate is somehow bad for you couldn’t be further off the mark.
The fact is, if you are getting enough folate, you’re fortunate because it’s doing your overall health a world of good. But if you’re not, then I’ll tell you how to increase folate intake, and why your heart will likely be in much better shape if you do.
Kuopio contradictions
First we’ll go to Kuopio, Finland, where researchers examined data from the Kuopio Ischaemic Heart Disease Risk Factor Study.
As reported in this month’s issue of the American Journal of Clinical Nutrition, the Kuopio team analyzed nearly eight years of general health and dietary data collected on more than 1,000 men during the 1990s. The men ranged in age from 46 to 64. None of the men had coronary artery disease when the data collection started in 1991.
Two striking results were noted. 1) When subjects who had the highest blood serum folate concentrations were compared to subjects with the lowest folate levels, the men with the highest were found to have 65 percent lower risk of an acute coronary event, such as heart attack or stroke. And 2) Elevated homocysteine levels were not associated with increased risk of acute coronary event.
The second result is somewhat surprising because it contradicts a number of studies that have shown high homocysteine to be an independent risk factor for heart disease and coronary events. For instance, just last year, researchers in Israel reported in the journal Stroke on an eight-year study of more than 3,000 patients who were at high risk of coronary heart disease (CHD). They concluded that total serum homocysteine concentration is, “a strong predictor for incident ischemic stroke among patients at increased risk because of chronic CHD.”
But while the Kuopio study seems to challenge the Israel conclusion (as well as other reliable research) there was one subgroup for which homocysteine was an important factor: Cigarette smokers with high homocysteine had almost twice the risk of coronary events compared to smokers who had low homocysteine levels.
Folate shopping list
As I noted in yesterday’s e-Alert, homocysteine levels may be effectively lowered when folate is taken with vitamins B-6 and B- 12; a combination referred to as “folate therapy.” The idea behind this therapy is simple. This set of nutrients prompts the metabolism of homocysteine (an amino acid), which brings the level down.
That’s the idea anyway. It doesn’t work quite that easily for everyone. Nevertheless, it’s obviously a good idea to try to incorporate folate-rich foods into your diet, especially because this important nutrient has also been shown to reduce the risk of colon cancer, hip fracture, and birth defects (when folate levels are sufficient in women of childbearing age).
According to the FDA, these foods deliver high folate concentrations:
Chicken Liver: 3.5 oz. contains 770 micrograms (mcg) Braised Beef Liver: 3.5 oz. contains 217 mcg Lentils: cup (cooked) contains 180 mcg Asparagus: cup contains 132 mcg Spinach: cup (cooked) contains 131 mcg Kidney Beans: cup contains 115 mcg Orange: A medium size contains 47 mcg
My favorite item on the FDA list: “Fast-Food French Fries.” A large order apparently contains 38 mcg of folate. So somewhere out there, someone may be super-sizing their order of fries, recalling that the FDA singled it out as a good source of folate.
You can’t make this stuff up.
Mixing up a folate cocktail
In the e-Alert “The B List” (2/2/04), HSI Panelist Allan Spreen, M.D., told us that low doses of folic acid (the synthetic form of folate) aren’t effective except in a small percentage of cases. He recommends 1.6 mg per day, although he believes that a dosage closer to 5 mg is better for those who want to address cardiovascular problems.
Unfortunately, folic acid is only available in very low doses of 0.8 mg (800 mcg), as mandated by the FDA. Dr. Spreen explains: “That’s all from the conventional medical dogma that folate can mask a vitamin B-12 deficiency if you take too much folate and zero B-12.” So take more B-12. Problem solved! Dr. Spreen recommends 1 mg of B-12 per day in sublingual form. He also suggests that to get the most out of folate, 100 mg per day of B-6 is necessary, as well as 400-500 mg of magnesium per day to make the B-6 more effective.
Sources:
“Serum Folate and Homocysteine and the Incidence of Acute Coronary Events: The Kuopio Ischaemic Heart Disease Risk Factor Study” American Journal of Clinical Nutrition, Vol. 80, No. 2, August 2004, ncbi.nlm.nih.gov “High Serum Folate Levels Associated with Greatly Reduced Acute Coronary Event Incidence” Life Extension Foundation, 7/30/04, lef.org “Prospective Study of Serum Homocysteine and Risk of Ischemic Stroke Among Patients With Preexisting Coronary Heart Disease” Stroke, Vol. 34, No. 3, 3/1/03, stroke.ahajournals.org “How Folate Can Help Prevent Birth Defects” FDA Consumer, July 1996, fda.gov
