by Karen Schroeder, MS, RD
Folate, also known as folic acid, is a B vitamin that is essential for good health. Specifically, it can help reduce your risk of heart disease and stroke by lowering the level of the amino acid homocysteine in the blood. The level of homocysteine in blood increases due to age, vitamin deficiencies, and some genetic abnormalities. At high levels, homocysteine can damage coronary arteries or make it easier for blood clotting cells to clump together and form a clot. This can increase your risk of heart attack or stroke.
Taking supplemental folic acid and other B vitamins may help reduce the risk of heart attack and/or ischemic stroke by lowering homocysteine level. Although the relationship between elevated levels of homocysteine and risk for cardiovascular events have been noted in many studies, some vitamin trials failed to confirm that treatment with folic acid reduces the risk. Also, the exact and most optimal dose of folic acid supplementation is not known. For example, a recent trial (called VISPVitamins in Stroke Prevention) looked at the role of vitamins in prevention of stroke. More than 3600 patients participated in a trial that lasted for almost two years. Patients with a recent history of ischemic stroke and elevated levels of homocysteine were divided into two groups. One group received a low dose of folic acid, and the other group a high dose. The trial failed to show a difference in risk reduction between the groups.
Beyond this one particular study, though, folate is considered important for pregnant women. Low blood levels of folate during pregnancy can cause neural tube defectsanencephaly and spina bifida . Every woman who might get pregnant should take 400 mcg of folic acid daily. Also, deficiency of folic acid can result in anemia. Recommended Intake Age group (in years) Recommended Dietary Allowance Females Males 1 - 3 150 mcg 150 mcg 4 - 8 200 mcg 200 mcg 9 - 13 300 mcg 300 mcg 14 - 18 400 mcg 400 mcg Pregnancy, ages 14-18 600 mcg n/a Lactation, ages 14-18 500 mcg n/a 19 - 50 400 mcg 400 mcg Pregnancy, ages 19-50 600 mcg n/a Lactation, ages 19-50 500 mcg n/a 51 - 69 400 mcg 400 mcg 70 + 400 mcg 400 mcg Here's How: Major Food Sources
Food Serving size Folate content (mcg) Chicken liver, simmered 3.5 oz 770 Fortified breakfast cereal 3/4 cup 100-400 (check Nutrition Facts label) Soy flour 1 cup 260 Beef liver, braised 3.5 oz 217 Chickpeas, canned 1 cup 160 Pinto beans, canned 1 cup 144 Spinach, boiled 1/2 cup 131 Lima beans, canned 1 cup 121 Papaya 1 medium 116 Avocado 1medium 113 Wheat germ, toasted 1/4 cup 102 Asparagus, boiled 4 spears 85 Orange juice, fresh 8 fl oz 75 Spinach, raw 1/2 cup 54 Whole wheat flour 1 cup 53 Green peas, boiled 1/2 cup 50 White rice, long-grain 1/2 cup 45 Orange, navel 1 medium 44 Peanuts, dry roasted 1 oz 41 Wheat flour 1 cup 40 Broccoli, boiled 1/2 cup 39 Tomatoes, sun-dried 1 cup 37 Tomato juice, canned 6 oz 35 Peanut butter, crunchy 2 T 29 Cashews, dry roasted 1 oz 20 Banana 1 medium 20 Bread, whole wheat 1 slice 15 Tips For Increasing Your Folate Intake
To help increase your intake of folate: Spread a little avocado on your sandwich in place of mayonnaise.Drink a glass of orange juice or tomato juice in the morning.Add spinach to your scrambled eggs.Slice a banana on top of your breakfast cereal.Sprinkle some toasted wheat germ on top of pasta or a stir-fry.Throw some chickpeas or kidney beans into a salad.If you take a vitamin supplement, make sure it contains folate. RESOURCES: American Dietetic Association http://www.eatright.org/Public/ Food and NutritionUS Department of Agriculture http://www.usda.gov/wps/portal/usdahome References: The Nutrition Desk Reference . Keats Publishing; 1995. Folic acid information. WIC Learning Center website. Available at: http://www.nal.usda.gov/wicworks/Learning_Center/WICfood_folic.html . Accessed on: November 12, 2006. Folic acid: Frequently asked questions. Center for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncbddd/folicacid/faqs.htm . Accessed on: November 12, 2006. Herrmann W. Significance of hyperhomocysteinemia. Clin Lab . 2006;52(review):367-374.
Hankey GJ. Is plasma homocysteine a modifiable risk factor for stroke? Nat Clin Pract Neurol. Jan 2006;2(review):26-33. Toole J, Malinow R, Chambless L, et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. JAMA . Feb 4, 2004;291:565-75. Last reviewed November 2006 by Marcin Chwistek, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
