Folate – Are You Getting Enough to Prevent Cardiovascular Disease?

If you are trying to conceive you will know all about the importance of folic acid for pregnancy. This is the synthetic form of the B vitamin folate and you are advised to take a supplement daily from the time you start trying for a baby to guard against neural tube defects such as spina bifida. However, were you aware that an adequate intake of folate may also help to protect your long-term cardiovascular health? There is evidence that along with the B vitamins B6 and B12, folate has a favorable effect on the risk of having a heart attack or stroke and may also help to reduce the likelihood of developing vascular dementia.

Folate, homocysteine and health

The benefits of the vitamin folate with regards to cardiovascular health relate to its ability to lower levels of a substance called homocysteine in the blood. Raised concentrations of homocysteine in the body are a risk factor for heart disease, stroke and dementia. How homocycteine exerts its negative effects is thought to be through promoting the build up of fatty deposits in the walls of the arteries, leading to narrowing and reduced blood flow; though this mechanism still needs to be proven. When the results of a number of studies were analyzed, folic acid supplements were able to reduce homocysteine levels by around a quarter. A large-scale study found that when taken together, folic acid and vitamin B6 were able to reduce the risk of heart attack or dying from heart disease by close to half. Similarly, another review examining the benefits of folic acid on stroke risk found that a daily supplement could reduce the likelihood of stroke by 11%. There is also evidence that the B vitamin has a significant benefit on cognitive function, memory and mood, highlighting that avoiding folic acid deficiency may help to prevent or at least slow the development of dementia.

Folate intake

The US recommendations for folate intake in the general population are 400μg daily, though pregnant women may benefit from raising this to 600μg. Without adequate intake, folate deficiency can occur which may not have any symptoms or may present as anemia, numbness, changes in mental function and low mood. Higher dose supplements are often required to correct deficiency of this vitamin, followed by blood testing to check folate levels have returned to normal. In people found to have high levels of homocysteine in their blood, folate doses of up to 1mg daily can help to lower homocysteine levels, though this may also be achievable at the recommended folate intake for the population as a whole. With the exception of women trying to conceive, it is advisable that people initially aim to meet their requirements for folate from diet before turning to supplements. It is also recommended that advice is sought from a doctor before commencing supplements if you have concerns about your risk of heart disease, stroke and dementia, as they will be able to conduct an assessment of your cardiovascular risk and advise whether any additional measures are required.

Folate rich foods

A range of foods in the diet provide folate, so eating a varied diet will help you to maximize your intake. For meat-eaters, liver, red meat, poultry and seafood offer an important source of this B vitamin, but there are plenty of plant-based options for vegetarians and others with a limited meat intake. Breakfast cereals are often fortified with the vitamin, but check the nutrition label to be sure; pasta, rice and oats are another good option for folate-rich carbohydrates. Pulses such as chickpeas, green peas, kidney beans, blackeye beans and soybeans – as well as any items produced from the latter such as tofu and soy milk – also offer a useful source. Green leafy vegetable such as spinach, kale, cabbage and broccoli are another good bet, but care has to be taken that these are cooked for the minimum time necessary, as B vitamins are lost on cooking, especially if this is for extended periods; microwaving, steaming and stir-frying help to preserve vitamin content. Fruits additionally provide folate, with oranges and berries offering the most. Refrigeration helps to maintain the folate content of fresh fruit and vegetables, but opting for frozen varieties is a good option, as their vitamin levels are locked in on freezing.

While a number of factors influence cardiovascular disease risk and adequate folate – either through diet or in combination with folic acid supplements – cannot promise to prevent adverse events, upping your intake of this B vitamin is a positive step towards better heart and blood vessel health.