Homocysteine and Cardiovascular disease risk: Dietary Folate or Supplementation?

2013-07-24 10:14:21

Homocysteine (Hcy) has come to be known as a reliable marker for cardiovascular disease risk. Elevated levels are associated with coronary heart disease and especially stroke.^{(1, 2)} We know that suboptimal intake of folate, B12, B6 elevates plasma Hcy⁽²⁾ while supplementing with them can reduce it. Although controversy exists around whether supplementation with these reduces the risk of cardiovascular disease, there are several studies that show that folate supplementation and/or the combination of folate, B12 and B6 not only reduces Hcy but also significantly reduces the risk of stroke.^{(3, 4)} A recently published study took a look at how dietary folate compared with supplemental forms of folate in reducing homocysteine levels. They took 149 people with mild hyperhomocysteinemia and prescribed either a 200mcg folate rich diet per day, 200mcg of 5-methytetrahydrofolate, 200mcg of folic acid or placebo⁽²⁾ Interestingly all three treatment groups had a significant reduction in Hcy levels to equal amounts. A folate rich diet has benefits over single ingredient supplementation, as foods high in folate also come packed with a number of other beneficial nutrients. This study illustrates that a folate rich diet can be as effective as supplementation in reducing Hcy levels and thereby lowering our risk of stroke. Daily recommendations for folate are 400mcg for adults, 600mcg in pregnancy and 500-600mcg during lactation. Although many foods are enriched with folate in the form of folic acid; we should always strive to look towards fresh foods to get our fill. A diet rich in fruits and vegetables can provide us with all the folate we truly need. For women that are considering getting pregnant, or are pregnant, a supplement of folic acid in addition to a healthy diet is essential in order to ensure sufficient amounts for proper fetal development. Foods naturally high in folate include: cooked edamame, cooked spinach, cooked artichoke, cooked asparagus, cooked beans (kidney, adzuki, pinto etc), and cooked lentils to name just a few.