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Study: Folic acid boost could save 50,000 lives a year

The government requires cereal makers to add folic acid  

In this story:

April 8, 1998
Web posted at: 11:23 p.m. EDT (0323 GMT)

WASHINGTON (CNN) -- A new study released Wednesday has found that increasing the intake of folic acid could prevent as many as 50,000 deaths a year from cardiovascular disease.

Folic acid is already being added to cereals in higher levels than ever before in light of evidence that it can prevent some types of birth defects.

As recently as Tuesday, a government panel raised the Recommended Daily Allowance to 400 micrograms, double the last level set in 1989.

But the new study, published in Thursday's edition of the New England Journal of Medicine by a team at the Oregon Regional Primate Research Center, found that even higher levels of folic acid may be desirable.

"Our results suggest that folic acid fortification at levels higher than the government recommendation may be warranted," said Dr. Manuel Rene Malinow, leader of the research team.

Folic acid deficiencies have been linked to birth defects of the brain and spine as well as to high blood levels of the amino acid homocysteine. Homocysteine, in turn, has been linked to heart attacks and strokes.

High levels of homocysteine are present in an estimated 20 million Americans, or more than one of every three people diagnosed with cardiovascular disease. One million Americans are projected to die in 1998 from the disease, the leading cause of death in the United States.

140 micrograms have no effect

Previous studies have shown that 400 micrograms a day of folic acid can cut the risk of birth defects in half and restore homocysteine to normal levels. Some studies have indicated that lowering homocysteine levels also lowers the risk of heart disease.

"I think one of the take-home messages (from the Oregon study) is that it will take more folic acid than most people are eating in order to bring homocysteines down," says Dr. Godfrey Oakley of the Centers for Disease Control and Prevention in Atlanta.

blood pressure
Research has found that folic acid may help prevent heart disease  

Folic acid is in leafy green vegetables, beans, eggs and grains, but few people get enough through diet alone.

New Food and Drug Administration guidelines that took effect January 1 require cereal, bread and pasta to be enriched so the average adult gets about 140 micrograms of the vitamin daily. A few cereals, such as Total and Product 19, contain 400 micrograms of folic acid, but most do not.

In the study, researchers fed breakfast cereal daily to 75 men and women with heart disease at the Providence St. Vincent Medical Center in Portland, Oregon.

They found that the more folic acid there was in their cereals, the more their blood homocysteine levels declined.

They also found that while cereals with the standard level of fortification had little effect, adding nearly five times as much, or a total of 665 micrograms of folic acid, cut homocysteine levels by 14 percent.

A multivitamin will do

"The level of fortification proposed by the FDA ... was insufficient to reduce plasma homocysteine levels significantly," the researchers report.

Malinow said that increasing folic acid levels immediately "would potentially prevent 50,000 deaths from vascular causes per year."

He added, "It will probably soon be as common to have one's homocysteine level checked as it is now to have one's cholesterol level checked."

Homocysteines can be measured with a simple blood test.

In an editorial accompanying the study, Oakley said that taking a standard multivitamin tablet or eating a full serving of fortified breakfast cereal "is a convenient, effective, safe and inexpensive way to increase the consumption of folic acid by 400 micrograms rapidly."

He also noted that the current FDA guidelines may not achieve their primary goal of preventing birth defects.

"The only sure way for most women to achieve the recommended intake of 400 micrograms of folic acid," he writes, "is to consume a multivitamin or a serving of fully fortified breakfast cereal daily."

Correspondent Eugenia Halsey and Reuters contributed to this report.


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