Folic Acid: The Forgotten Nutrient That Will Keep You Alive And Kicking Into Your 90s

You probably already know that folic acid is one of the most important of the B vitamins. I've been talking about this super-nutrient for years - in fact, I just wrote a Health Note about how it can help reduce stroke risk in last month's issue.

But up until recently, most of the general public didn't even know that folic acid was a vitamin, much less a B vitamin. Now, even university dieticians recognise its importance, and the US and UK governments have mandated that it be put in all those nutrition-free breads lining your local supermarket shelves.

The emergence of folic acid as a primary contributor to a long, healthy life is one of the major nutrition breakthroughs of the 20th century. But it certainly had a rocky path to greatness.

Forget cholesterol
Dr. Kilmer McCully was a Harvard researcher when he began his work on folic acid (folate). I first heard of his research back in the '80s. But he discovered the relationship between homocysteine and arteriosclerosis (hardening of the arteries) more than a decade before that - 1968.

McCully learned about homocystinuria, a newly discovered disease, at a medical conference. Apparently, mentally challenged youngsters had often been found to have a chemical, homocysteine, in the urine. These children died from a condition undistinguishable from hardening of the arteries in the elderly.

If homocysteine was in the urine, then it must be in the blood. Researchers found that it was. This got McCully thinking: Can homocysteine be found in the blood of adults, and does the level of the chemical in the blood correlate with hardening of the arteries? Is it possible that the fat and cholesterol deposits seen in arteriosclerotic arterial plaques are merely secondary accretions after homocysteine has already done the damage? The answer was yes, and in 1969 he announced the homocysteine theory of heart disease - to a brain-dead medical world.

Not only did Dr. McCully discover the etiology of atherosclerotic disease - heart attacks and strokes - but he also defined the prevention of these killers. Taking just three low-cost, zero-risk nutrients would effectively wipe out atherosclerotic disease and enable the average citizen to live to 90 or 100 in good health.

Those three nutrients are folic acid, vitamin B6 (pyridoxine), and vitamin B12. Folate is the most important but the others play an important role. Forget cholesterol and animal fat, McCully said - the whole thing was a hoax and a delusion.

Homocysteine and heart disease: Forgotten, but not gone
This was not what the drug industry, the universities, the government, and even the average doctor, whose practice can be as high as 100 percent devoted to treating hardened arteries, wanted to hear. Suddenly, McCully found himself knee-deep in crocodiles.

The forces of commerce, self-interest and vanity had a different agenda, an agenda based on the evil chemical cholesterol, which they claimed was absolutely, positively killing people by the millions. Meat and the fat of meat, they posited (with no evidence), was the primary source of killer cholesterol.

In the US, the government and 98 percent of the medical community were gearing up for a propaganda blitz of the American people concerning the evils of cholesterol. Unfortunately for Dr. McCully, the war on cholesterol coincided closely with his announcement that cholesterol was not the problem. This campaign was so successful, in spite of the fact that McCully disproved it, that the entire world followed these false prophets and piled into the bus marked 'Cholesterol Fighters of the World,' waving the banner 'Cholesterol Equals Death'.

But now, after nearly 40 years of neglect, folic acid and Dr. McCully have finally made it to the big time.

The mainstream finally endorses folate - but only if they can control it
In a study published in the Journal of the American College of Cardiology a few years ago, researchers noted that the increase in the blood flow rate after folate therapy was 'similar to that seen with statin drugs and ACE inhibitors.' Imagine that: a simple, safe and cheap nutrient can do what the expensive and not-so-safe drugs do - without side effects.

In another 2000 study, researchers found a high degree of folate deficiency in heart disease patients. They urged further work to determine if recent efforts to fortify the US and UK food supplies with folic acid are enough to decrease the proportion of the population at risk for heart disease resulting from insufficient folate levels. Unfortunately, government mandates always fall far short of what is needed - the notorious cover-your-butt syndrome.

Now in the early 21st century, it looks like the folate war is almost over and McCully has won. Last year, the Journal of the American Medical Association published a study recommending six months of 'vitamin therapy' to reduce the need of repeating angioplasty (angioplasty is the Roto-Ruter technique applied to 'unclog' the arteries of the heart). The dose of folate, the article explained, should be 'prescription strength'. This advice was repeated in the Journal of Family Practice in January of this year.

While I'm all for the use of folic acid instead of drugs or surgery, there is one part of this recommendation that doesn't sit well with me. When the journals talk about 'prescription strength' folate, they're making a not-so-subtle attempt to capture the market on this nutrient for druggists, the pharmaceutical industry and doctors.

The best food source of folate the FDA won't tell you about
Now, with all of the good news and evidence supporting folic acid, how can you make sure you're getting enough? Everything you read - not only the lay press but even the medical journals - tells you that you can get all the folic acid you need from fruits and vegetables. That just isn't true. Official measurements clearly show that fruits and vegetables are poor sources of folic acid. And those are just the raw values. After they're boiled, vegetables are essentially nutrition-free. Remember, folic acid, B6 and B12 are all water-soluble vitamins so they are carried out of the vegetables and dissolved in the boiling water - and then poured down your sink.

Although the official tables of nutrient content reveal that animal food - dairy, meat, liver, fish and shellfish - is superior to fruits and vegetables in folic acid content, recommendations to the public rarely mention this fact. Let me give you a good example of this 'propaganda by silence'. The US Food and Drug Administration (FDA) published a 'fact sheet' on folic acid in 1996. It turned out to be a not-so-factual fact sheet: 'FDA also emphasises that adequate levels of folic acid, in the form of folate, can be obtained by eating natural sources such as:

• Leafy dark green vegetables
• Legumes (dried beans and peas)
• Citrus fruits and juices
• Most berries'

The best sources of folate - animal protein, animal fat, and dairy products - aren't even listed. When I heard that the FDA had updated the fact sheet in 1999, I thought surely this awful omission must have been corrected. Not a word had been changed. Was it ignorance, stupidity, or conspiracy? I'm a conspiracy theorist, myself.

But even with a healthy diet containing plenty of folate-rich animal food, you should still take a supplement just to be absolutely certain you're getting enough of this nutrient. And I'll fill you in on a secret the pharmaceutical industry doesn't want you to know: Their 'prescription strength' folic acid is only 20 percent higher than the regular folic acid supplement you can buy at any health food store in the US.

All you have to do is take two of the over-the-counter, 800-microgram capsules and you'll be well over their 'prescription strength' (which isn't enough to do much good anyway). In the UK, the situation is even worse, as the normal recommended daily allowance (RDA) of folic acid is just 200 micrograms.

Actions to take:
If you want to be alive and kicking at 90, you've got to take your folate; there's no time to waste.

(1) As usual, the dosage regulations established by the government are far too low.
Take at least 800 micrograms a day (and keep in mind that doses up to 5,000 micrograms - and more - are safe and will do you even more good. I take 5,000 to 15,000 micrograms a day).

(2) Don't fall for the 'prescription strength' scam - you can buy folic acid supplements in just about any chemist, supermarket and health food store. These work just as well.

(3) In addition to your supplements, there are some good food sources of folate that can boost your levels a bit further. The leader in folate nutrition by a wide margin is liver. A small serving of beef liver - 3 oz., for instance - contains 174 micrograms of folic acid. When is the last time a nutritionist or doctor advised you to eat some variety of liver at least once a week? Probably never. Chicken liver is the tastiest and, with the proper sauce, an outstanding dish. BUT, don't overcook it. It should be a little red or at least pink.

(4) If you are a dyed-in-the-wool, pasty-faced vegan, I can still offer you a little help. Cauliflower, cabbage and navy beans average about 70 micrograms, but remember, that's before they're cooked.

If you boil these vegetables, the nutrients end up getting poured down your trendy, stainless-steel sink. Eat them raw and you'll get by, but you'd better take a supplement too.

I could write a book on this subject but it would be a disservice to Dr. McCully's seminal book on folate and the medical diktats now extant in America: The Heart Revolution. You can get it in most bookstores or order it online from amazon.com.

References:
'Effect of folic acid and antioxidant vitamins on endothelial dysfunction in patients with coronary artery disease' Journal of the American College of Cardiology 2000; 36(3): 758-765
'Serum folate and cardiovascular disease mortality among US men and women' Archives of Internal Medicine 2000; 160(21): 3,258-3,262
'The Fall and Rise Of Kilmer McCully' New York Times Magazine, 10/8/97 (section 6, page 25)
'Effect of Homocysteine-Lowering Therapy With Folic Acid, Vitamin B12, and Vitamin B6 on Clinical Outcome After Percutaneous Coronary Intervention,' Journal of the American Medical Association 2002; 288(8): 973-979
'Should patients with coronary disease and high homocysteine take folic acid?' Journal of Family Practice 2003; 52(1): 16-18
McCully, Kilmer M.D. The Homocysteine Revolution, New York, McGraw-Hill/Contemporary Books 1999