Folic Acid and Heart Disease

Health Professional

What is folic acid?

Folic acid is a synthetic form of the water-soluble vitamin B9; it plays an important role in energy production and the immune system. Folate is the natural form of this vitamin found in foods. There is debate surrounding which form of vitamin B9 is healthiest, folic acid versus folate, but I don’t want to explore that argument today. For the sake of our discussion, folic acid is equal to folate and I’m using the terms interchangeably.

How is folic acid connected to heart disease?

Homocysteine is an amino acid that comes from the normal breakdown of proteins in the body. Folic acid is one vitamin supporting the breakdown of amino acid. Research has suggested that deficiencies of folic acid and other B vitamins lead to elevated homocysteine levels, which has been identified as a potential risk factor for heart disease and stroke.

How much folic acid do you need daily?

The daily recommend value for folic acid is 400 micrograms (mcg) for adults. The recommended intake for pregnant women is 600 mcg daily.

Because folic acid is a water-soluble B vitamin, it leaves the body quickly. For this reason, a folic acid supplement should be divided and taken twice daily.

Please note that the American Heart Association does not currently support supplementing B vitamins to reduce heart disease and stroke risk.

While folic acid does lower homocysteine levels, research does not show supplements decrease heart disease risk. Some research, however, indicates folic acid may provide stroke protection.

Supplemental folic acid levels used in research on stroke and heart disease vary greatly. For example, one study gave participants a high folic acid dose of 2500 mcg. This study did not find a conclusive connection between folic acid and reduced heart disease risk. Another study supplemented a more modest 800 mcg folic acid and found a potential connection between folic acid and reduced stroke risk.

Instead of trying to determine what level of supplemental folic acid is safe and right for you, adjust your diet to contain foods rich in folate.

What are dietary sources of folate?

Good dietary sources of folate include:

  • Beans, cooked (black, navy, pinto, kidney) – 115-145 mcg per half-cup
  • Okra, cooked – 135 mcg per half-cup
  • Spinach, raw – 110 mcg per 1 cup
  • Asparagus, cooked – 100 mcg per 5 spears
  • Orange juice – 80 mcg per 1 cup
  • Broccoli – 50 mcg per half-cup
  • Romaine lettuce – 40 mcg per 1 cup
  • Peanuts – 40 mcg per quarter-cup

Some foods are fortified with folic acid, such as some breakfast cereal, breads, pasta, and rice. Many of these foods containing folic acid will promote overall heart health and are a good addition to a heart healthy diet.