Exercising, eating healthy and making other lifestyle changes may benefit your heart much more than folic acid supplements, especially if you've already had a heart attack, researchers said.

Several studies show the supplements failed to reduce heart attacks and strokes in high-risk people, but the researchers said you can still get many other health benefits from folic acid.

"I was surprised that the supplementation wasn't working," said Dr. Lydia Bazzano, an assistant professor of epidemiology at Tulane University's School of Public Health and Tropical Medicine in New Orleans. "I've actually looked at folate coming from natural foods in the past, and we did see some lower risks of heart attacks. Folate from natural foods may be different from folic acid in a supplement.''

Mixed results

More than 72 million American adults have one or more forms of cardiovascular disease, which also accounts for 37 percent of the country's deaths, according to federal health officials.

Research on the benefits of over-the-counter supplements have yielded mixed results. Some studies, for example, indicate that increasing your dietary intake of folate is linked to a lower risk of cardiovascular disease, while others show  supplements help reduce levels of homocysteine, a protein in the blood that may raise your risk of heart disease.

Still other studies are inconclusive.

Meanwhile, Bazzano's team analyzed research projects for the past 40 years to unearth 12 studies on the benefits of folic acid in people with histories of cardiovascular disease. The studies involved nearly 17,000 people, many of whom took the supplements for at least six months.

'Not as simple as a pill'

Slightly more than 18 percent of them suffered new events of cardiovascular diseases, not that far below those in the studies who took fake pills for comparison's sake, Bazzano said.

"Therefore, it is important to focus on strategies of proven benefit, including smoking cessation, lipid reduction, treatment of hypertension and diabetes, maintenance of a healthy weight, and physical activity," Bazzano's team wrote in the latest Journal of the American Medical Association. 

Dr. Julius Gardin, cardiology chief at St. John Hospital and Medical Center in Detroit, said the study sends a clear message to people concerned about their hearts.

"It shows that cardiovascular disease prevention is not as simple as taking a pill," he said.

Important for overall health

But Bazzano said consuming folic acid - called "folate" in its natural form - in meals is important for overall health. For one reason, she added, her study does not include the effects of folic-acid supplements in people with no history of heart attacks and strokes.

In addition, leafy green vegetables and citrus fruits are rich in folate and are important components in a healthy diet.

Folic acid, also known vitamin B-9, works with vitamins B-12 and C to help the body digest and use proteins. The nutrient is necessary for:

•  production of red-blood cells;

•  synthesis of DNA, which controls heredity and guides cells in their operations:

•  tissue growth;

•  cell function;

•  increasing appetite and digestive acids.

Adequate levels of folic acid are particularly important for pregnant women because studies show it prevents certain birth defects.

You can get folic acid from:

•  beans and legumes;

•  citrus fruits;

•  whole grains;

•  dark, green, leafy vegetables;

•  poultry, pork and shellfish;

•  liver;

•  fruit juices.

For more information

•  Why Folic Acid is Important

•  U.S. National Library of Medicine

•  Folate Fact Sheet

This article includes information from HealthDay. 

Source: American Medical Association
Reference: Journal of the American Medical Association

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