Several studies, including the recent multi-center European trial, have found relationships of blood levels mediated, at least in part, by effects on homocysteine concentrations. As yet there has been no controlled trial of the effects of administering these vitamins on the development or recurrence of cardiovascular disease. Further, there may be variation in individual responses to the presence of pernicious anemia. For these reasons, the American Heart Association advises a healthy balanced diet, and use of supplements only when diet is not adequate to achieve these intakes. For folic acid, the recommended daily value is 400 micrograms.
Good sources are citrus fruits, tomatoes, vegetables, and grain products.
In January 1998, wheat flour will be fortified with folic acid to add an estimated 100 micrograms per day to the average diet. The recent findings indicating a graded association of plasma homocysteine levels with cardiovascular risk suggests that the availability of laboratory testing for plasma homocysteine levels can improve the assessment of risk, particularly in patients with a personal or family history of cardiovascular disease. Although evidence for the benefit of lowering homocysteine levels is lacking, patients at high risk should be strongly advised to follow an overall diet that ensures adequate intake of folic acid and vitamins B6 and B12. Inc. All rights reserved. Unauthorized use prohibited.