Folic acid supplementation may reduce progression of atherosclerosis.

Researchers have conducted a meta-analysis of relevant randomized trials to assess whether folic acid supplementation reduces the progression of atherosclerosis as measured by carotid intima-media thickness (CIMT). This analysis included 2,052 subjects from 10 folic acid randomized trials. The analysis showed that folic acid supplementation significantly reduces the progression of CIMT, particularly in subjects with chronic kidney disease (CKD) or high cardiovascular disease (CVD) risk but not in subjects who were generally healthy with only elevated homocysteine concentrations. Furthermore, meta-regression analysis of the data showed that the baseline CIMT levels and the percent reduction of homocysteine were positively related to the effect size. Consistently, a greater beneficial effect was seen in those trials with baseline CIMT levels ≥0.8 mm, and a reduction in the homocysteine concentration ≥30%. The authors conclude "Our findings underscore the importance of identifying target populations that can particularly benefit from folic acid therapy".

Qin X, Xu M, Zhang Y, Li J, Xu X, Wang X, Xu X, Huo Y. Effect of folic acid supplementation on the progression of carotid intima-media thickness: a meta-analysis of randomized controlled trials. Atherosclerosis. 2012 Jun;222(2):307-13.

Reduced stroke risk associated with B vitamin supplementation.

This study systematically reviewed the effects of B vitamin supplementation on plasma homocysteine (Hcy), cardiovascular and all-cause mortality in randomized controlled trials. Data from 19 studies including 47,921 participants was analyzed and the results showed a significant protective effect on stroke and a decrease in blood Hcy levels with B vitamin supplementation.

Note, be sure your daily multi-vitamin provides at least 400 iu folic acid and 25 to 50 mg of the B complex vitamins, including at least 1000 mcg B-12.

Huang T, Chen Y, Yang B, Yang J, Wahlqvist ML, Li D. Meta-analysis of B vitamin supplementation on plasma homocysteine, cardiovascular and all-cause mortality. Clin Nutr. 2012 Aug;31(4):448-54.

B Vitamins Can Slow Cognitive Decline

This study found that people with mild cognitive impairment had their cognitive decline slowed by taking B vitamins. The modest doses used were easy to replicate. 800 mcg Folic Acid. 500 mcg B-12, 20 mg B-6 and they took them for two years.
Benefits seen? Significant improvements in homocysteine levels, in global cognition, episodic memory, delayed recall and semantic memory. Progression of memory impairment was slowed in the B vitamin group and not at all in the placebo group.

de Jager, Jacoby et al, 'Cognitive and clinical outcomes of homocysteine-lowering B-vitamin treatment in mild cognitive impairment: a randomized controlled trial', International Journal of Geriatric Psychiatry, 2011.

Blood Vessel Damage and Elevated Homocysteine

A bit of background...the post before this one tells of a link between dementia and low vitamin B-12 and Folic Acid status. You are taking a good multi-vitamin aren't you? When we have too little of those two B vitamins, or of vitamin B-6 we run the risk of having an elevations of a compound in the blood called homocysteine. 


Why do we worry about this? Well, aside from the risk of dementia..or Alzheimer's, having elevated homocysteine also puts us in danger of heart attack, and blood clots in our brains or in our legs...and yes the ones in our legs are very dangerous. They can move to our lungs and kill us...just as a clot in the brain can cause a stroke, or one in a coronary artery can cause a heart attack.


Suffice it to say...we don't want to ignore elevated homocysteine. Homocysteine is thought to cause vascular disease because of its effect on blood vessel walls. Homocysteine binds to certain proteins in the body affecting their structure and function. The binding of homocysteine to proteins will degrade and inhibit repair and maintenance of three main vascular connective tissue structures—cartilage, elastin and proteolgycans—making them more susceptible to disease processes, including vascular disease.


How might we protect ourselves....well that part is easy!


B Vitamins...B-12, Folic acid and B-6..and another supplement called NAC. N Acetyl Cysteine. You can have your doctor add the homocysteine screening to your cholesterol panel next time you're in for a check-up...you ARE getting them routinely yes? If your multi-vitamin isn't getting the job done...meaning your level is higher than what is ideal...you could use a higher potency B-Complex for a bit, and some NAC to reduce your risk.


Here's an abstract from one study that identified the mechanisms I mentioned above for blood vessel damage...


"Elevated blood levels of homocysteine also are considered an independent risk factor for atherosclerosis and thromboembolism (the obstruction of a blood vessel by a clot), and are correlated with a significant risk for coronary, cerebral and peripheral vascular disease, myocardial infarction (heart attacks), peripheral vascular occlusive disease, cerebral vascular occlusive disease, and retinal vascular disease."

Lentz SR. 

"Mechanisms of homocysteine-induced atherothrombosis." J Thromb Haemost. 2005 Aug;3(8):1646-54.

       And one more thing to think about...stress, anger, and hostility..seem to raise homocysteine levels...Results showed that there was a positive and significant association between hostility and homocysteine levels for all participants, and a positive and significant correlation between anger in and homocysteine levels for men. This is one suggested potential mechanism for the increased cardiovascular risk associated with hostility and anger expression Psychological factors appear to be related to blood concentrations of homocysteine. It is possible that hostility may be a sign of more life stress, and that stress appears to increase homocysteine levels. So take it easy! 

 Stoney CM, Engebretson TO

"Plasma Homocysteine Concentrations Are Positively Associated With Hostility and Anger," , Life Sci, 2000;66(23):2267-2275.

  

Vitamin B-12 and Folic Acid May Be Important For Dementia Patients

If you have a loved one who suffers with Dementia or Alzheimer's Disease supplemental B-12 and folic acid is inexpensive and may be helpful. For the rest of us, supplemental B-12 and folic acid not only protect our blood vessels from being damaged by elevated homocysteine, but may protect our cognitive processes as we age...

In a retrospective study involving 32 Alzheimer's disease (AD) patients, 12 vascular dementia (VaD) patients, 83 dementia due to other causes (DOC) patients, and 127 controls, results indicate that AD and VaD patients may benefit from vitamin B12 and folate supplementation. In AD, VaD, and DOC patients, the levels of vitamin B(12), and folate were significantly lower, compared with controls. Thus, the authors of this study conclude, "Vitamin B(12) and folate were significantly low in both AD and VaD patients. Hence, B vitamin supplementation should be considered as possible targets for the therapeutic intervention in dementia." Vitamin B(12) and folate represent modifiable risk factors for dementia. Deficient or insufficient levels may increase the risk of Alzheimer's dementia (AD) and vascular dementia (VaD) as their deficiency can increase the homocysteine level due to slowed methylation reaction. Homocysteine elevation has a neurotoxic effect that could lead to neurologic disturbances. http://www.ncbi.nlm.nih.gov/pubmed/21264133