You know which foods are high in fat and fiber, but can you
name three good sources of folate? Along with keeping fat in
check and consuming a high-fiber diet, health experts agree
that a folate-rich diet can reduce your risk of heart disease,
due to its role in keeping homocysteine levels normal.
Elevated homocysteine, an intermediary in protein metabolism,
has recently been shown to be associated with an increased
risk of heart disease. Therefore, low dietary folate levels
indirectly contribute to heart attack and stroke risk.
Are You Getting Enough Folate?
The current Recommended Dietary Allowance (RDA) for folate
for non-pregnant women is 180 mcg per day and 230 mcg per day
for men. However, this RDA level may be insufficient to
minimize the risk of neural tube defects and possibly heart
disease, since an estimated 88 percent of American adults
consume less than 400 mcg of folate per day, the level which
is needed to produce low, stable homocysteine levels. Based on
these data, many experts have urged an increase in the RDA for
folate. In addition, a national campaign to fortify certain
foods with folate, such as cereal and grains, has already
begun.
What are the Controversies?
The association between elevated homocysteine levels and
heart disease appears to be very strong, however, does taking
folate to reduce homocysteine reduce the risk of heart
disease? We do not know yet. Should homocysteine levels be
measured or should we prescribe extra folate to everyone?
These and other questions are being actively researched and
debated. Since most multivitamins contain 400 mcg of folate,
which appears to be the amount needed to lower homocysteine
levels, it may be useful to take a multivitamin, especially if
you do not eat a variety of foods, do not eat five servings of
fruits and vegetables a day, have increased nutrient
requirements such as pregnancy, or are taking medications,
such as Methotrexate which decreases folate absorption.
Where to Find Folate:
Folate, a B vitamin, is found mainly in citrus fruits and
juices, such as oranges and orange juice, leafy dark green
vegetables, including spinach and asparagus, and legumes, such
as lentils and pinto beans. As of January 1, 1998, folic acid
is found in enriched flour, bread, rice, noodles, and other
grains. For a folate-rich diet, include some of these foods on
your plate:
FOOD, FOLATE (mcg.), PORTION
Fortified, ready-to-eat, breakfast cereal
100-400 1 cup
Black-eyed peas (cooked) 179 ½ cup
Lentils (cooked) 179 ½ cup
Pinto beans (cooked) 147 ½ cup
Garbanzo beans/ chickpeas (cooked) 141 ½
cup
Asparagus (cooked) 132 ½ cup
Spinach (cooked) 131 ½ cup
Orange juice from concentrate 109 1 cup
Roasted peanuts 109 1/3 cup
Wheat germ 82 ¼ cup
Orange 47 1 medium
Brussels sprouts (cooked) 47 ½ cup
Simple Ways to Increase
Folate in Your Diet:
Start the day right. Regularly include a fortified
breakfast cereal in your meal plan. Hike the folate higher by
tossing berries in your cereal bowl and enjoying a glass of
orange or grapefruit juice.
Make your fluids count. When grabbing a beverage, reach for
fruit or veggie juice instead of cola.
Boost you bean intake. For convenience, use drained and
rinsed canned beans. Stir whole or pureed beans into a
favorite soup, chili, or casserole. Sprinkle them on top of
salads or add them to rice or pasta dishes. Puree beans and
use in muffins and cookies as a low-fat way to add moisture
and more folate. And, enjoy beans as flavorful main dishes too
– like bean burritos or red beans and rice.
Go for the grains. Now that grain products are enriched
with folic acid, choose high-fiber, fortified breakfast
cereals anytime of the day. Choose grain products as main
dishes – not just side dishes. Use leftover rice or pasta as
cold salad by adding chopped veggies and low-fat dressing.
Remember to get your five-a-day. Choose fresh fruits and
vegetables for a quick and healthy snack or dessert, anytime
and anywhere. Add dark leafy greens to hot or cold sandwiches.
Mix orange juice with olive oil and vinegar for a
heart-healthy salad dressing. For an unusual twist, try orange
juice concentrate as a tangy, folate-rich dressing on a
spinach salad. And, make sure you have ready-to-eat fruits and
vegetables in-sight – a fresh fruit bowl at home, raw veggies
in your briefcase or purse, and dried fruit at your desk.
SOURCES:
Wi JW, Enns CW, Goldman KS. et. al. Data tables: combined
results from USDA’s 1994 and 1995 Continuing Survey of Food
Intakes by Individuals and 1994 and 1995 Diet and Health
Knowledge Survey. From:
www.barc.usda.gov/bhnrc/foodsurvey/home.htm.
Recommended Dietary Allowances (RDA). 10th Edition.
National research Council. National Academy Press. Washington,
D.C. 1989.
Stampfer MJ, Rimm EB. Folate and cardiovascular disease.
Why we need a clinical trial now. JAMA 1996;275:1929-30.
Oakley GP, Erickson JD, Adams MJ, Urgent need to increase
folic acid consumption (editorial) JAMA 1995;274:1717-8.
Food and Drug Administration. Food standards: amendment of
standards of identity for enriched grain products to require
addition of folic acid. Federal Register
1996;61(41):8781-97.
Appel LJ. Folic acid fortification of Food. JAMA
1996;275:681-682.
Graham IM, Daly LE, Refsum HM, et al: Plasma homocysteine
as a risk factor for vascular disease. The European converted
action project. JAMA 1997;277:1775-1781.
by Jackie Newgent, R.D., C.D.N.
4/3/98
