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 (µg) | 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 | ⅓ 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
