Wednesday, February 20, 2008

Smokers: Folic Acid Reduces Risk of Stroke If You Can't Quit

From the Finnish National Public Health Institute and the Karolinska Institutet in Sweden comes recent research finding that smokers who get more folic acid have lower risk of stroke.

These two Scandinavian research centers have been analyzing data they've collected from 26,000 Finnish smokers since at least 1994. Most of their conclusions support the idea that single-shot vitamin supplementation does more harm than good. Smokers who were given beta-carotene supplements without the alpha-carotene you'd get in real vegetables or at least in mixed carotenoid nutritional supplements, for instance, were more likely to get lung cancer, not less.

So the researchers were very careful in reviewing their records before they came out with this most recent recommendation:

For men who can't quit smoking, getting enough of the B-vitamin folic acid reduces the risk of stroke by about 20 per cent.

They didn't find that other B vitamins played the same role in stroke prevention. Only folic acid (also known as folate) helped lower this particular risk.

Why should folic acid protect smokers? Dr. Susanna Larsson, a lead investigator of the study, explains:

"An inverse association between folate intake and risk of stroke is biologically plausible because folic acid supplementation lowers blood homocysteine, which in high concentrations may cause vascular damage (endothelial dysfunction, increased arterial intimal-medial thickness, and increased arterial stiffness) and increased procoagulant activity."

Homocysteine levels, as you may know, are lowered by folic acid working in concert with B6 and B12 and the amino acid methionine, but deficiences of these nutrients weren't associated with stroke in the study.

One word of caution about interpreting these results. The smokers involved in this study lived in Europe. American breads and cereals are fortified with folic acid, while European breads and cereals are much less likely to be vitamin-enriched. The findings of this study support the idea that folic acid is important to cardiovascular health in smokers, but Americans may already get enough if they eat packaged cereals and commercial breads (the foods you may want to avoid for other reasons).

Larsson SC, Männistö S, Virtanen MJ, Kontto J, Albanes D, Virtamo J. Folate, Vitamin B6, Vitamin B12, and Methionine Intakes and Risk of Stroke Subtypes in Male Smokers. Am J Epidemiol. 2008 Feb 12 [Epub ahead of print]

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