Folic Acid and Fatal Coronary Heart Disease

Howard I. Morrison, Douglas Schaubel, Marie Desmeules and Donald T. Wigle JAMA 1996;275:1893-1896

Folic acid (folate) is one of the B-complex vitamins. Canadian researchers reported that men and women with low blood (serum) levels of folate have a 69 percent increase in risk of fatal coronary heart disease (relative risk=1.69, 95 percent confidence interval 1.10-2.61).

This risk estimate was reported based on a 15-year study of more than 5,000 individuals. As a result of this study, the researchers indicated that folic acid fortification of food products is warranted.

Although the researchers associated low serum folate levels with fatal coronary heart disease, they were not able to associate dietary folic acid consumption (by food or vitamin supplements) with a decrease in risk of coronary heart disease. Why would they advocate fortifying foods with folic acid if they were unable to associate dietary intake of folic acid with decreased risk?

The researcher's response to this question is:

The failure to note a dietary effect should not be taken as evidence that dietary intervention is not to be encouraged. ... Dietary folic acid supplementation has also been associated with reduced risk of neural tube (i.e., birth) defects.

Can someone explain to me what the folic acid-birth defect link has to do with a potential folic acid-coronary heart disease link?

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