Heart risk for elderly
6 March 2002
Elderly people need to boost the amount of folic acid they take by almost three times the official recommended level to minimise the risk of stroke, thrombosis and heart disease a new study funded by the Wellcome Trust biomedical research charity has shown.
Folate helps reduce the level of homocysteine, an amino-acid, which in turn can precipitate vascular disease.
The necessary intake is far higher than previously thought and highlights the fact that the elderly need to consume more folate than younger people.
Professor Michael Golden, who recently retired and led the study which involved over 300 men and women aged 65-74 in Aberdeen, said : " This could have major implications because it is the elderly who bear the brunt of cardio-vascular problems.
" If public health policy decisions safely raise the folate intake substantially, these results suggest we could save lots of lives, improve the health and quality of life of many people and save the health service an awful lot of money."
According to the Department of Health although those aged 65 plus make up just one in six of the population they consume 39% of the National Health Service budget. During 2000 heart disease claimed the lives of 27,964 people aged 65-74 in the UK.
Dr. Ross Taylor, from the University of Aberdeen Medical School, who also worked on the study, said : " The Committee on Medical Aspects of Food and Nutrition Policy (COMA) recommended an extra intake of 200 micrograms a day for those of 50 plus.
" But we discovered it should be almost three times that amount to ensure 95% of the elderly were not at risk from high homocysteine, and therefore vascular disease.
" This is not achievable for most people because of the amount of fruit and vegetables they would have to consume. So you would need to fortify food with folic acid and the best way is to add it to bread, biscuits, cakes, and breakfast cereals, which should not be expensive.
" If individuals were to take the extra folate in tablet form again the cost would not be high, probably in the region of £10 a year per person."
However, the authors warn, there is a danger in adding too much folate. An excess causes people with deficiency of vitamin B12 to develop irreversible nerve damage rather than the more usual and treatable anaemia.
This could be avoided by fortification with both vitamins - folate and B12. The elderly are particularly prone to vitamin B12 deficiency because they commonly develop an inability to absorb it from their diet. Indeed, many of the elderly in this study had marginal vitamin B12 deficiency that was not detected by the usual test.
The results of the research present a public health dilemma in that the elderly need much more folate in their diet but there may be a substantial proportion with unrecognised vitamin B12 deficiency that will only be picked up by screening with a more sensitive test than is currently available.
The three-year study involved patients from two general practices in Aberdeen who were given folic tablets of varying strengths over a six week period. Only those taking the highest level of folate, between 400 and 600 micrograms, recorded a drop in homocysteine levels. Results of the research, are published in the latest edition of the Quarterly Journal of Medicine.
Ends.
• The study involved 368 men and women aged 65-75.
• Different groups were given folate dosages from 0 ( placebo) - 600micrograms.
* Figures from the British Heart Foundation's Coronary Heart Disease statistics.
Notes.
1. The Wellcome Trust is an independent research-funding charity, established in 1936 under the will of tropical medicine pioneer Sir Henry Wellcome. The Trust's mission is to promote research with the aim of improving human and animal health and currently spends £600m a year in this area.
2. In the last two years the Trust has invested more than £36m in cardiology and stroke research.
For further information please contact :
Barry Gardner, Wellcome Trust Press office. 0207 611 7329 :
E-mail :
b.gardner@wellcome.ac.uk.