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Folate and Reduced Risk of Alzheimer’s Disease
Alzheimer’s Disease in America
Alzheimer’s disease, the most common form of mental disease, is affecting
over 13 million people around the world, and is expected to quadruple
by the year 2047. In the United States alone the cost of care, both
directly and indirectly, is over $100 billion dollars. And then there
is the daily emotional stress and strain to the care giver(s).
New research published in the January 2007 issue of Archives of Neurology by researcher Jose Luchsinger of Columbia University Medical Center, revealed that an increased intake of folic acid from both food and supplements may reduce the risk of Alzheimer’s disease by 50%.
Study Protocol
The conclusion of the reduced risk of Alzheimer’s disease from folate
was based on a six year study where the diets of 965 people with the
average age of 75.8 years were analyzed. The people involved were comprised
of 70.2% women, 45.3% Hispanic, 32.6% African American, and 22.1% Caucasian.
Most of the analysis of the diets were completed in or before 1996,
which was before the mandatory enrichment of grain and cereal products
with the synthetic form of folate known as folic acid. It wasn’t until
1998 that folate enrichment of food was legislated based on research
that a folate deficiency during pregnancy increased the risk of neural
tube defects. This synthetic form is also widely used in supplements.
Study Results
After nearly six years of continuous analysis there were 192 people
out of 965 diagnosed with Alzheimer’s disease. When the researchers
had adjusted for other contributing factors such as their age, cardiovascular
history, and intake of B12 and B6, they discovered that when the folate
level was increased from both diet and supplements, there was a link
to a reduced risk of Alzheimer’s disease by 50%. The researchers also
found that this link to a reduced risk was only associated to the combination
of diet and supplementation and not to either one alone. Also, the amount
of B12 and B6 had no link to the reduced risk of Alzheimer’s disease.
Abnormalities of the
Brains of Alzheimer’s Disease
Examination of the brains of Alzheimer’s victims at autopsy reveals
three distinct abnormalities, (1) a large loss of neurons in specific
areas of the brain, (2) tangled protein filaments within neurons, and
(3) an accumulation of abnormal amyloid plaques deposited outside of
neurons. Also, some even have elevated levels of aluminum in the brain
which has no known use.
Alzheimer’s disease patients have a severe loss of neurons in the areas of the hippocampus and cerebral cortex that are critical for memory and learning. But besides the loss of neurons there is the degenerating of the axons, axon terminals, and fibrils by the accumulation of amyloid plaques by an abnormal protein called beta amyloid.
Homocysteine’s Possible
Effects On Amyloid Plaques for Increased Risk of Alzheimer’s
Researchers have found a link between the level of homocysteine and
the degree of accumulation of amyloid proteins in the brain. When there
is a combination of low folate and high homocysteine levels amyloid
beta’s effects may be enhanced increasing the risk of Alzheimer’s disease.
Folate and Healthier Homocysteine
Levels
The higher amounts of folate in the study from the combination of food
and supplements correlated to a lower level of homocysteine. This in
turn suggests that a higher level of folate would result in a lowered
risk of Alzheimer’s disease.
Advantages of Bioactive
Folate Compared to Folic Acid
The form of folate that was added in 1998 to the grains and cereals
because of dietary folate deficiencies was folic acid, a synthetic oxidized
folate not normally found in plants and animals. It is not bioactive,
ready to be used by the body, and is also the most commonly used form
in vitamin supplements. This synthetic form of folate must be converted
to tetrahydrofolate by the intestines and the liver before the body
can use it for essential folate-dependent metabolic reactions.
Folic Acid Deficiency
is Very Common
Even though folic acid occurs widely in food it is the most common deficiency
in the world. This is due in part to eating too many processed foods,
and failure eat to eat enough of the natural unprocessed whole plant
foods that contain folic acid. Some natural whole food sources where
folic acid is found in high concentrations are green leafy vegetables
such as kale, spinach, beet greens, and chard. Some other food sources
include whole grains, root vegetables, cabbage, broccoli, cauliflower,
avocados, oranges, asparagus, legumes, sesame seeds, and nuts such as
filberts, hazelnuts, cashews, walnuts, and almonds. Folic acid is very
sensitive and destroyed easily by light and heat so it is important
to eat foods high in folic acid with as little cooking as possible,
including micro waving. 1
People Are Not Converting
Synthetic Folic Acid Into the Bioactive Form
Because of this worldwide deficiency of folic acid grains and cereals
have been fortified with synthetic folic acid as mentioned earlier since
1998. Many people also take supplements, such as a multiple, for insurance
against any possible shortage of a vitamin or mineral, which in this
case would be folic acid. However, what people don’t realize is that
this synthetic form of folic acid added to food and put into supplements
is not being effectively absorbed and converted into the bioactive form
for use by the body. Factors contributing to the poor absorption and
conversion process and interference to its activity are mineral and
enzyme deficiencies, poor bowel and liver health, bowel and liver disease,
processed and cooked food, chlorine and sodium fluoride, alcohol, smoking,
and medications such as NSAIDS and antibiotics, oral contraceptives,
aspirin, levodopa/carbidopa (Sinemet®), and other drugs that interfere
with folate activity such as estrogens, methotrexate, sulfasalazine,
and trimethoprim, anti-seizure agents, and barbiturates. .
Unconverted Folic
Acid Cannot Be Used
Unmetabolized folic acid entering the blood stream and taken up by cells
cannot be used by the body and prevents folate-dependent chemical reactions
involving DNA and RNA increasing the risk of genetic mutations within
cells. Many people do not have the ability to make bioactive folates,
especially L-5-methyltetrahydrofolate (L-5-MTHF) because of gene mutations.
Around 25% of the population have a genetic variant for an enzyme required
to make L-5-methyltetrahydrofolate and are especially susceptible to
a deficiency of folate putting them at higher risk for birth defects
and cancer. And as brought out in the study above insufficient levels
of bioactive folate contributes to higher levels of homocysteine that
also damages the inner linings of blood vessels, increases abnormal
clotting time, oxidizes LDL cholesterol making it more prone to blocking
the arteries, and promotes inflammation adversely affecting the health
of the cardiovascular, neurological, skeletal, endocrine, and digestive
systems.
Superior Patented
Supplemental Form of Bioactive Folic Acid
To insure that the proper level of folic acid is available in a bioactive
form you should take a supplement that contains it. Unfortunately, not
many vitamin supplements have the bioactive forms. Most use only the
synthetic form of folic acid. If you cannot find a multiple containing
the bioactive form of folic acid you can examine Live Well Naturally’s
MultiFuel™ Vitamin/Mineral
Formula. MultiFuel™ contains a 50/50 mixture of 800 mcg of two bioactive
forms of folic acid, folinic acid and L-5-methyltetrahydrofolate (L-5-MTHF).
Patented Form of Bioactive Folate
The L-5-methyltetrahydrofolate (L-5-MTHF) is a form providing a stable,
pure, crystalline L-5-MTHF monoglutamate. It requires no conversion
to be absorbed in the small intestine unlike synthetic folic acid which
must first be reduced to tetrahydrofolate (THF) and then be joined with
either a methyl or formyl group in the intestinal lining. Because this
reduction process is quickly exhausted those taking more than 400 mcg
daily will have high levels of metabolically inactive folic acid in
the blood and urine. Most natural occurring folates are either mono
or polyglumated derivatives of L-5-MTHF and are converted and absorbed
by the small intestinal lining as L-5-MTHF.
The most common form of folate circulating in the blood is L-5-MTHF and is transported to the liver, brain, and other body tissues. It is the only form that crosses the blood brain barrier along with other folates being essential for normal brain development, growth, and function. The active form of L-5-MTHF polyglutamate is part of the methylation cycle supplying the methyl group needed for the conversion of the toxic amino acid homocysteine to the metabolically crucial amino acid, methionine.
L-5-MTHF Reduces Risk
of Masking a B12 Deficiency.
One of the results of a B12 deficiency is reduced red blood cell production
and anemia. Synthetic folic acid can mask a B12 deficiency because it
can reverse anemia but cannot prevent or reverse the neurological symptoms
of a B12 deficiency which could result in nerve damage. However,
folate in the bioactive form of L-5-MTHF must first be converted to
tetrahydrofolate in a B12 dependent reaction before it can be used by
the body in other folate-mediated reactions which includes red blood
cell production. As a result this makes the bioactive form L-5-MTHF
less likely to mask a B12 deficiency and more appropriate to use than
the synthetic form of folic acid as a supplement.
MultiFuel™ Vitamin/Mineral
Formula Iron Free
As the article brought out it is important to supplement with a bioactive
form of folate. If you look at your multiple and others in the stores
you will have to look hard and long to find a multiple that contains
the bioactive form of folate. While I sell supplements I never try to
use my newsletters to push my supplements on people. People sign up
for the newsletter to read about information that can help them to stay
healthy, and improve their health and quality of life. But from time
to time I may have to mention one of my supplements. In this case it
is MultiFuel™ a multiple that contains high quality vitamins, minerals,
and antioxidants, and two bioactive forms of folate, L-5-methyltetrahydrofolate,
and folinic acid.
B12 Works with Folate
to Maintain Healthy Homocysteine Levels
It is just as important to supplement with the biocative form of B12
as it too is very difficult to convert and absorb in the synthetic form,
cyanocobalamin. However, MultiFuel™ contains not only one bioactive
form of B12 but two, methylcobalamin and S-adenosylcobalamin. And if
you look at your multiple it most likely is the synthetic B12, cyanocobalamin.
While some multiples may contain the bioactive form of methylcobalamin,
although there aren’t many, you will be hard pressed to find any that
contain S-adenosylcobalamin. To demonstrate the importance of B12 and
folate in the control of homocysteine one study showed that even when
the level of homocysteine was within normal values the addition of the
combination of B12 and folate brought their levels down even more.
2
Bioactive Forms of
B12 and Folate For Increased Absorption and Effectiveness
As you will recall in the article an elevated level of homocysteine
has a strong link as a contributing factor to Alzheimer’s disease, as
well as to other diseases such as cardiovascular, neurological, skeletal,
endocrine, and digestive. B12 works with folate in the metabolic processes
of converting the toxic homocysteine into the usable amino acid methionine,
reducing the risks of these diseases. That being the case it would be
of great benefit to supplement with the bioactive forms for increased
absorption and effectiveness.
References:
Source of Study:
Archives of Neurology
January 2007, Volume 64, Pages 86-92
“Relation of Higher Folate Intake to Lower Risk of Alzheimer Disease
in the Elderly”
Authors: J. Luchsinger, M-X. Tang, J. Miller, R. Green, R. Mayeux
1. Baily, L. B., Folate in Health and Disease, Marcel Dekker, New York, N.Y., 1995
2. Nillson K., et al., Plasma homocysteine in relationship to serum cobalamin and folate in a psychogeriatric population. Eur J Clin Invest 24, 600-606, 1994
Marieb, E. N., R.N. Ph.D (1992)
Human Anatomy and Physiology. (2nd ed.) Redwood City, CA:
The Benjamin Cummings Publishing Co. Inc.
Tortora, G. J., Grabowski,
S. R., (1996) Principles of Anatomy and Physiology (8th ed.)
New York, N. Y: Harper Collins Publishing Inc.
Holford, P., (1999) The Optimum Nutrition Bible Berkeley, CA: The Crossing Press
Murray, M. T., N.D. (1996) Encyclopedia of Nutritional Supplements Rocklin, CA: Prima Publsihing
DISCLAIMER: The information in this article is for educational purposes only, and is not intended to provide medical advice which should always be obtained from a qualified health practitioner, and has not been approved by the U.S. FDA.
