Folic Acid Fortification and Stroke in the US & Canada.





Related Monographs

Consumer Data: Folic Acid Stroke
Professional Data: Folic Acid Stroke


The term "stroke" or "paralytic stroke" is commonly used to describe a sudden problem with the brain that is usually related to its blood supply. A "stroke," therefore, can be due to ischemia (decreased blood supply), infarction (interrupted blood supply), or hemorrhage (severe bleeding), and usually means that there is some kind of permanent problem with the nervous system. All three of these causes (ischemia, infarction, or hemorrhage) would be due to cerebrovascular disease (disease related to the blood supply to the brain). Homocysteine is an amino acid that may be a significant risk factor for cardiovascular diseases. Folic acid has been shown to decrease levels of homocysteine.

Folic acid occurs in a wide variety of foods. Best sources include dark green leafy vegetables, brewer's yeast, liver, and eggs. Other good sources are beets, broccoli, brussels sprouts, orange juice, cabbage, cauliflower, cantaloupe, kidney and lima beans, wheat germ, and whole grain cereals and breads. The body's "friendly" intestinal bacteria also produce folic acid.

In 1998, the United States and Canada fully executed folic acid fortification in grain products. In a recent study published in the journal Circulation, investigators stated that because of this fortification, lower homocysteine levels may lead to an overall decrease in strokes in the US and Canada. Researchers evaluated stroke related death rates before and after the fortification in a population-based cohort study. Also, stroke trends were recorded in England and Wales, where folic acid fortification is not required. The results showed that the mortality rates declined each year in the US and in Canada. These results were not seen in Wales or England. The authors concluded that the results are consistent with the hypothesis that folic acid may help reduce stroke-related deaths.1


1. Yang Q, et al. Improvement in Stroke Mortality in Canada and the United States, 1990-2002. Circulation. Mar 2006;113:1335-43.