For years, mounting research has indicated that consumption of folic acid is associated with a lower risk of developing heart disease and stroke.

Now the scientific evidence is strong enough to justify using folic acid as a cheap and simple way of combatting heart disease and strokes say researchers.

Among medical experts, debate continues over whether or not elevated homocysteine (an amino acid implicated in the development of arterial disease) levels in the blood cause heart disease and stroke, and whether or not folic acid, which lowers homocysteine, can help reduce the risk of these disorders.

Heart expert Dr. David Wald and colleagues set out to clarify the issue. They examined all the evidence from different studies to see whether raised homocysteine really causes cardiovascular disease.

Some studies looked at homocysteine and the occurrence of heart attacks and strokes in large numbers of people (cohort studies), some focused on people with a common genetic variant which increases homocysteine levels to a small extent (genetic studies), while others tested the effects of lowering homocysteine levels (randomized controlled trials).

Published in the November issue of the British Medical Journal, their conclusion that homocysteine is a cause of cardiovascular disease explains the observations from all the different types of studies, even if the results from any one study are, on their own, insufficient to reach that conclusion say the authors.

Since folic acid reduces homocysteine concentrations, it follows that increasing folic acid consumption will reduce the risk of heart attack and stroke.

The authors, therefore, feel that there is now enough evidence to recommend that we all make certain that our diet is rich in folic acid.

Folic acid and the related folate are forms of vitamin B that are available both in food and in supplements. Leafy vegetables such as spinach and turnip greens, dried beans and peas, cereal products, sun flower seeds and other fruits and vegetables are good sources of folate. Some breakfast cereals are fortified with up to 100 percent of the recommended dietary allowance (RDA) for folic acid.