Natural Health

It has been reported that supplements of folic acid may prevent age-related hearing loss in older men and women. This is according to a new double-blind, randomized, placebo-controlled trial from the Netherlands.

The study published in Jan 2nd, 2007 issue of the Annals of Internal Medicine, states supplements of folic acid may prevent age-related hearing loss in older men and women. In a Netherlands trial, the study followed 728 men and women between the ages of 50 and 70 who were to receive either a folic acid supplement (800 micrograms per day—the level found in an anti-aging formula, Vita-Che) or placebo for three years.

According to Jane Durga, lead author, and her colleagues from Wageningen University and Wageningen Centre for Food Sciences, and University Hospital Maastricht, said that in the low frequency regions the folic acid-supplemented group exhibited lower age-related hearing loss.

Durga holds high hopes for the use of folic acid in countries currently not fortifying their diets with folic acid. Durga said, "Considering that the folate status of older adults is generally low in countries without folic acid fortification programs, our findings suggest a possible way to diminish the public health burden of hearing loss in those countries.”

Folate is found in foods such as green leafy vegetables, chickpeas and lentils. We have recognized through an overwhelming body of evidence that folate deficiency in early pregnancy (unfortunately not all pregnant women took advantage of dietary folate) is linked to an increased risk of neural tube defects (NTD) – most commonly spina bifida and anencephaly – in infants. This is what led to the mandatory fortification programs that we are now learning may be helping in areas other than NTD.

At the start of the Netherlands study, the average threshold for hearing in the low frequency range (0.5 to 2 kHz) was 11.7 decibels (dB), and 34.2 dB in the high frequency range (4 to 8 kHz).

At the end of the study, the thresholds had increased for both folic acid and placebo groups, meaning a louder noise was required before the participants heard the noise. However, the increase was lower in the supplemented group in the low frequency range (1.0 versus 1.7 dB increase for folic acid versus placebo groups, respectively).

Researchers suggested that the hearing loss may be linked to homocysteine levels, which could be reduced by folic acid supplementation.

Durga, focused on older men and women with average plasma total homocysteine concentrations of 13 micromoles per liter or more and vitamin B12 levels of at least 200 picomoles per liter.

Normal homocysteine levels are defined as between five and 15 micromoles per liter of blood. This placed the study participants at the upper end of the ‘normal’ bracket.

What is homocysteine? It’s a metabolite (meaning a product of metabolism that is generally required for normal growth, development and reproduction). Like I was saying it’s a metabolite of the essential amino acid methionine.

It’s good to have low levels of homocysteine in the body, high levels are suspected of causing heart diseases like angina, stroke and deep vein thrombosis, in addition to over 100 other medical conditions.

The results were stated by the researchers: “Folic acid supplementation slowed the decline in hearing of the speech frequencies associated with aging in a population from a country without folic acid fortification of food. The effect requires confirmation, especially in populations from countries with folic acid fortification programs.”

Robert Dobie from the University of California, Davis said that if such a benefit could be applied generally then a five-decibel decrease in age-related hearing loss might be observed over a 20-year period. This would lead to a subsequent significant reduction in the need for hearing aids.

Certainly bonds well for the continuation of mandatory fortification and makes a good case for supplementation—especially for seniors.

Can older people taking folic acid supplementation had improved memory and ability to process information, as well as a slower rate of age-related cognitive decline?

Jane Durga, the lead author, wrote in the Jan. 20, 2007 issue of the Lancet: “In 818 older adults, daily oral folic acid supplementation for three years beneficially affected global cognitive function, and specifically memory, and information processing: functions that are sensitive to aging.”

While we know that cognitive performance declines naturally with age, the results of Folic Acid and Carotid Intima-media Thickness (FACIT) trial suggests that this could be slowed by folic acid supplementation.

The same study randomly assigned the subjects between the ages of 50 and 70 to receive either a folic acid supplement (800 micrograms per day) or a placebo for three years. And, all of the other parameters applied too (upper “normal” ranges of homocysteine and B12 levels of at least 200 Picomoles per liter.)

They used a battery of tests to assess cognitive function, including the word learning test, concept shifting test, stroop color-word test, verbal fluency test, and the letter digit substitution test. The mini-mental state examination to screen for possible dementia; but it was not used for the study outcome.

The researchers reported: “Three-year folic acid supplementation confers an individual the performance of someone 4.7 years younger for memory, 1.7 years younger for sensory motor speed, 2.1 years younger for information processing speed, and 1.5 years younger for global cognitive function.”

They also report that delayed recall for the folic acid supplemented group was similar to a performance of someone 6.9 years younger.

The researchers summed it up this way: "We have shown that 3-year folic acid supplementation improves performance on tests that measure information processing speed and memory, domains that are known to decline with age. [Our study was conducted] in older adults with raised total homocysteine concentrations.”

The researchers wanted to be sure that the public knew they recognized that “the effect of folic acid supplementation might be greater than would be expected in populations with lower plasma total homocysteine concentrations – eg. in countries such as the USA, with mandated fortification of flour with folic acid.”

They made it clear that all of the participants had sufficient levels of Vitamin B12 because Vitamin B12 deficiency can cause a form of anemia in elderly people, which can cause dementia.

Durga asked and answered the question most of us want to know: “Will folic acid supplementation lead to a reduced incidence of dementia?”

Durga answered this way: “Although folic acid improved performance on tests of memory, including delayed recall, additional research is needed to determine whether folic acid supplementation can reduce the risk of mild cognitive impairment or Alzheimer’s disease.”

There was an editorial comment from Martha Morris and Christine Tangney from Rush University Medical Center, Chicago, who said, in an accompanying editorial, the FACIT trial was “well-designed and unique in its approach of targeting individuals who might benefit from folate supplementation.”

They also agreed with others that the trial warrants further investigation.

These two new areas of hope(age-related hearing loss and mental decline) certainly do make folic acid an important target nutrient especially when coupled with the information of it potential impact on heart disease and stroke as presented in the 2002 British Medical Journal.

A study from the Wolfson Institute for Preventive Medicine in London found that folic acid can help offset heart disease and stroke by reducing levels of homocysteine (a known risk factor since the 1970’s) in the body.

High homocysteine levels can be caused by various factors, including shifting hormone levels (like menopause), genetics and vitamin B deficiencies. Taking extra folic acid -- along with vitamin B6 and B12 has been shown to bring levels back to normal.

According to the study published in the British Medical Journal in 2002 it was estimated that even a very small decrease (3 micromoles per liter) in homocysteine levels can reduce your risk of coronary heart disease by 16 percent and cut your stroke risk by 24 percent.

Pretty impressive statistics. These statistics seem to be born out by the following results based on what one can call a “Reality Check”, because it deals with known statistics of countries using folic acid fortification as opposed to those not using it. Perhaps these facts will be the determining factor in your realization that folic acid is necessary for your general well-being.

When was mandatory fortification introduced in the U.S. and Canada?

Mandatory fortification of certain foods with folic acid was introduced in the US and Canada in 1998.

The reason this was implemented was to reduce birth defects; and, that the program has been successful in cutting the number of children born with neural tube defects by over 25 per cent.

Researchers from the US Centers for Disease Control and Prevention (CDC) compared stroke mortality rates in the United States and Canada for 1990 to 1997 ( the period before fortification), and 1998 to 2002( the period after fortification), with stroke mortality rates in England and Wales.

The study based stroke mortality rates on statistics from the national centers for health statistics in the respective countries. And, that the reported rate of decline in the number of deaths from stroke in the U.S. between 1990 and 1997 was .3% as compared to 2.9% after introduction of the mandatory fortification program.

In Canada, the fall in stroke mortality was even more dramatic, with the average decrease being 1% between 1990 and 1997, and 5.4 per cent between 1998 and 2002.

What types of trends were observed in countries not receiving fortification?

The researchers reported that in England and Wales, the death rate due to stroke was actually greater for 1999 to 2002(this was the period in which deaths trended down in the U.S. and Canada presumably due to folic acid fortification) than for 1990 to 1997.

The lead author, Quahne Yang, wrote in the journal, Circulation (Vol. 113, pp. 1335-1343):“The epidemiological analysis presented here certainly does not establish causality, but the trends we observed are consistent with the hypothesis that folic acid fortification is contributing to a reduction in stroke deaths.”

As you might suppose, the review of the compiled complete medical records from the United States participants revealed that the levels of homocysteine decreased and folate levels in the blood increased for all age groups and races studied after the introduction of fortification. This gives support for the hypothesis that folic acid may reduce stroke mortality.

Yang went on to say, “If folic acid fortification is responsible for even a fraction of the accelerated improvement we observed, this public health benefit is an important bonus to the reduction in neural tube defect rates previously demonstrated.”

The value of folic acid in the prevention of birth defects is well known, making the taking of folic acid supplementation vital to young women and possibly even men of child bearing age. Perhaps the information presented will impress upon you the potential health benefits of taking folic acid as you age.

So, whether you’re young enough to take Children’s Chewable Vitamins or Vita One or your young at heart enough for our anti-aging formula, Vita-Che, or you are a woman with special needs that call for VitaWoman you’ll get folic acid at optimum, supportive levels.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.