New data from a large placebo-controlled clinical trial investigating the effect of daily vitamin D and omega-3 use indicates the supplements may reduce the risk of developing autoimmune disease. At the five-year follow-up, the trial found those taking vitamin D alone, or in conjunction with omega-3, showed lower rates of autoimmune disease compared to those taking placebo.
Called VITAL, the ongoing trial has enrolled more than 25,000 participants who were randomly assigned to one of four groups: vitamin D and omega 3 (2,000 IU plus 1 gram of fish oil per day), vitamin D plus placebo, omega-3 plus placebo, or double placebo. At the time of recruitment the participants were aged over 50 and generally healthy.
This latest analysis of the trial data looked at the emergence of newly diagnosed autoimmune diseases during the five-year trial. Autoimmune diseases in the trial included rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis, and inflammatory bowel disease.
Overall, after five years, those taking either vitamin D alone or vitamin D alongside omega-3 displayed significantly lower rates of autoimmune disease compared to those in the placebo group. Little difference was seen in rates of autoimmune disease between the placebo group and those taking omega-3 alone, suggesting the benefits detected were primarily due to vitamin D supplementation.
Another important finding was the longer the trial went on, the lower the risk for autoimmune disease in the vitamin D group. Looking at the data from just the last three years of the trial saw 39 percent fewer cases of autoimmune disease in the vitamin D group compared to placebo. This suggests the greatest benefits of vitamin D supplementation in terms of autoimmune disease comes from a cumulative effect over several years.
“This is the first direct evidence we have that daily supplementation may reduce AD [autoimmune disease] incidence, and what looks like more pronounced effect after two years of supplementation for vitamin D,” said senior author Karen Costenbader.
“We look forward to honing and expanding our findings and encourage professional societies to consider these results and emerging data when developing future guidelines for the prevention of autoimmune diseases in midlife and older adults.”
This study is, of course, not without limitations. Despite the large number of trial participants and the robust protocol there was a relatively small volume of autoimmune disease diagnoses. Due to the slow onset of many autoimmune diseases a longer follow-up will be necessary to better understand the efficacy of these supplements as preventative tools.
The trial also solely focused on older healthy adults so there is no indication the results are transferable to younger populations or those already diagnosed with autoimmune disease. However, Costenbader is relatively comfortable recommending the vitamin D/omega-3 combination to those over the age of 50 looking for ways to reduce their risk of autoimmune disease.
“Now, when my patients, colleagues, or friends ask me which vitamins or supplements I’d recommend they take to reduce risk of autoimmune disease, I have new evidence-based recommendations for women age 55 years and older and men 50 years and older,” noted Costenbader. “I suggest vitamin D 2,000 IU a day and marine omega-3 fatty acids (fish oil), 1,000 mg a day – the doses used in VITAL.”
Rich is based in Melbourne, Australia and has strong interests in film, new media, and the new wave of psychedelic science. He has written for a number of online and print publications over the last decade while also acting as film critic for several radio broadcasters and podcasts. Rich was Chair of the Australian Film Critics Association for two years (2013-2015) and completed a Masters degree at the University of Melbourne. Since joining the New Atlas team three years ago Rich’s interests have considerably broadened to examine the era-defining effects of new technology on culture and life in the 21st century.
Many people don’t think about integrating folate or folic acid into their diet until they’re trying to get pregnant, which is an unfortunate oversight. In fact, a new scientific study just further affirmed the fact that folate is an important nutrient and key to maintaining optimal health at all phases of life. Here’s what you should know about the importance of eating folate-rich foods daily.
What is folate, and what is the difference between folate vs. folic acid?
It also helps a baby’s brain, skull, and spinal cord develop properly, which is why folate is so closely associated with the conception and pregnancy periods. On the other hand, folic acid is the synthetic version found in supplements and fortified foods. It’s important to note that folate is not made by the body, which makes it an essential nutrient that we must get from outside sources, meaning foods rich in folate
Whether you’re consuming folate or folic acid, in order to reap these benefits, the nutrient will need to be converted into an active form. This process is far more likely to happen when you are getting the vitamin naturally from folate foods versus folic acid supplements. “This is because folate is converted into its active form in the digestive system before entering the bloodstream.
With folic acid, however, not all of it is converted in the digestive system,” explains Lyssie Lakatos, RDN, CDN, CFT and Tammy Lakatos, RDN, CDN, CFT, The Nutrition Twins and founders of 21-Day Body Reboot. “Instead, some needs to be converted in the liver and in other tissues, which is not an efficient process. Unmetabolized folic acid can sit in the bloodstream for a long time and it can’t be utilized, which has been associated with a number of health problems.”
The new research findings on folate deficiency
Now, there is one more key reason to zone in on folate. A new study published in Frontiers in Neuroscience—a systematic review and meta-analysis of the association between folate and Alzheimer’s Disease—found that there is evidence to show that the vitamin plays an important role in the development of Alzheimer’s Disease. This is critical because Alzheimer’s is, today, the most common type of neurodegenerative disease leading to dementia in the elderly.
Around 60 publications were included in the review, each of which had a sample size ranging from 24 to 965, to comprehensively evaluate the associations between Alzheimer’s and folate levels. The results showed that the folate level of Alzheimer’s patients was lower compared with that of the healthy controls. Therefore, researchers concluded that there’s plausible reason to think that a deficiency of folate increases the risk for Alzheimer’s and, arguably more importantly, sufficient daily intake of folate could reduce the risk of Alzheimer’s.
“From the information in this study and considering the other known benefits of folate for our body and brain, it is encouraged to have sufficient daily intake of folate to reduce risk of Alzheimer’s,” says Lauren Hubert, MS, RD.
Amy Cameron O’Rourke, MPH, CMC, an advocate for senior care in the U.S. and the author of The Fragile Years echoes this. “I have been a long time believer in a deficient diet being a risk factor for many medical diagnoses and Alzheimer’s is no exception. Folate aids in the growth of healthy cells, so it isn’t difficult to make the leap to see proper folate as a protective factor for Alzheimer’s.” O’Rourke goes on to say that exercise, along with being socially engaged and following an anti-inflammatory diet (or a diet with less processed food), are some other effective ways to prevent Alzheimer’s.
The recommended daily amount of folate for adults is 400 micrograms (mcg). For those who are pregnant, it is about 600 -1000 mcg. “If a person is eating a balanced diet, they are likely getting enough folate,” says Lauren Manaker, MS, RDN, LD, a registered dietitian for Zhou Nutrition.
She goes on to advise that women of childbearing age consider taking a supplement and eating fortified foods to make sure they’re reducing the risk of developing certain birth defects should they become pregnant. In general, however, she affirms that supplements are a supplement to a healthy diet.
“It’s also important to note that like anything in life, you can consume too much folate and that can have other impacts on the body,” says Hubert. “For most people, you don’t need folic acid supplementation and should instead focus on getting folate through natural food sources in your diet.” Luckily there are many non-processed, anti-inflammatory foods that contain folate. Here’s a look at five of the best, according to The Nutrition Twins.
The top 5 folate foods
1. Edamame
“One-half cup cooked edamame has 241 mcg folate, or 60 percent of the daily requirement. It makes a delicious snack or appetizer that provides a prolonged energy boost thanks to the combination of fiber and protein, which help to keep blood sugar stable. You can toss edamame beans on salads, too.”
2. Lentils
“One-half cup of cooked lentils has 179 mcg of folate—almost half of the daily requirement. Lentils are a great source of protein and fiber and are a super satisfying source of plant protein. They’re wonderful to add to the diet as their fiber helps to keep you regular and improve gut health. They’re also a great source of iron, which is particularly good for vegetarians who often struggle to get enough. They make a great substitution for meat in tacos, salads, and soups.”
3. Asparagus
“One-half cup asparagus has 164 mcg, or 40 percent of the daily requirement. It’s also rich in fiber, and is a great source of anthocyanins—these antioxidants help protect the body from the damage caused by free radicals, which can lead to chronic disease. Another fun reason to add it to the diet: asparagus contain the amino acid asparagine, which acts as a natural diuretic, helping to flush excess fluid and salt from your body.”
4. Spinach
“A half cup of steamed spinach provides 131 mcg of folate, which is around one third of the daily 400 mcg requirement. It promotes immune and skin health since it’s rich in vitamin C. Spinach is also great for vegetarians and vegans since it’s a rich source of iron and calcium, two nutrients that most people associate with animal products.”
5. Black Beans
“One half cup serving of black beans contains 128 mcg of folate, roughly a third of the daily requirement. Add beans to your salad, make bean soup, chili, burrito, bean salsa, or a casserole and you’ll also get a hefty dose of fiber, antioxidants, plus protein.”
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