Let Them Eat Cake

Folate, a B vitamin found almost ubiquitously in foods, is required for de novo nucleotide synthesis and methylation reactions in our body. A shortage of folate can lead to macrocytic anemia, however, extra folic acid, the synthetic form of folate, is considered to be a modern day panacea for a variety of diseases, specifically vascular disease. This review summarizes the evidence from randomized controlled trials and illustrates the weak foundation on which health claims regarding the possible beneficial effect of extra folic acid for vascular disease are based. It is prudent for public health policy makers to await trials--the conventional golden standard by which to test causality--before deciding on folic acid fortification for the general population.