“The Folic Acid Debate”
Why it’s important to not listen to everything you hear! Think critically!
Folic acid has been claimed to do numerous things, from lowering allergies, lowering risk of multiple types of cancer, to decreasing neural tube defects in babies. Folate works epigenetically through methylation. Like other “health claims” there has been much debate on whether increasing a nutrient that alters the DNA is beneficial or harmful… Here are two articles with opposing views on folate and folic acid:
What are your thoughts? Would you advise family, friends, or patients to take folic acid? Knowing about nutrition claims and the epigenetics, what do you think is the best way to implement folate into a healthy diet, if at all?
A few other views on the Folate vs. Folic Acid debate: Just for your own interests..
While I think the author opposed to the vilification of folate/folic acid has a point, I don't think the government should necessarily be requiring the fortification of many of our foods (causing other foods to be fortified in their wake) because there are other ways to get that folate/folic acid. Without a doubt, eating a balanced diet is the best to get it. If this were not a bountiful country where most people could not get the foods they would need to ingest the daily allowance of folate/folic acid, then by all means the government should weigh risks and consider the fortification of foods. To fortify foods (especially those foods in which one can easily eat more than one serving size such as most junks foods) because people in this country lack the nutritional education to know what to eat has the potential to cause overdose scares, and possibly worse. It also gives people less choice over what kind of things they take into their bodies. Many do not trust the government additives that are put into food, water, etc. So, I would probably recommend people, unless pregnant (though still questionably,) to just get their folate through a healthy diet.
ReplyDeleteThe second article criticizing the studies published in the Journal of the American Medical Association makes an important point. We as consumers should be critical of what we hear, even if it's coming from famous or reliable sources. I do still think that a diet rich in folate is important for pregnant women and for other populations that are susceptible to low folic acid levels. However, too much of anything usually isn't a good thing for the body. Some cereals are so heavily fortified with folic acid that one serving (3/4-1 cup without milk) provides 100% of the the Daily Value. That's pretty scary considering a lot of other carbs we eat throughout the day are fortified with folic acid as well. The problem may be that we consume too many foods fortified with folic acid (e.g. processed foods), but not enough natural folate-rich foods (e.g. leafy greens). If anything, I would say that higher consumption of processed foods leads to a higher risk of developing cancers than a diet rich in folate. I'm a little skeptical of the idea that excess folic acid consumption can directly lead to certain cancers but I do think that excess consumption is not beneficial in the long run.
ReplyDeleteI think that Andrew and Suzann made some great points. It's terrifying to read Beil's article on Folic Acid and the risk of developing colon or lung cancer, but then reassuring to read Saul's opposing article. It just goes to show how complicated science- and particularly epidemiology- can be. I do not believe that scientists and nutritionists should draw such heavy and life-changing conclusions from one study that showed an increased risk in developing cancer as consumption of folic acid increased. In the world of science, we know that one study is not enough evidence. But we need to stop and think about why these results occurred in such a study. Saul remarks that 94% of the participants were smokers, hinting that smoking was a confounding variable. Smoking is what causes cancer, he states. But I would be interested in reading the results of a study that excludes the smoking population and generally focuses on healthy people. Would the results change, as Saul suggests? Saul also states how "one proton doesn't cause cancer". But I would argue that it's not the proton but the change in structure from folate to folic acid that investigators are concerned with. Saul's article makes good points but it is also lacking scientific or epidemiologic evidence to support his case.
DeleteAndrew states that the government shouldn't necessarily require the fortification of many of our foods, which I can understand. Although folic acid is effective in preventing neural tube defects such as Spina Bifida or Anencephaly in newborns, perhaps it isn't completely necessary to enrich all our grains with it. I am a proponent for the human diet to subsist mainly on natural foods-- fruits, vegetables, wheat, dairy, poultry, etc. The more processed that foods become, the less they feel "truly healthy". Suzann makes the point that natural folate-rich foods should be consumed more. I'm not sure if I would largely support a movement to end fortification of cereals and grains, but I do feel that consuming folate in natural folate-containing foods would probably be better for the human body altogether.
Overall, I would advise family and friends to consume plenty of vegetables, fruits, lean meats, whole grains on a daily basis, getting most of their daily vitamins and minerals from these foods rather than turning to vitamin supplements or folic acid fortified foods. But I love cereal and I'm not going to stop consuming it because of the folic acid scare. Cereal is a healthier alternative to eating sweets or junk food, so I don't want to get too paranoid about folic acid. Everything nowadays has been "shown to increase the risk for or cause cancer". It's a nutrigenomic headache, that's for sure!
Despite all our good intentions to encourage people to eat whole grains and get their folate through leafy dark green vegetables and other natural sources, there's unfortunately a disconnect between what the public health community has been recommending (for decades!) and what the vast majority of the public is actually eating. One of the simplest fixes could be to simply decrease the amount of folic acid present in multivitamins - especially when many people are getting more than enough from their diet of processed enriched grain products. A multivitamin should function as a supplement for the nutrients you don't get enough of otherwise, and shouldn't be a substitute - especially because folic acid is not the naturally occurring vitamin our bodies need.
DeleteWhile it may indeed be true that too much folic acid can be harmful (though the research is still relatively contradictory on this point), it is much more firmly established that a folic acid deficiency is associated with neural deformities. More importantly, in order to prevent these deficiencies, women need to be taking folic acid before they become pregnant (and thus supplementation only during pregnancy is not a viable alternative). As is the case with many public health interventions, a cost-benefit analysis must be undertaken. Is it worth the potential expenses and health risks to continue to enrich many food products? Or are the expenses and risks of neural tube defects more detrimental to the healthcare system?
I couldn't agree more with Susann. All research articles much be taken with a grain of salt. Was the research study a correlational study or an intervention study? Were there any possible confounding variables? Does the hypothesis make sense to begin with?
DeleteI was particularly alarmed with the statement in the second article that JAMA is biased against vitamins and that it recieves funding from pharmaceutical companies. I don't mean to wag a finger at funding, but doesn't funding in general call into question the integrity of the thing being funded? At the very least JAMA may find itself publishing more articles against vitamins than other studies. Funding certainly shouldn't be cut, but with both papers against folic acid appearing in JAMA, I have to step back and ask if their authors tried to get published anywhere else and were refused.
I think it is most important for the general population to be aware of folic acid and the potential benefits/harms to the vitamin. It seems that not enough research has been done to definitively say that folic acid is positively associated with certain cancers, like colon cancer which was mentioned in the first article. However, not enough research has been done showing that fortifying food with folic acid is beneficial either. Until more research is done to help better understand the effects of folic acid, it is most important for consumers to be aware of the amount of folic acid that they are consuming each day. Like the second article mentioned and Suzann briefly mentioned, there is not an issue with consuming foods that are naturally rich with folate. The debate is focused on whether or not foods that are fortified with folic acid could cause negative side effects. It seems that eating a healthy, well-balanced diet is the best way to control folic acid intake.
ReplyDeleteI think that people in general should be aware of this vitamin. Most people do know about it and pregnant women certainly do. However, I don't think there is enough evidence out there yet that folic acid actually causes cancer. Like the second article said, it's much more likely that a scientist made a mistake because of the 1.8 million animal species that all eat a lot of folate from plants on a regular basis and usually do not die from cancer. I would recommend that pregnant women ensure they are getting enough folic acid daily, but not to worry too much about it. Unless you're only eating fortified cereal all day every day and are also pill popping like a celebrity who dropped out of rehab, I don't think this poses much of a threat. I agree with Alyssa in the fact that eating a well balanced diet is the best way to control your folic acid intake. I would advise people to keep eating healthy greens and taking their multivitamin because much more research needs to be published before anyone should freak out about this potential harm.
ReplyDelete- Caroline Booth
The first thing that I thought of after reading these articles was what Professor Salge-Blake always said in Nutrition 201, that too much of any vitamin can be a bad thing. I agree with Alyssa that not enough research has been done and we therefore cannot say for sure whether folate or folic acid is beneficial or harmful. However, I do think that the general population (not including pregnant women) can receive the adequate amount of folate through natural diet. The issue arises when people are receiving too much folic acid through foods that are fortified with folic acid. Whether or not fortified folic acid is related to colon and lung cancer or not I think that as the second article stated people need to be more conscious about what they are putting into their body and too much of anything can simply be too much. The example that Suzanne gave about one serving of cereal providing 100% of a person's Daily Value is ridiculous. As the previous comments stated I think it's best to stick to a well balanced diet in which individuals obtain folate naturally.
ReplyDeleteWhile I agree with Kristen and Suzanne that we are at risk of consuming too much folic acid or folate and that excessive amounts (particularly of supplements) may be injurious, I would be very cautious to make the leap that MSNBC makes. While I understand the idea behind their article, there is also the risk of bias. A headline that says something causes cancer grabs much more attention than a headline that excess supplements may in some cases cause adverse reactions. Though we can consume enough folate to achieve our recommended dietary intake, many foods are enriched because folic acid helps reduce serious birth defects.
ReplyDeleteThough these allegations are serious, they are based on a limited number of studies. Replication is essential to ensure accurate results. While the risk of cancer is severe, the alternative is children with neural tube defects, which are often fatal or severely disabling. Considering that both sides offer serious health risks, further studies are needed to give results free of bias, as the commentary article mentions.
I was not aware that folic acid was a synthetic version for folate, and even though I am not totally convinced that folic acid causes the cancers that they do because that the research failed to mention many confounding factors the researchers did not rule out environmental and hereditary reasons for these cancer. Like many other studies I have ran into to much of anything is going to cause cancer it seems now a days so it is hard to believe anthing that anyone says though I think moderation of most things will at least help in keeping a safe range for the body. Though I did find it interesting that folic acid had a extra proton and that it dissociates , even the smallest change to a molecule can make the biggest difference. It might be true that the liver just process folic acid into folate but the research that was done on rat was probably not long term enough to see a real effect, if there is one.
ReplyDeleteI think that folic acid does help to reduce neural defects in a fetus but I know that a women must be taking it before the baby is even concieved for folic acid to have the best results, since the neural tube is formed very early on in development. What is scary is that along with all the enriched food stuffs that are going around a birth control I had also was enriched with folic acid along with taking vitamins everyday I could also be having to much folic acid. But I was under the impression that what ever your body does not need it will get rid of in your urine and unless folic acid has an effect that traps it in the body, I do not see it being able to cause as much harm as is being shown.
Before even reading the articles, I noticed the source, audience, and purpose of both. The MSNBC "Is your breakfast giving you cancer?" article is written towards the general population, with a goal of reaching as many audience viewers as possible, and provoking new discussion. The orthomolecular article is a scholarly article based on science and molecular biology of foods. It is peer-reviewed by a board of doctors, where the MSNBC article is reviewed by someone in the news industry. Also, the title of the MSNBC article made me skeptical of the information that they were providing, since the article title seemed to be a very general, bold statement. Therefore, I do not think the information in the MSNBC article is portrayed to be truthful, and the author is making way to broad of a statement.
ReplyDeleteAfter reading both articles, I have to agree with the students who commented before me; eating a well-balanced diet will not cause cancer, despite the food manufacturer's addition of folic acid. Of course anything in excess is unhealthy, which is why it is possible to overdose on folic acid if a supplement is taken in addition to a well-balanced diet.
I agree with the comments above- you can't go wrong with a well rounded diet. There is not enough research available to make a diffinitive statement on whether too much folic acid is bad or not, but either way I personally try to get all needed vitamins by eating nutrient rich foods. I believe that nothing is good for you in excessive quantities, and since our country has the resources available we should spend our time and effort creating well-balanced naturally nutritious diets. I think that an article like this can be misleading to the general public because they skew the titles to appear more dramatic than what is actually true and proven. They are trying to attract readers and they know any mention of cancer will call an audience.
ReplyDeleteHaving a well rounded diet is important to get the nutrients we need to live a healthy life. Information about the harms of essentially everything we consume is constantly being given. Therefore, it is important to take in any of this information and analyze it critically. Anything in excess can create damaging effects even though we would normally view somethings as always being healhty or beneficial to us. With all the research on the benefits and need of folic acid during pregnancy it is still a necessity to have the appropriate amount for this purpose. It is important to note the audience authors are trying to reach and if there may some form of bias to the study. The aim seemed to be the general public and including intense diagnosis like cancer was something the authors knew would provoke the reader and make them reconsider recommendations for folic acid. This could be harmful because the information could be twisted and the results given in a way that helps their case and the readers are mislead to the meaning of the information.
ReplyDeleteJust a personal story for the blog that I think people will find interesting. I have eye problems that require me to take a medication that depletes my folic acid consumption. Not only does the folic acid that I consume daily as a supplement replenish the folic acid that I have lost, but also cures the nausea that is often associated with this medication.
ReplyDeleteI have been warned by all of my doctors (which is quite the list) that folic acid is the most important supplement for women when they are trying to get pregnant. I am obviously at a higher risk for neural tube deformities with my fetus if and when I become pregnant, so my doctors are overly concerned that I need to do more than just eat the folic acid through foods.
I have not heard, from any sources in the medical field, that folic acid can be harmful to your health as a woman or a man. In fact, it has been suggested by my healthcare professionals that any growing woman take a supplement to enhance their intake, especially if it means they are not receiving the proper amount through their diet.
I agree with the comments above overall. Taking supplements, first of all, is not as effective as has been thought to be in the past. A very low percentage of the supplement actually gets absorbed in the bloodstream when a supplement is taken orally. However, through foods, absorption is enhanced so that is why vitamins and minerals are often added to foods. I believe that, through the folic acid enhanced foods, an individual does not need a supplement, even if they are women. However, I think when a woman becomes pregnant, that is a different story. Neural tube deformities are very real and can lead to miscarriage or birth defects that extend throughout the lifespan.
As for the cancer debate, I think that not having the study in front of us makes the argument moot. I cannot count the amount of times I will read the NY Times and read a health article claiming one thing, and then, the next day, an article claiming the complete opposite. I would need to see more research on this topic and the study itself to really believe that folic acid causes cancer.
I agree with many of Dana's comments. I have always traditionally been told to get my vitamins and nutrients directly through foods, as they are the best source and most readily absorbed into the body, and if I am having trouble getting particular vitamins or nutrients, to add a supplement in addition to the foods I'm eating. Folate and folic acid have never been main concerns of mine when it comes to getting enough vitamins. Although I do not eat cereal or breads on a daily basis, I do on occasion and consume a multi-vitamin so I believe I am consuming a healthy amount, however the first article has made me consider, what is a "healthy amount". I think that it is important not to take everything that each article writes to be truth, but to use the information as an opportunity to evaluate what I/you are doing. Like the second article, I do find the implications from the first article somewhat confusing and alarming, and I would want to read about the study, its methods, limitations, who put forth the study, etc. Folate/folic acid is not a vitamin that I have ever advocated that I or family members take. I do agree that due to the fortifications being made, that it is absolutely possible that individuals are consuming too high of a level of folate/folic acid, however I think that more research needs to be conducted.
DeleteIn terms of implementing folate/folic acid into the diet, I think it is important that the information being put forth that folate/folic acid contribute to the development of certain kinds of cancer be evaluated and researched further. If it is the case that only high levels are needed for pregnant women, then i think that the FDA should look at no longer refining certain food items, but should have fortified items available as well as more non-fortified items, that way people who do need more folate/folic acid have the option, and people who do not need more will also have options. I also think that perhaps there should be different levels as opposed to standard levels of folate/folic acid in multi-vitamins, so that people do not have to take 12 individual vitamins just to prevent themselves from getting too much folate.
I definitely think more concrete research and evidence needs to be made for there to be a "winner" to this debate. With the msnbc.com article, all the evidence it gives saying that too much folic acid is bad are from observational studies and comparing rates & associations. For all of these studies, there can be so many confounding variables that can factor into why colon cancer or lung cancer increased. There needs to be more scientific research and evidence put forth for the argument to be stronger. But I do agree with the point that it is so easy to overdose on any nutrient/vitamin because of the increased use of supplements. I think that people should refocus on getting their daily nutrients from natural sources instead of looking for the foods that are advertised to give extra boosts of vitamins/nutrients. That just leads to consuming more than you really need.
ReplyDeleteI agree with the comments above which state that a well rounded diet is obviously a good solution to this problem. But the articles and research show that a a diet which involves folic acid is what is recommended for women to avoid neural tube damage to their fetuses. I believe the government has the right idea, it is just being done in the wrong form. Although fortifying the food leads to the risk of overdosing on this vitamin which some say is dangerous some say is not. I believe what the government should do is change the law so that it is not in the air what you can fortify food with, you can't choose folic acid or folate, but you must use folate in its natural form, because one of the youtube videos does point out that there is a synthetic form. Doing this may be the costly option but it is the one that is in the general interest of the population. By doing this you will not have to worry about excess levels of folate since it is natural, and our bodies will know what to do with it. If this does not take place I would suggest people watch their levels of folic acid and avoid multivitamins unless necessary or the mixing of the two. At least until further research is done into the connection between folic acid and cancer, because as the doctor pointed out the JAMA has a conflict of interest in certain areas and has been known to be opposed to multivitamins. I also suggest doing more research into the connection of smoking, since the second article pointed to this as a possible connection.
ReplyDeleteI think everyone makes really good points, and that finding a level of balance between ensuring that a beneficial amount of folic acid is included in an everyday diet while also not overly "stuffing" foods with extra folate/folic acid is ideal. That being said, I think that the author of the article supporting folic acid made an excellent point that studies often overlook (either by accident or intentionally) confounding factors that may have skewed the findings. The example given of the study that initially found a correlation between folic acid and lung cancer was a great case in point. Neither article seemed to argue with the fact that folic acid was very beneficial in preventing (or decreasing the risk of) neural tube defects in fetuses. It seems logical to me that if the vitamin has such a positive effect during pregnancy, it should be encouraged throughout the lifespan instead of just during the nine months a woman is pregnant because the overall positive effects are likely to be greater. Also, even the article skeptical of folic acid suggested that extremely high amounts were necessary to generate a potentially negative result. For these reasons, I would recommend people to continue consuming folic acid (within reason).
ReplyDeleteHowever, I do think it's important to question any/all nutritional recommendations and to not put excessive amounts of any vitamin into multiple food sources for the very reason that its full effects are very difficult to measure. If the government were to change anything, I think it might be helpful to regulate the amount of folic acid allowed to be placed in foods such as white rice or cereals. This way, people could still ingest lower amounts of folic acid without having to worry about potentially negative side effects.
I agree with a lot of what my classmates have posted above. I think that people are more weary of supplements than in the past but the pharmaceutical industry is still a multi-billion dollar industry with some heavy hitting lobbyist. People are presented with so many "health claims" now-a-days because pharmaceutical companies can afford to market these claims even without approval from the FDA; therefore it is so difficult to keep up with what claims have some semblance of truth to them. Supplements are a great way to manage deficiencies or aid healthy development but consumers read the labels of supplements and want the benefits without realizing they already have healthy levels of nutrients and that is when they end up harming themselves. I believe that maintaining a healthy diet can provide the average person with a healthy amount of nutrients and provide them with benefits that supplements cannot, for example phytochemicals. I do believe that there are some specific cases when supplements are necessary including: pregnant women, people with certain deficiencies, environmental barriers to acquiring nutrients are just a few examples.
ReplyDeleteI'm not completely convinced that folic acid causes cancer. I think that a lot more research needs to be done in order to get a definitive answer because it seems as though there is too much debate going on. This argument can go either way--it's just up to the reader to decide who to believe I guess. But whether or not one believes that folic acid causes cancer, it's always a smart idea for people to read the labels and understand what they are putting in their bodies. As Kristen mentioned, too much any vitamin can cause positive and/or negative effects. So I think it's safe to say that having a healthy, well-balanced diet is the best way to implement folate without risking the harmful effects of folic acid (whether it is cancer or not). This is a great way to lower one's risk until researchers come up with a definitive answer regarding folic acid and its effects.
ReplyDeleteI agree with Danielle that more research needs to be done and also that it is up to the reader to make a logical conclusion. As readers, we need to understand that not everything we read is true. We have a responsibility to look at the information we receive and analyze it. Where is this information coming from? How much research backs the conclusions? Who did the research and what were their motivations? These are all things we need to consider when deciding what information to believe.
DeleteAfter reading both articles I definitely think that folic acid/folate should remain a part of one’s everyday diet for in its natural form it is contained in foods that provide an overall benefit to one’s health. It seems to me that the main problem with the possibility of consuming too much folic acid is that fact that is has become abundantly present in ‘not so healthy foods’ like sugary cereals that are not necessary to be eaten as a part of one’s daily diet. Therefore if one just began eating better overall and avoiding such processed foods that contain high amounts of folic acid along with other ingredients not beneficial to our health, then one could decrease the risk of consuming too much folic acid if it does prove to influence/cause health problems.
ReplyDeleteTherefore I would recommend for any family member to simply improve their diet overall and reap all the benefits of eating healthy to avoid health issues in the future. As for pregnant women, they can also just ingest more folic acid when needed to protect their child and then return back to normal eating habits after the birth.
Bianca, I definitely agree with you on how individuals should improve their overall diet and eat healthy getting their nutrients through their foods. I believe that people should get their nutrients through their food only, unless if they are extremely low in a supplement, or need to take a supplement advised by their doctor.
DeleteHowever, now after seeing the debate of folate/folic acid, I will probably never take folic acid unless I am planning on having a child. Watching the youtube video about the testing of folic acid in the liver, I am now very hesitant on folic acid. They said that our liver has a very slow enzyme to take in the folate, therefore possibly starting up causes for cancer. I really don't know what exactly to make out of this, but it was very shocking and definitely caught my attention! This is something I would like to know more about so I can advise my friends and family about this.
I believe that people can OD on vitamins/supplements. There have been previous studies where other minerals, such as Selenium, has caused precautions such as hair loss, fatigue, and weakness. Knowing that individuals can OD on vitamins is something very eye opening. I believe that people should be more aware of DRI's (Daily Recommended Intake) from the government, so they know how much of what they should be consuming.
This debate has opened the door to find out more information to the public on toxicity from minerals/vitamins. It's something that I would like to know more about!
I also agree with Jenelle and Biana that as a society we should be focusing on our overall health and not just folic acid intake. If we didn't eat as much junk food or so unhealthy…would this even be an issue?
DeleteI agree with Andrew’s above argument: the government should not be requiring the fortification of so many foods. I understand why the government decided to fortify foods with folic acid in the first place, pregnant women were not receiving enough folate which can cause major neural tube defects in their unborn babies. I also learned in nutrition class that the neural tube develops early on in the pregnancy, and about 50% of pregnancies are unplanned. Most women do not know they are pregnant by the time the neural tube defects would have developed, therefore they would not know to increase their folate intake. Because of this dilemma, women of child bearing age should have 400 mcg/day whether they are pregnant or not.
ReplyDeleteHowever, to be fortifying so much food with folic acid, which is unknown to most consumers, seems a bit concerning. There are recommended upper limits to folic acid intake and people are likely to exceed these upper limits if they eat different fortified foods. There should be more consumer education and awareness about the fortification and need for folate in general. A solution would be to decrease the amount of folic acid in the fortified food.
I would like to look at the actual research done about the potential of folic acid’s association with cancer. I’m sure there can be some association but I am sceptic that folic acid causes cancer. It could be other supplements that are being fortified into the foods that are causing an increase in cancer rates. Even if there is not direct linkage, I do think that the amount of folic acid in foods need to be addressed.
To connect the two articles, here's what I think: The orthomolecular article made the most obviously logical point...either we're saying nature is wrong or we have to look at what scientists are doing to produce folic acid. The msnbc article highlighted that research studies have shown many negative effects of excess consumption of folic acid and jumped to the conclusion that large amounts of folic acid is bad for us. I say, research is probably right that folic acid consumption has lead to increased risks of developing certain cancers (esp. in societies where many things are artifically fortified with folic acid), but that doesn't mean folic acid is bad for us....what it means is that man-made folic acid is suspicious!
ReplyDeleteMy nutrition professor mentioned the importance of taking folic acid for women of childbearing age sooo much that I actually decided to give it a try. After a week or two of popping folic acid supplements, I started feeling lethargic and kind of gross. So that worked out well (not). I may be biased from personal experience, but I think we should stick to getting our folic acid fix from natural sources. Besides, what evidence suggests our government eagerly looks out for our best interests? If they are so obsessed with fortifying our foods with something...I'd logically suspect a backstory to their interest in making healthy foods "healthier".
I believe it's important to realize that the MSN article is designed to quickly grab the reader's attention. Therefore, a really easy way to interest the public is to instill fear. The author of this particular MSN article did a great job attempting to show a link between excess folic acid consumption and cancer. The author chose to highlight that in Chile "...hospitalization rates for colon cancer among men and women age 45 and older more than doubled in their country since fortification was introduced in 2000". Unfortunately, this seems more like a coincidence than an actual causality. The fact that the introduction of fortification caused a dramatic increase so quickly seems unlikely. It would be nice to point out a single thing as the source of all things wrong, but diseases such as cancer are much more complicated than that. The response that fortification is the sole cause of these cancer outbreaks instead of a combination of other factors seems a bit too simplistic to me.
ReplyDeleteAnother interesting part of the article is when the author wrote about a study "...in which men took either folic acid or a placebo, showed those consuming 1,000 mcg of folic acid daily had more than twice the risk of prostate cancer". The fact that men who take either a Placebo or Folic Acid had the same increase risk of cancer is very significant. To me, it seems like that shows that folic acid cannot be the sole reason for an increase in cancer.
Overall, I think the article seems to simplify this issue to an extreme degree. While I'm sure it got a lot of media attention, it's important to have further tests before alarming everyone. I would still tell my family to take multivitamins if they needed it and would rather advise regular check-ups for cancer screening than to eliminate folic acid intake.
The very suggestion that government established programs are detrimental to the public will always have the scandalous implications necessary to make the news. The folic acid debate is no different. It grabs people's attention because most of us have eaten cereal or bread or grains fortified with folic acid. The problem directly affects the public and in particular the individual. All that is left to set the issue ablaze is to make the public aware.
ReplyDeleteHowever, I find myself more inclined towards the second article than the one that claims my breakfast will give me cancer. Folate/Folic Acid aids methylation, that's easy enough to understand, so unless it is the cause of new methylations, I doubt it actually causes cancer. Concern over folic acid causing cancer would have risen much earlier if that were the case and it would be labeled a carcinogen. In addition, the studies referenced in the MSN article all involve folic acid supplements, not foods fortified with folic acid. Here is a big discrepancy as we know the amount of a supplement you place in your mouth is not the same amount your body actually absorbs and there isn't really a way to document what percentage is expected to be absorbed, especially in a small study, since that differs from person to person.
My other concern is with the question being posed. Is folic acid bad for you? If the growing obesity epidemic is any indication, too much of anything is bad for you. And if many of the foods we eat daily are fortified, what is the need of folate supplements. Perhaps those fortified foods are the issue and we should only rely on the natural sources? That's a great idea... but it only works for people who can afford to think that way. Healthy diets that provide everything the body needs through natural foods are far from ordinary. The benefit of carbohydrates with folate is that you get both the energy and the vitamin. Foliage does not give you energy to power through your day. At least for people who live in food deserts and have a hard enough time getting healthy foods to begin with, fortification should not be abolished.
I wasn't very surprised by the first article about the negative affects of folic acid. Too much of anything is always bad for you. But many have mentioned we as consumers should be critical of what we hear regardless of the reliability of the sources. I definitely agree with Shweeta that these articles attract a lot of attention because it applies to everyone. It's a public matter and with all the opposition in research and controversy it’ll probably just create more stress and worry. If it’s not canned corn or too much popcorn…it’s always something else that has negative effect. And her point about obesity proving the point that too much of anything is bad for you is definitely a strong one.
ReplyDeleteI definitely agree with Pricilla that more research needs to be done. Min brought up a good point that the MSN article is designed to quickly grab the reader's attention which was a convenient way to get a lot of interest in the public which lead to a lot of fear. But either way I think both sides of the argument needs to find more information and do more research to back their claims. Maybe they should have waited to publish their work until it was legitimately confirmed?
I would still suggest that my family and friends are pregnant to take folic acid but in moderation. I don't think they should turn their lives upside down for it. But besides that they should be focusing on staying healthy and fit and doing things like putting sun screen on to prevent other things besides the affects of folic acid.
DeleteFirst off I'd like to comment on the second article, whose author, a respected scientist makes the claim that " I have never seen evidence that protons cause cancer." A statement like this arouses the logos in the reader, making those unversed in the complexity of organic molecules assume that a fantastically small, seemingly insignificant proton could not possibly change anything about a molecule. That the first article must be purely "fluff" created by the media in naivety and misinterpretation. In fact though small molecular differences account for very large differences in the usage of molecules, as well as their properties, such as the small molecular differences between molecules of codeine and morphine and heroine. Additionally, the article claims that "As for lung cancer, the research accusing folic acid also happens to show that 94% of the study subjects who developed lung cancer were either current or former smokers." This is a fact that not only has already been validated multiple times but is not the main focus of the study in question by any means, a study that looks at a causal affect of increased levels of folic acid in relation to colon cancer. As many of my classmates refuse to look at the presented first article without skepticism, I refuse to take the second article at face value either. I find their points quite valid, especially the point that Shweta made about the news loving to report on potential "mistakes" that the government has made. i think it is quite important to take these studies as exploratory rather than factual.
ReplyDeleteFirst, the MSNBC article, which suggests that too much folic acid might increase your odds of developing cancer, made me think of a quote that I recently read in a book by Marion Nestle, a nutrition professor from NYU. She writes, “Attributing a disease to any one food or food component is always problematic because diets contain many foods, and foods contain a great many components that singly and collectively can affect health.” I think this is very true in the case of linking cancer to extra folic acid.
ReplyDeleteSecond, you certainly have to think critically about what you read or hear (no matter the source). With the article from MSNBC, the evidence that the author cites has limitations. As Min said, the author mentions that Chile experienced a rise in hospitalization rates for colon cancer after it began fortifying foods with folic acid in 2000. This does seem more coincidental than causal, especially since colon cancer is a slow-growing cancer. In addition, the MSNBC article cites a JAMA study, which the article from Orthomolecular Medicine points out may not be the most reliable or valid study. However, like Katelin said, I do not think you can take the Orthomolecular Medicine article at face value either. I am also skeptical of the author’s claim that there is virtually no difference between folate (the natural form) and folic acid (the synthetic form). Even though the difference between the two—a single proton—may seem minor, I do think the difference matters, especially in how the body handles folate and folic acid.
The link between excess folic acid and cancer is weak (and controversial), but I do think that excess folic acid is something to be aware of. I do believe that too much of anything can be bad for you; the consequences of too much folic acid may not be as serious as cancer, but there may be other adverse effects.
I think the best way to implement folate into a healthy diet (and what I would advise to family, friends, and patients) is to consume a diet of mostly whole, natural, unprocessed foods. That way, you get folate and all the essential nutrients (in their natural forms), as well as the other beneficial food components, like fiber and phytochemicals, that are largely absent from processed foods. However, in reality, as much as we advocate for people to eat diets of natural, unprocessed foods, many people eat still eat diets of processed foods (whether by choice, lack of education, limited access to healthy foods, etc.). So, at this point, it doesn’t make sense to stop fortifying foods with folic acid and risk nutritional deficiencies, especially among women of childbearing age. There is evidence that folic acid reduces the incidence of neural tube defects in babies, but there is not yet strong evidence linking excess folic acid consumption to cancer.
Finally, articles like the one from MSNBC, which are meant for the public, can have negative effects on the public—such articles may give misconstrued information, may confusion, or may instill unnecessary fear in people. At the same time, though, such articles from the popular media may also cause people to think about and reconsider what they eat, and people may make beneficial changes to their diet in response.
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