It’s not easy being a high-profile B-lister. One minute you’re being promoted as so necessary to human survival that you have to appear everywhere, from TV to cereal packets, the next, you’re caught in a 3-in-a-bed romp with some very unsavoury characters.
Maybe I’ve been reading the tabloids a little too much, or maybe it’s just the nutrition press releases I receive, but in the world of vitamins, that celebrity of the B-group, folic acid, is currently experiencing all the roller-coaster ups and downs of public life.
Only last week the UK’s Food Standards Authority (FSA) was joining the chorus of voices in Europe calling for compulsory fortification of flour with folic acid. The US and many other countries have been doing this for a number of years, since folic acid fortification reduces the numbers of babies born with neural tube defects. The occurrence and biochemistry of folate and the case for its fortification in flour are covered in detail in an excellent review on www.nutritionandfoodsciences.org.
In recent months, folic acid has been splashed across the front of all the medical journals, linked to headline-grabbing conditions like cardiovascular disease, mental performance, memory, cleft lip, Alzheimer’s, depression and stroke.
Amidst all the calls for flour fortification, the biotechnologists jumped on the folate bandwagon, with a group claiming to have created a genetically modified tomato that could deliver a whole day’s supply of folic acid in just one serving.
It was beginning to seem like we just couldn’t get enough of this punchy little vitamin.
But just like the relationship between many other B-list celebs and the press, just when you’ve been built up to god-like proportions, they start to try and shoot you down.
For folate, the bad press began last week. Following a rumour that taking folic acid supplements might not protect against lung cancer, two more studies hit the medical headlines, both exposing relationships between folic acid supplements and a couple of things we’d perhaps rather not think too much about.
The first appeared in Cancer Research on the 1st June. The authors pointed out that, while eating diets that are naturally rich in B-vitamins could protect slim, healthy people from pancreatic cancer, a very nasty disease, people taking those vitamins as supplements instead of getting it naturally from food were, instead, 139 percent more likely to get the disease.
Hot on the heels of this story was report of folic acid’s involvement in another sordid relationship. A paper in the Journal of the American Medical Association on the 6th June claimed that previous work indicating that folate supplementation could help prevent colorectal tumours may be misleading. Worse still, this new data speculated that taking folic acid supplements, even in the form of fortified foods, may be putting us at risk of developing colorectal tumours.
There is actually a more serious message underlying all this tabloid drama. While the stories behind the headlines may be perfectly true, given the circumstances of their collection, even the headlines in the journals are written specifically to grab your attention and make you read the rest. Eating diets that are naturally rich in certain nutrients and non-nutrients may help you to live a healthier life. Fruits and vegetables are especially good, even more so when eaten as part of a healthy lifestyle. Folic acid has an important function in the body – it is essential for a reason. Tip the balance of any individual component and you may end up doing more harm than good. The individual data are just pieces of a much bigger, more complex picture. To get the biggest picture available, why not try CAB Abstracts? Let me know what juicy pieces of gossip I’ve missed.
DIAGRAM: Lucock (2007). Is folic acid the ultimate functional food? British Medical Journal Vol. 328, pp. 211-214.
Cole et al. (2007). Folic Acid for the Prevention of Colorectal Adenomas: A Randomized Clinical Trial. Journal of the American Medical Association. Vol. 297 pp. 2351-2359.
Díaz de la Garza et al. (2007). Folate biofortification of tomato fruit. Proceedings of the National Academy of Sciences, Vol. 104, No. 10, pp. 4218-4222.
Durga et al. (2007). Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. The Lancet Vol. 369, pp. 208-216.
Larsson et al. (2007). Folate and Risk of Breast Cancer: A Meta-analysis. Journal of the National Cancer Institute, Vol. 99, No. 1, pp. 64-76.
Luchsinger et al. (2007). Relation of Higher Folate Intake to Lower Risk of Alzheimer Disease in the Elderly. Archives of Neurology, Vol. 64, pp. 86-92.
NIHR Health Technology Assessment. Folate and depression.
Schernhammer et al. (2007). Plasma Folate, Vitamin B6, Vitamin B12, and Homocysteine and Pancreatic Cancer Risk in Four Large Cohorts. Cancer Research, Vol. 67, pp. 5553-5560.
Slatore et al. (2007). Lung Cancer: Association with supplemental multivitamin, vitamin C & E and folate intake. Proceedings of the American Thoracic Society International Conference, May 18-23 San Fransisco, California, USA, p. A329.
Wald et al. (2006). Folic acid, homocysteine, and cardiovascular disease: judging causality in the face of inconclusive trial evidence. British Medical Journal 333, pp. 1114-1117.
Wang et al. (2007). Efficacy of folic acid supplementation in stroke prevention: a meta-analysis The Lancet, Vol. 369, pp.1876-1882.
Wilcox et al. (2007). Folic acid supplements and risk of facial clefts: national population based case-control study. British Medical Journal, Vol. 334, p. 464.
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