Folic acid is getting renewed focus as a baby protecting vitamin. Also known as Vitamin B9, it is essential to many bodily functions, not only guarding against spina bifida and other related birth defects, but now also linked to the prevention of premature births and heart defects.
According to the AP, doctors specializing in pregnancy are now questioning whether or not it is time for the government to increase the levels of folic acid added to some foods to help ensure expectant mothers get the necessary amounts. However, there are drawbacks to this proposal, as too much folic acid poses a cancer risk for older adults.
“Folate is assuming the role of a chameleon, if you will,” says Dr. Joel Mason of Tufts University’s nutrition research center, who is researching that possible risk.
Folic acid is a synthetic version of the B vitamin, folate. Folate occurs naturally in green, leafy vegetables, citrus and dried beans, and is essential to healthy growth at a cellular level. Therefore, all humans need it, but our bodies do not store enough of it.
Pregnant women need high levels of it, even before conception, to prevent neural tube defects, which are abnormalities of the spine and brain. These types of birth defects have decreased by 33% since the U.S. mandated the fortification of certain breads, cereals and pastas with folic acid in 1998.
Two new studies indicate folic acid may be more beneficial than previously believed.
In the first study, researchers in Texas evaluated nearly 35,000 pregnancies and concluded that women who reported taking folic acid supplements for at least one year prior to conceiving reduced their risk of having a premature baby by 50%.
In the second study, Canadian researchers evaluated 1.3 million births in Quebec since 1990 looking for heart defects. They discovered that the number of defects decreased by 6% each year since 1998, the year Canada began fortifying its food.
Health authorities have advised women who could become pregnant to take a daily supplement containing 400 micrograms of folic acid, for years. This is recommended because obtaining enough folate through a normal diet is very difficult.
Last month, the U.S. Preventive Services Task Force further encouraged women to take a daily vitamin that contained 400-800 micrograms of folic acid.
“We’ve seen in the U.S. and Canada dramatic changes in neural tube defects just with fortification. The question now is would a little more fortification, or even twice as much fortification, impact that bottom line, as well as those other potential benefits,” says Dr. Alan Fleischman, medical director of the March of Dimes.
Fleischman’s organization will summon pregnancy and folate specialists this summer to discuss this issue.
Currently, the European Union and Britain are debating whether or not to begin food fortification in their countries as well.
The issue is further complicated by the potential cancer risk to older adults, both male and female, who consume too much folic acid.
The dilemma lies in that some studies indicate that people who do not eat enough folate are at an increased risk for colon cancer and certain other cancers, while other research in animals shows that too much of the vitamin can stimulate the growth of some cancers.
There is little human evidence to support the results of the animal tests. However, when researchers followed the cases of patients predisposed to precancerous colon polyps, the ones taking a high-dosage folic acid, 1,000 micrograms daily for three years, had more new polyps than those given a dummy pill.
In March, scientists analyzed 640 men from the earlier study and discovered that after 10 years, the ones who took folic acid were more likely to have been diagnosed with prostate cancer.
Tufts’ Mason explained this phenomenon indicating that while folate is normally a protective agent, if a person’s body already has some precancerous or cancerous cells, too much folate can exacerbate their growth.
Because older adults are more likely to harbor cancerous cells in their colons or prostates, those taking a folic acid supplement will be more prone to these types of cancer.
Fortified foods alone wouldn’t be enough to cause any damage, stresses Fleischman: “I don’t think it’s going to end up being a generational argument.”
Everyone should eat plenty of leafy greens and citrus fruits, both good source of folate. Deriving your daily folate from natural food sources is important at all ages. However, until the issue is settled, Mason warns that older adults “really ought to think twice about whether you should take a vitamin supplement that contains folic acid.”
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