Folic acid and cancer risk? Relax and have another cracker

January 25, 2013 | by Tami Dennis

Folic acid is now a staple in U.S. diets, added to bread, flour, cereals, pastas and other baked goods as a way to reduce neural tube defects such as spina bifida. Most Americans simply take it for granted.

Bread and crackers The Food and Drug Administration requires that folic acid be added to bread and grain products in the U.S. to reduce the risk of neural tube defects.

But in some countries, people wonder. And they worry. Despite some studies linking folic acid to a lower risk of colon cancer, they worry whether fortification might increase the risk of some types of cancer. As the American Cancer Society points out: “Whether folic acid works against cancer may also depend on when it is taken. Some researchers think that folic acid may not be helpful, and could even be harmful, in people who already have cancer or pre-cancerous conditions.”

A new study should help put those concerns to rest.

In a report published this week in The Lancet, researchers analyzed previously published research to assess just what the effect of folic acid supplementation might be on cancer incidence overall or on the incidence of cancer of the large intestine, prostate, lung, breast or any other specific site. They could find no connection.

Further, they pointed out, the amount of folic acid found in fortified foods is considerably smaller than the folic acid supplements used in the trials.

"The study provides reassurance about the safety of folic acid intake, either from supplements or through fortification, when taken for up to five years," study author Robert Clarke, from the University of Oxford, said in a journal news release reported by HealthDay News.  

"The nationwide fortification of foods involves much lower doses of folic acid than studied in these trials, which is reassuring not only for the U.S.A., who have been enriching flour with folic acid to prevent neural tube birth defects [such as spina bifida] since 1998, but also for over 50 other countries where fortification is mandatory [such as] Australia, South Africa, Chile, Argentina and Brazil," Clarke said.

All of this is not to say that folic acid supplementation is perfect. It’s not. Folic acid can hide the symptoms of vitamin B12 deficiency, which is common in older people, and by the time the deficiency is diagnosed, the nervous system can be permanently damaged.

Further, high doses can pose a problem to cancer patients on some chemotherapy drugs, the American Cancer Society notes.  

But overall, as Clark says, the results are reassuring.

They're likely especially reassuring to nutritionists, dietitians and others concerned about our overall nutritional intake. Although folic acid can be found naturally in a variety of food sources,  including leafy green vegetables, dried beans and peas, the healthfulness of the average American diet shouldn’t be overestimated.

But crackers, cookies, baked goods? Americans are in no danger of giving up on those.

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