Selenium Supplements May Cause Premature Death

Recent research suggests that supplementing with selenium can increase your cholesterol levels by almost 10%, leading to an increased risk of coronary heart disease.

Selenium is an essential mineral, which people normally obtain from foods such as vegetables, meat and seafood. However, there have been many claims over the past few years that over-working of the soil has led to a depletion of its selenium content, and to a corresponding drop in selenium levels within food.

Selenium and Chronic Disease

Given that some chronic health conditions, especially those related to the thyroid such as hypothyroidism, have been linked to selenium deficiency, this has led to an increase in the number of people taking selenium supplements. The efficacy of selenium has not been in doubt, whereas its deficiency has been mentioned as causing a number of problems, so the news on selenium all seemed positive, as noted in this recent article from the UK medical journal, The Lancet:

• "Selenium is needed for the proper functioning of the immune system, and appears to be a key nutrient in counteracting the development of virulence and inhibiting HIV progression to AIDS. It is required for sperm motility and may reduce the risk of miscarriage. Deficiency has been linked to adverse mood states. An elevated selenium intake may be associated with reduced cancer risk." (1)

Selenium Supplements and Cholesterol Increase

In late 2009, a team of researchers at the University of Warwick's Medical School (UK) discovered something surprising: high levels of selenium are associated with higher levels of cholesterol, which significantly increases the risk of heart disease. The research team examined the association between levels of selenium in the blood (plasma selenium) with those of fats in the blood (blood lipids), and found that in people with higher plasma selenium (over 1.20 µmol/L) there was an increase in the average total cholesterol level of 8%. Researchers also noted a 10% increase in the "bad" (non-HDL) cholesterol levels – these lipoproteins, such as LDL, VLDL and IDL are associated with heart attacks and angina (chest pain).
Almost half of the 1042 study participants with the highest selenium levels admitted that they took dietary supplements regularly.
Dr. Saverio Stranges, leader of the study team, said that although high selenium levels were not always caused by people taking supplements, the use of them had risen considerably in recent years, and he felt this was largely due to the belief that selenium can reduce the risk of cancer and other diseases.
In an apparent contradiction of the earlier article (quoted above) in The Lancet, Dr. Stranges said that selenium supplementation "has spread despite a lack of definitive evidence on selenium supplements efficacy for cancer and other chronic disease prevention. The cholesterol increases we have identified may have important implications for public health. In fact, such a difference could translate into a large number of premature deaths from coronary heart disease.
"We believe that the widespread use of selenium supplements, or of any other strategy that artificially increases selenium status above the level required is unwarranted at the present time. Further research is needed to examine the full range of health effects of increased selenium, whether beneficial or detrimental." (2)
Related articles:
Are Your Vitamin D Supplements Making You Sick?
References:

1. "The importance of selenium to human health", Margaret Rayman, D Phil; The Lancet, Vol 356, Issue 9225, pp.233–241, 15 July 2000.
2. University of Warwick

Are Your Vitamin D Supplements Making You Sick?

Some research scientists believe that autoimmune disease is caused by a massive intracellular invasion of bacteria, which hijacks the body's vitamin D receptor.


The Marshall Protocol is an ongoing research study, which believes that where low levels of vitamin D have been associated with disease, this is not because low levels are causing disease, but because the disease processes themselves have taken control of the vitamin D regulatory process. This would mean that the low values of vitamin D are the result, not the cause, of the disease.

What is Vitamin D?

Vitamin D was designated a nutrient, and vitamin during the 20th century, but it is actually a seco-steroid transcriptional activator. This means it is a hormone, with a complex control system. The clinically accepted role of the vitamin D metabolites – regulating calcium homeostasis – is actually just a small part of what these hormones do.

How Does Vitamin D Work in the Body?

Vitamin D is the primary ligand (linking ion or molecule) that activates the VDR receptor. This is a key intracellular hormone receptor; once activated by vitamin D, it produces certain gene-products, including anti-microbial peptides and proteins. These are both very important to our intra-phagocytic immune defenses - they are our bodies’ defence against those bacteria that have developed the ability to live inside the nuclei of our cells.
The VDR also converts 25-D (the non-active form of vitamin D) into 1,25-D (the active form, or hormone) which in turn activates the VDR to produce an enzyme to inactivate 1,25-D – preventing it from reaching high concentrations. In this way it has its own feedback system: once levels of 1,25-D reach a certain level, the system switches off.
The VDR is also involved in the transcription and translation of DNA: the receptor belongs to the family of transacting transcriptional regulatory factors, and has been found to affect up to 27,091 genes within the body. (1) These include genes and proteins known to be active in cancer (1) and those that are key to our immune systems: beta-defensin and cathelicidin. (2)

Low Levels of Vitamin D in Disease

Researchers on the Marshall Protocol believe that pathogens invade the nuclei of many of the body’s cells over time, causing inflammation and chronic disease. They also release substances that stop the VDR from working correctly; so it is unable to produce anti-micrbial peptides and proteins to kill the pathogens, and it is unable to regulate itself – it has no ‘turn off’ switch, and so levels of 1,25-D (the active form of vitamin D) keep growing.
The pathogens also hijack the RNA/DNA messaging – and can change over 900 genes within the body (all of those transcribed by the VDR). And because the pathogens block the VDR’s action, other nuclear receptors (the VDR, PXR, GCR, Thyroid-alpha-1 and beta-1) are all seriously affected. The loss of the GCR – the glucocorticoid receptor – and thyroid homeostasis, or balance – leads to diagnoses of hypo-thyroidism and adrenal insufficiency.

Can’t Doctors Measure the Vitamin D and Spot the Problem?

The ‘vitamin D’ that doctors measure is 25-Hydroxyvitamin-D (25-D) – the inactive metabolite form. But this doesn’t mean the body is deficient in vitamin D – it means the body is no longer regulating it correctly. Because the VDR isn’t functioning correctly, it can’t degrade the 1,25-D to 25-D even when levels are high; so the level of 1,25D becomes ever higher, affecting the body’s other receptors. So the body tries to block metabolism at the pathway, by downregulating the level of 25-Hydroxyvitamin-D. This is why people with autoimmune diseases show a ‘deficiency’ of the ‘vitamin’. (http://marshallprotocol.com/forum39/11053.html).

Should I Stop Taking Vitamin D Supplements?

The Marshall Protocol researchers certainly think so; but their research is not yet accepted by the medical establishment as the preferred treatment. The Marshall Protocol team believe that all forms of supplemental Vitamin D is converted into more and more 1,25-D, causing increasing receptor problems. Plus the vitamin D that we eat, and the 25-D that is hydroxylated from that both act to displace the active metabolite from the VDR.
Read more:
The Marshall Protocol Cure
Can Antibiotics Cure Hashimoto's Disease?
The Marshall Protocol Home Website

1. “Large-scale in silico and microarray-based identification of direct 1,25-dihydroxyvitamin D3 target genes”, Wang, Tavera-Mendoza, Laperriere, Libby, MacLeod, Nagai, Bourdeau, Konstorum, et al, Mol Endocrinology: 19 (11): 2685-95
2. “Human cathelicidin antimircobial peptide gene is a direct target of the vitamin D receptor and is strongly upregulated in myeloid cells by 1,25-dihydroxyvitamin D3”; Gombart, Borregaard, Koeffler; FASEB J. 19(9):1067-77

Don’t take vitamin supplements

No one loves me more than my mother; even though there were times during my childhood when I thought she was trying to poison me. Could the chemical aftertaste, belching, and nausea I experienced following the One-a-Day multivitamin capsule she forced me to take along with my orange juice at breakfast have been a warning? She told me vitamins tasted bad, like medicine, so that if a little child found them he or she wouldn’t mistake these pills for candy. By this time in history, medical achievements included the cure of deadly vitamin deficiency diseases, such as scurvy, beriberi, and pellagra. People reasoned, if a few vitamins can cure these ravagers of health, then maybe the answers to cancer or heart disease will be found in supplements too. Why not? This was during the atomic bomb era following WWII when people believed that science would someday soon find the answer to all things important.

Nearly forty percent of the US population takes supplements, with many people spending hundreds of dollars a month. Based on what objective evidence? How many friends and relatives do you know who have suffered from illnesses caused by a vitamin deficiency, such as scurvy from vitamin C deficiency, beriberi from insufficient vitamin B1, or pellagra from a lack of niacin? How about protein or essential fatty acid deficiencies? The truth is none. Now, turn your vision 180 degrees. I’ll ask you the opposite question. How many of your friends and relatives have diseases caused by nutritional excesses—from consuming too much cholesterol, fat, sodium, protein and/or far too many calories? The answer is most of them.

Health problems from excesses cannot be corrected with treatments useful for deficiencies. Have you ever known a person who has lost 100 pounds by taking supplements or cured their arthritis, hypertension, colitis, or type-2 diabetes through vitamin and mineral therapies? I bet you haven’t and neither have I. But every day I have contact with someone, in person or by e-mail, who has achieved such benefits by changing their diet and going for a daily walk out in the sunshine. Thus, there is no “bang for the buck” in believing in supplements. They simply don’t work for the problems that currently plague people. Doctors who prescribe supplements are practicing “faith-based medicine.” They must believe, because there is no good evidence supporting their actions—no valid research to guide them and no patient results to reward them.

Supplements Are Not Food

In an effort to improve on Mother Nature’s creations, and to make big fat profits, scientists and entrepreneurs have developed thousands of products based on isolated concentrated nutrients. The enterprise begins by finding a pharmacologically active ingredient in a common food. Through science and manufacturing technology this substance is purified, then replicated into large quantities, and sold to the customer as a “potent, but natural remedy.” Familiar examples of such concentrates include isolates of soy and whey proteins, omega-3 fish and flaxseed oils, and vitamins and minerals. These magic bullets are delivered to the consumer in the form of pills, powders, liquids, nutrition bars, “health” drinks, and fortified foods. They are supposed to offset the effects of destructive habits and fix the customers’ bad health, naturally (like with no side effects) and almost effortlessly. High profits, and the satisfaction of consumers’ desires for quick fixes, guarantee healthy businesses based on selling various concentrates.

Vitamins are organic compounds that cannot be synthesized by the human body and therefore must be eaten in order for us to remain healthy and prevent serious illnesses. Plants synthesize 11 of the 13 known vitamins. Vitamin D is actually not a vitamin, but a hormone manufactured by the body with the action of sunlight on the skin, and bacteria make the only non-plant-derived vitamin, which is B12. Plants are also the source for minerals, all of which originate in the ground and enter into living systems through the roots of plants. Plant parts (starches, vegetables, and fruits) are the proper packages for delivering these, and many more, essential nutrients to the body. A harmonious relationship between people and plants translates into good health.

The Whole Is Much Greater than the Parts

Place an assortment of fruit on the table in front of you. Can you identify the yellow banana? Are you having any trouble picking out the orange? Are you calling the small, oblong round green objects grapes? Notice that you have no difficulty distinguishing between and properly naming each and every fruit. This is because their precise and perfect molecular architecture results in a distinct easily identifiable form for each and every fruit (and vegetable). Tens of thousands of proteins, fats, carbohydrates, fibers, vitamins, minerals and other phyto (plant)-chemicals are present in proper amounts, kinds, and physical positions within each food. If not for the exact correctness then you would not have a green kiwi fruit.

Good nutrition begins as the whole food is chewed into smaller parts and swallowed. The masticated parts still contain all of the basic components and most of the same physical relationships as the original whole food. After more digestion, these food parts enter the blood stream and are carried to the body’s 10 trillion cells. This blood-borne mixture of nutrients actively passes through the cells’ membranes into the inner cellular fluid (cytoplasm). Here this vital balance of nutrients provides the raw materials for the cellular machinery to run properly. If too few or too many of any of the components of the digested and assimilated food are present within the cell then imbalances occur, resulting in less than optimal function at the cellular level, followed by disease. Scientists barely understand the orchestrations that take place between our foods and our bodies. But they do recognize that perfect harmony exists.

Supplements Make People Sick

People believe in supplements, even though the preponderance of scientific evidence condemns taking isolated concentrated nutrients. Most carefully studied are the effects of beta-carotene, vitamin E (alpha-tocopherol), and folic acid. Randomized controlled trials involving more than a hundred thousand subjects have proven that taking these and other supplements increase a person’s risk of heart disease, cancers, and premature death. Damage to the kidneys in diabetics and an increase in the severity of respiratory infections have also been shown. (See below for details on some of these major studies.) Vitamin supplement manufacturers, stores selling vitamins, medical doctors, and dietitians should act responsibly and warn consumers about the serious health hazards from these highly profitable potions.¹ For the same reasons, fortification of our food supply (cereals and flours) with folic acid and other nutrients should be stopped.²

Two highly respected Cochrane Reviews published in 2008 concluded, “Beta-carotene, vitamin A, and vitamin E given singly or combined with other antioxidant supplements significantly increase mortality (death).”^3,4 There is no higher authority than a report from the Cochrane Collaboration.

Supplements Kill By Causing Metabolic Imbalances

Three decades ago it was well established that people who consume more beta-carotene in their diets are less likely to develop many kinds of cancer, including lung cancer.^5,6 Following this observation, a hypothesis was developed that a single nutrient, beta-carotene, was the key to cancer prevention. Two well-designed trials published in 1994 and 1996 compared the effects of taking beta-carotene supplements to a placebo for people at high risk for developing lung cancer (smokers and those exposed to asbestos).^7,8

Unexpectedly, in these two investigations more cancers were found in those people taking the beta-carotene pills. However, these findings did not invalidate the original observation: People who eat more fruits and vegetable have a lower risk of cancer. Beta-carotene is only found in plants, thus serves as a marker for the quantity of fruits and vegetables consumed. What is true is that a diet high in plant foods protects against cancer. The same effect does not carry over to consuming single nutrients, like beta-carotene. A pill is not a plant.

Beta-carotene is one of about 50 similar naturally occurring active substances in our diet classified as carotenoids. They are all especially abundant in yellow and orange fruits and vegetables. After nutrients enter cells they float around in the cell’s fluids (cytoplasm) until they attach themselves to the cellular machinery through a specific receptor, like a key fits into a lock. Beta-carotene and all of the other biologically active carotenoids must attach to these specific carotenoid receptors before they can function.

When a cell is flooded with one kind of carotenoid, in this case beta-carotene after vitamin supplementation, then there is an overwhelming competition for the carotenoid receptor sites.⁹ The other 50 functional carotenoids are displaced by the beta-carotene from their cellular connections, creating deadly nutritional imbalances.

Consider this analogy: A person drives from home to work. After entering the building, the typical employee begins the day by walking around and greeting fellow workers, stopping by the water cooler to catch up on some daily gossip. So far nothing productive for the company has been accomplished. Finally, the worker sits at his or her designated workstation—say a desk with a computer and a telephone—and becomes productive. At this place of business there are many workstations and many workers with different talents—accountants, secretaries, designers, managers, etc.—who collectively and interactively make the company run productively and profitably. This would all change if one day the boss decided to hire a hundred extra accountants without any real need for their services, and to make matters worse, without adding any new workstations. The result would be chaos and soon bankruptcy from the disharmony created in the organization.

Save Your Money and Your Health

In the mid-nineties I was the host of a Sunday evening radio talk show called “To Your Health.” My two-hour broadcast was carried by the largest radio stations in the biggest cities, such as Los Angeles (KABC), San Diego (KSDO), Sacramento (KSTE), and San Francisco (KNBR), all over the west coast and was heard by millions of people. I received over 2000 phone calls each evening on average (of course, only a fraction of those callers could be answered). The show’s sponsors were mostly natural food stores and their top revenue streams came from the supplement aisles. During my monologue at the beginning of each show I would discuss the newest scientific research. I tried to balance “negative” articles, such as, vitamin A (Retinol) causes a 1 in 57 chance of birth defects when taken by a pregnant woman and increases hip fractures in elderly adults, with “positive” ones, for example, folic acid supplementation taken before pregnancy reduces the risk of serious birth defects.^10-13

However, I wasn’t balanced enough for one group of “vitamin activists” from Los Angeles who edited together excerpts of my anti-supplement messages into a tape played for my sponsors each Monday morning. Fortunately, I weathered these attacks and survived for three years on this large network. In time, the really big sponsors of these powerful radio stations took a listen to my anti-meat, anti–dairy, and anti-pharmaceutical messages. In spite of my popularity I lost all of my shows over a three-week period in 1996. Money talks, even on talk radio. But that does not change the truth.

Whether you are scientifically minded and believe in the perfection created by 400 million years of evolution, or devoutly religious and believe in the perfection of a Divine Creator, or both, you must believe that the world we live in is inherently correct. The trillions of interactions that occur between flora, fauna and Mother Earth are purposeful and harmonious. You have also observed that man’s interference with Nature’s mysterious workings usually results in unintended catastrophes. Failure to follow the natural starch-based diet for humans is the reason more than a billion people are overweight and sick today. Trying to fix modern day health problems with supplements adds to the injury at great financial costs. (Sales of dietary supplements to US Consumers were $25.2 billion in 2008.)¹⁴ Scientific facts and reasoning call for the blind and misguided faith in supplements to stop.

Randomized Controlled Trials Prove Supplements Are Dangerous: More Cancer The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. A total of 29,133 male smokers were assigned to one of four regimens: alpha-tocopherol (vitamin E) alone, beta-carotene alone, both alpha-tocopherol and beta-carotene, or placebo.7 Findings: 18 percent more lung cancer and 8 percent more deaths in those taking the preparations with beta-carotene. The Beta Carotene and Retinol Efficacy Trial. A total of 18,314 smokers, former smokers, and workers exposed to asbestos assigned to take beta-carotene and retinol (vitamin A) or placebo.8 Findings: 17 percent more deaths, 46 percent more lung cancer, and 26 percent more cardiovascular disease for those taking the supplement. The Selenium and Vitamin E Cancer Prevention Trial (SELECT). A total of 35,533 men were assigned to one of four groups: selenium, vitamin E, selenium plus vitamin E, or placebo.15 Findings: 13 percent more prostate cancer for the vitamin E groups. No prevention of prostate cancer by any supplement intervention. More Heart Disease MRC/BHF Heart Protection Study. A total of 20,536 adults with coronary disease, other occlusive arterial disease, or diabetes were allocated to receive antioxidant vitamin supplementation (vitamin E, vitamin C, and beta-carotene daily) or placebo.16 Findings: Increased vitamin concentrations in the subjects’ blood, but no reductions in vascular disease, cancer, or death. Alpha-tocopherol Beta-carotene Cancer Prevention Study. A total of 1862 male smokers who had had a previous myocardial infarction were assigned to dietary supplements of alpha-tocopherol, beta-carotene, both, or placebo.17 Findings: There were 75% more deaths from fatal coronary artery disease in the beta-carotene groups and a slight increase in the alpha-tocopherol groups. The HOPE-TOO trial. A total of 9541 patients were assigned to vitamin E or placebo.18 Findings: No difference in cancer or cardiovascular deaths. Patients in the vitamin E group had a higher risk of heart failure. Folate After Coronary Intervention Trial. A total of 636 patients with heart artery stents were assigned to receive folic acid, vitamin B6, and vitamin B12 or placebo.19 Findings: Greater restenosis (artery closure) and repeat heart surgery for those taking the supplement with folic acid. The NORVIT Trial. A total of 3749 men and women who had had an acute myocardial infarction within seven days were assigned to be in one of four groups: folic acid, vitamin B12, and vitamin B6; folic acid and vitamin B12; vitamin B6; or placebo.20 Findings: Homocysteine decreased by 27 percent, but the risk of heart attack, stroke, and cancer was increased by 20 to 30 percent in the groups with the folic acid supplement. Women’s Antioxidant and Folic Acid Cardiovascular Study. 5442 women with either a history of CVD or 3 or more coronary risk factors were assigned to receive folic acid, vitamin B6, and vitamin B12, or placebo.21 Findings: Homocysteine decreased by 19 percent, but the risk of heart attacks, strokes, heart surgery, and death was not reduced. More Kidney Damage in Diabetics The Diabetic Intervention with Vitamins to Improve Nephropathy Trial. A total of 238 participants who had type-1 or -2 diabetes and a clinical diagnosis of diabetic nephropathy (kidney disease) were assigned to folic acid, vitamin B6, and vitamin B12, or placebo.22 Findings: The vitamin group had worse kidney function and twice as many vascular events. More Fractures in Elderly High Dose Oral Vitamin D Trial. A total of 2256 community-dwelling women, aged 70 years or older, were assigned to receive 500,000 IU of Vitamin D (cholecalciferol) or placebo.23 Findings: Women taking the vitamin D had more falls and fractures. More Severe Respiratory Infections A Randomized Trial on Vitamin E and Infections. A total of 652 non-institutionalized elderly were assigned multivitamin-minerals, 200 mg of vitamin E, both, or placebo.24 Findings: No change in frequency of respiratory infections, but the severity was worse in those taking vitamin E.

References:

1) Miller ER 3rd, Guallar E. Vitamin E supplementation: what's the harm in that? Clin Trials. 2009 Feb;6(1):47-9.

2) Hubner RA, Houlston RD, Muir KR. Should folic acid fortification be mandatory? No. BMJ. 2007 Jun 16;334(7606):1253.

3) Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD007176.

4) Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. Antioxidant supplements for preventing gastrointestinal cancers.

Cochrane Database Syst Rev. 2008 Jul 16;(3):CD004183.

5) Peto R, Doll R, Buckley JD, Sporn MB. Can dietary beta-carotene materially reduce human cancer rates? Nature. 1981 Mar 19;290(5803):201-8.

6) Bjelke E. Dietary vitamin A and human lung cancer. Int J Cancer. 1975 Apr 15;15(4):561-5

7) The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. N Engl J Med. 1994 Apr 14;330(15):1029-35.

8) Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, Keogh JP, Meyskens FL, Valanis B, Williams JH, Barnhart S, Hammar S. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med. 1996 May 2;334(18):1150-5.　

9) Pietrzik K. Antioxidant vitamins, cancer, and cardiovascular disease. N Engl J Med. 1996 Oct 3;335(14):1065-6;

10) Dolk HM.  Dietary vitamin A and teratogenic risk: European Teratology Society discussion paper. Eur J Obstet Gynecol Reprod Biol. 1999 Mar;83(1):31-6.

11) Rothman KJ. Teratogenicity of high vitamin A intake.  N Engl J Med. 1995 Nov 23;333(21):1369-73.

12) Michaelsson K.  Serum retinol levels and the risk of fracture.  N Engl J Med. 2003 Jan 23;348(4):287-94.

13) Blencowe H, Cousens S, Modell B, Lawn J. Folic acid to reduce neonatal mortality from neural tube disorders. Int J Epidemiol. 2010 Apr;39 Suppl 1:i110-21.

14) http://www.npicenter.com/anm/templates/newsATemp.aspx?articleid=25335&zoneid=2

15) Lippman SM, Klein EA, Goodman PJ, Lucia MS, Thompson IM, Ford LG, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2009;301:39-51.

16) Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002 Jul 6;360(9326):23-33.

17) Rapola JM, Virtamo J, Ripatti S, Huttunen JK, Albanes D, Taylor PR, Heinonen OP. Randomised trial of alpha-tocopherol and beta-carotene supplements on incidence of major coronary events in men with previous myocardial infarction. Lancet. 1997 Jun 14;349(9067):1715-20.

18) Lonn E, Bosch J, Yusuf S, Sheridan P, Pogue J, Arnold JM, Ross C, Arnold A, Sleight P, Probstfield J, Dagenais GR; HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA. 2005 Mar 16;293(11):1338-47.

19) Lange H, Suryapranata H, De Luca G, Bˆrner C, Dille J, Kallmayer K, Pasalary MN, Scherer E, Dambrink JH. Folate therapy and in-stent restenosis after coronary stenting. N Engl J Med. 2004 Jun 24;350(26):2673-81.

20) B¯naa KH, Nj¯lstad I, Ueland PM, Schirmer H, Tverdal A, Steigen T, Wang H, Nordrehaug JE, Arnesen E, Rasmussen K; NORVIT Trial Investigators. Homocysteine lowering and cardiovascular events after acute myocardial infarction. N Engl J Med. 2006 Apr 13;354(15):1578-88.

21) Albert CM, Cook NR, Gaziano JM, Zaharris E, MacFadyen J, Danielson E, Buring JE, Manson JE. Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial. JAMA. 2008 May 7;299(17):2027-36.

22) House AA, Eliasziw M, Cattran DC, Churchill DN, Oliver MJ, Fine A, Dresser GK, Spence JD. Effect of B-vitamin therapy on progression of diabetic nephropathy: a randomized controlled trial. JAMA. 2010 Apr 28;303(16):1603-9.

23) Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, Nicholson GC. Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA. 2010 May 12;303(18):1815-22.

24) Graat JM, Schouten EG, Kok FJ. Effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons: a randomized controlled trial. JAMA. 2002 Aug 14;288(6):715-21.

  http://www.drmcdougall.com/misc/2010nl/may/vitamins.htm

Excess Animal Protein Increases Death Risk

If you’ve added some extra pounds and think a high-protein diet is a better way to manage your weight, think again. Numerous studies show that consuming excess animal proteins such as meat, milk, and cheese has significant health consequences and should give enthusiastic Paleo, Atkins, and other dieters reason for pause.
Such is the case with the latest research out of the University of Southern California’s Davis School of Gerontology. In a study, professor Valter Longo, director of the Longevity Institute at USC, and his colleagues analyzed data from 6,318 American adults ages 50-65 taking part in the National Health and Nutrition Examination Survey (NHANES) III, a strategic effort to assess health and diet status in the U.S.
First, researchers categorized participants into three groups—a “high-protein” group (20 percent or more), a “moderate-protein” group (10 to 19 percent), and a “low-protein” group (less than 10 percent)—based on calorie intake from all protein sources. On average, 16 percent of total daily calories were obtained from protein, while two-thirds of those calories came from animal protein.
Then, investigators compared disease and death rates between groups during an 18-year period.
According to study results published in the journal Cell Metabolism, researchers found that people who ate a diet rich in animal proteins were more than four times as likely to die of cancer as those who ate a low-protein diet. In fact, researchers were surprised that consuming a high protein diet during middle age provided nearly the same risk of dying from cancer as smoking!
Additionally, those who consumed diets high in animal proteins were several times more likely to die of diabetes, as well as 74 percent more likely to die prematurely from any cause.
Interestingly, only seniors (65 years and older) benefited from consuming moderate to high amounts of protein, as these higher levels seemed to protect against diseases like cancer, as well as early death.
The source of protein is most important
Also, researchers found that plant-based proteins—like those derived from beans, nuts, and seeds—did not seem to have the same negative impact on mortality as animal proteins. In fact, the link between high-protein intake and risk of cancer disappeared almost entirely when considering participants whose protein was derived primarily from plants. Additionally, controlling for the amount of carbohydrate and fat intake did not seem to alter cancer or death rates, suggesting that excess animal proteins were indeed the culprit.
While the CDC recommends 46 grams of protein for women and 56 grams for men daily, Longo cautions that “The majority of Americans are eating about twice as much protein as they should, and it seems that the best change would be to lower the daily intake of all proteins but especially animal-derived proteins.”
At Beyond Health, we suggest limiting your intake of animal protein to one egg or 2-3 ounces of organic chicken or red meat per day, but you can safely consume all the plant protein you like.
Sources:

1. http://news.usc.edu/59199/meat-and-cheese-may-be-as-bad-for-you-as-smoking/
2. http://www.scientificamerican.com/article/diet-high-in-meat-proteins-raises-cancer-risk-for-middle-aged-people/

Low-carb, high-protein diet increases risk of death from all causes

The low-carb fad has had its peak, and although it is declining in popularity, the myth persists that eating lots of meat and little or no ‘carbs’ is a great way to lose weight.

Plenty of studies have established that low-carb diets are moderately effective for weight loss over periods of 6 months to 2 years[1-3], though much of the weight lost initially is typically regained. This may be a better option than the processed food-soda diet many other Americans consume, so of course they are moderately effective – the number of calories consumed decreases as refined carbohydrates are eliminated from the diet. Low-carbohydrate diets cause people to lose some weight but at what cost? The short durations of these studies meant that they could not determine whether the diets are sustainable for long-term health. The current state of the medical literature would suggest that they are not – there is abundant data associating high meat consumption with adverse outcomes: weight gain, cardiovascular disease, cancer, diabetes, and all-cause mortality, just to name a few.[4-10] I have been warning for years that the long-term outcome of meat-based diets would not be favorable.
A long-term observational study of low-carbohydrate diets has finally been published this Tuesday in the Annals of Internal Medicine, and the results are intriguing. This study by researchers from the Harvard School of Public Health is the nail in the coffin of the low-carb, high-protein myth. The article details data from a prospective study in which 130,000 total participants provided information about their eating habits and were followed for a minimum of twenty years – this is true long-term data. At baseline, none of the participants had heart disease, cancer, or diabetes. The researchers classified the participants’ diets according to degree of adherence to the following dietary patterns: overall low-carbohydrate, animal-based low-carbohydrate, and high-vegetable low carbohydrate. They then compared death rates between the highest and lowest adherence groups for each pattern.

The authors’ conclusions: A low-carbohydrate diet rich in animal foods was associated with a 23% increased risk of death from all causes (14% increased risk of death from cardiovascular disease). In contrast, a low-carbohydrate diet rich in vegetables was associated with a 20% decreased risk of death from all causes (23% decreased risk of death from cardiovascular disease).[11]

The low-carb proponents had one thing right: the avoidance of refined carbohydrates – white flour, white rice, white pasta, added sugars, etc. are disease-promoting foods. However, the protein sources emphasized in most low-carb diets are micronutrient-poor animal products rather than micronutrient-packed plant products. The current study suggests that plant sources of protein (for example vegetables, nuts, beans, and seeds) promote longevity, whereas high protein animal foods have the opposite effect. This data supports the essential nutritional concept I illustrate with my health equation: Health = Nutrients / Calories. Micronutrient density determines the quality of one’s diet, and since animal products are deficient in micronutrients, they should be minimized. The authors agree that their results likely reflect the lack of protective fiber, minerals, vitamins, and phytochemicals in animal products. [12]
Many proponents of meat-based diets argue that the refined carbohydrate rather than the meat content of the American diet is to blame for our skyrocketing rates of chronic disease. However, too many studies contradict this opinion – and this study clearly demonstrates that choosing plant foods instead of animal foods, even within the context of minimal refined carbohydrate, promotes longevity.
There really should not be any controversy anymore about the health effects of low-carb, high-protein diets. This study (among others) confirms that the current amount of animal-source foods within the American diet should be reduced, not increased, and that meat-centered diets promote premature death; and that diets based predominantly on whole plant foods are lifespan-enhancing.
The “nutritarian” diet I recommend is unique because it focuses on consuming more of the highest micronutrient containing vegetation, as it reduces animal products to a condiment or minimal role held to less than 10 percent of total calories. Vegetables rule!
References:
1. Foster, G.D., et al., Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Ann Intern Med, 2010. 153(3): p. 147-57.
2. Brinkworth, G.D., et al., Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Am J Clin Nutr, 2009. 90(1): p. 23-32.
3. Sacks, F.M., et al., Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med, 2009. 360(9): p. 859-73.
4. Sinha, R., et al., Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med, 2009. 169(6): p. 562-71.
5. Vergnaud, A.C., et al., Meat consumption and prospective weight change in participants of the EPIC-PANACEA study. Am J Clin Nutr, 2010. 92(2): p. 398-407.
6. Zheng, W. and S.-A. Lee, Well-Done Meat Intake, Heterocyclic Amine Exposure, and Cancer Risk. Nutrition and Cancer, 2009. 61(4): p. 437-446.
7. Key, T.J., et al., Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr, 1999. 70(3 Suppl): p. 516S-524S.
8. Ashaye, A., J. Gaziano, and L. Djousse, Red meat consumption and risk of heart failure in male physicians. Nutr Metab Cardiovasc Dis, 2010.
9. Snowdon, D.A., R.L. Phillips, and G.E. Fraser, Meat consumption and fatal ischemic heart disease. Prev Med, 1984. 13(5): p. 490-500.
10. Aune, D., G. Ursin, and M.B. Veierod, Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies. Diabetologia, 2009. 52(11): p. 2277-87.
11. Fung TT, v.D.R., Hankinson SE,Stampfer M, Willett WC, Hu FB, Low-Carbohydrate Diets and All-Cause and Cause-Specific Mortality: Two Cohort Studies. Ann Intern Med, 2010. 153(5): p. 289-298.
12. Fiore, K. Low-Carb Diet is Better When Rich in Veggies. 2010 September 7, 2010]; Available from: http://www.medpagetoday.com/PrimaryCare/DietNutrition/22035.

 Posted on September 8, 2010 by Joel Fuhrman, M.D.

Certain dietary supplements associated with increased risk of death in older women

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Consuming dietary supplements, including multivitamins, folic acid, iron and copper, among others, appears to be associated with an increased risk of death in older women, according to a report in the October 10 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. The article is part of the journal's Less Is More series.

The use of dietary supplements in the United States has increased considerably over the last decade, according to background information in the article. "At the population level, dietary supplements contributed substantially to the total intake of several nutrients, particularly in elderly individuals," the authors write.
Jaakko Mursu, Ph.D., of the University of Eastern Finland, Kuopio, Finland, and the University of Minnesota, Minneapolis, and colleagues used data collected during the Iowa Women's Health Study to examine the association between vitamin and mineral supplements and mortality (death) rate among 38,772 older women (average age 61.6 years). Supplement use was self-reported in 1986, 1997 and 2004 via questionnaires.
Among the 38,772 women who started follow-up with the first survey in 1986, 15,594 deaths (40.2 percent) occurred over an average follow-up time of 19 years. Self-reported supplement use increased substantially between 1986 and 2004, with 62.7 percent of women reporting use of at least one supplement daily in 1986, 75.1 percent in 1997 and 85.1 percent in 2004.
The authors found that use of most supplements was not associated with reduced total mortality in older women, and many supplements appeared associated with increased mortality risk. After adjustment, use of multivitamins, vitamin B6, folic acid, iron, magnesium, zinc and copper, were all associated with increased risk of death in the study population. Conversely, calcium supplements appear to reduce risk of mortality. The association between supplement intake and mortality risk was strongest with iron, and the authors found a dose-response relationship as increased risk of mortality was seen at progressively lower doses as women aged throughout the study.
Findings for both iron and calcium supplements were replicated in separate, short-term analyses with follow-up occurring at four years, six years and 10 years.
"Based on existing evidence, we see little justification for the general and widespread use of dietary supplements," the authors conclude. "We recommend that they be used with strong medically based cause, such as symptomatic nutrient deficiency disease."
Commentary: The Importance of Food
In an invited commentary, Goran Bjelakovic, M.D., D.M.Sc., of the University of Nis, Nis, Serbia, and Christian Gluud, M.D., D.M.Sc., of Copenhagen University Hospital, Copenhagen, Denmark, discuss the findings of Mursu and colleagues saying they "add to the growing evidence demonstrating that certain antioxidant supplements, such as vitamin E, vitamin A, and beta-carotene, can be harmful."
"Dietary supplementation has shifted from preventing deficiency to trying to promote wellness and prevent disease," the authors write. "Until recently, the available data regarding the adverse effects of dietary supplements has been limited and grossly underreported. We think the paradigm 'the more the better' is wrong. One should consider the likely U-shaped relationship between micronutrient status and health."
"We cannot recommend the use of vitamin and mineral supplements as a preventive measure, at least not in a well-nourished population," the authors conclude. "Older women (and perhaps men) may benefit from intake of vitamin D3 supplements, especially if they have insufficient vitamin D supply from the sun and from their diet. The issue of whether to use calcium supplements may require further study."

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Story Source:
The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.

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Journal References:

1. J. Mursu, K. Robien, L. J. Harnack, K. Park, D. R. Jacobs. Dietary Supplements and Mortality Rate in Older Women: The Iowa Women's Health Study. Archives of Internal Medicine, 2011; 171 (18): 1625 DOI: 10.1001/archinternmed.2011.445
2. G. Bjelakovic, C. Gluud. Vitamin and Mineral Supplement Use in Relation to All-Cause Mortality in the Iowa Women's Health Study: Comment on 'Dietary Supplements and Mortality Rate in Older Women'. Archives of Internal Medicine, 2011; 171 (18): 1633 DOI: 10.1001/archinternmed.2011.459

Τα αντιοξειδωτικά ίσως επιταχύνουν την εκδήλωση του καρκίνου

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Νέα Υόρκη

Οι καπνιστές και άλλα άτομα που ανήκουν στις ομάδες υψηλού κινδύνου για εκδήλωση καρκίνου του πνεύμονα, ενδεχομένως να καθιστούν τους εαυτούς τους πιο ευάλωτους στη νόσο όταν παίρνουν συμπληρώματα αντιοξειδωτικών ουσιών, σύμφωνα με μελέτη που δημοσιεύεται στο επιστημονικό έντυπο Science Translational Medicine.

Όπως υποστηρίζουν ερευνητές από το Πανεπιστήμιο του Γκέτεμποργκ στη Σουηδία, τα αντιοξειδωτικά φαίνεται να επιταχύνουν την πρόοδο του καρκίνου βραχυκυκλώνοντας μια από τις βασικές αντιδράσεις του ανοσοποιητικού συστήματος στα κακοήθη κύτταρα.

Συγκεκριμένα, οι επιστήμονες παρατήρησαν ότι οι φυσιολογικές δόσεις βιταμίνης Ε και οι μικρότερες δόσεις του αντιοξειδωτικού συμπληρώματος ακετυλκυστεΐνης αύξησαν την ανάπτυξη των όγκων στα ποντίκια με πρώιμο καρκίνο του πνεύμονα.

«Παρατηρήσαμε ότι τα αντιοξειδωτικά προκαλούσαν τριπλάσια αύξηση του αριθμού των όγκων και έκαναν τους όγκους πιο επιθετικούς», εξηγεί ο Δρ Μάρτιν Μπεργκο, επικεφαλής της επιστημονικής ομάδας. «Τα αντιοξειδωτικά προκάλεσαν το θάνατο των τρωκτικών με διπλάσια ταχύτητα, και η σχέση ήταν δοσο-εξαρτώμενη. Αν η δόση ήταν μικρή, οι όγκοι αναπτύσσονταν λίγο. Αν η δόση ήταν μεγάλη, τότε οι όγκοι μεγάλωναν περισσότερο», συμπληρώνει.

Τα αποτελέσματα της μελέτης προκαλούν ιδιαίτερη ανησυχία στους επιστήμονες επειδή η ακετυλκυστεΐνη χρησιμοποιείται για τη βελτίωση της αναπνοής των ασθενών με χρόνια αποφρακτική πνευμονοπάθεια (ΧΑΠ). Οι περισσότεροι πάσχοντες από ΧΑΠ είναι νυν ή πρώην καπνιστές.

Τα αντιοξειδωτικά υποτίθεται ότι προστατεύουν τον οργανισμό από την ασθένεια, εμποδίζοντας την κυτταρική βλάβη που προκαλούν οι ελεύθερες ρίζες. «Οι ελεύθερες ρίζες μπορούν να καταστρέφουν τα πάντα μέσα στο κύτταρο, ακόμη και το DNA. Και η βλάβη στο DNA του κυττάρου μπορεί να προκαλέσει την εκδήλωση καρκίνου», εξηγεί ο Δρ Μπέργκο.

Αλλά αυτή η προστασία αποτυγχάνει στα άτομα που έχουν ήδη καρκινικά ή προκαρκινικά κύτταρα.

Όταν το σώμα ανιχνεύει βλάβη στο κυτταρικό DNA που μπορεί να οδηγήσει στην εκδήλωση καρκίνου, εκκρίνει την ογκο-κατασταλτική πρωτεΐνη p53.

Στα εργαστηριακά πειράματα που έκαναν οι ερευνητές σε καρκινικά κύτταρα από ποντίκια και ανθρώπους, διαπίστωσαν ότι τα αντιοξειδωτικά κατέστειλαν την έκκριση της πρωτεΐνης p53 αναστέλλοντας την βλάβη στο DNA που γίνεται στα καρκινικά κύτταρα από τις ελεύθερες ρίζες.

«Μειώνοντας τη βλάβη στο DNA, τα αντιοξειδωτικά στην πραγματικότητα βοηθούν τα καρκινικά κύτταρα να αποφύγουν το σύστημα ανίχνευσης του οργανισμού», εξηγεί ο Δρ Περ Λινταλ, καθηγητής Βιοχημείας και Κυτταρικής Βιολογίας στο Πανεπιστήμιο του Γκέτεμποργκ.

Αυτό πρακτικά σημαίνει ότι τα άτομα που είναι φορείς μικρών αδιάγνωστων όγκων στους πνεύμονές τους θα πρέπει να αποφεύγουν τη χρήση συμπληρωμάτων αντιοξειδωτικών ουσιών.

Αν μάλιστα κάποιος πάσχει ήδη από καρκίνο του πνεύμονα ή ανήκει σε ομάδα υψηλού κινδύνου, τότε τα αντιοξειδωτικά μπορεί να συντελέσουν στην περαιτέρω ανάπτυξη των καρκινικών όγκων.

Κι ενώ θα πρέπει πάντα να είμαστε επιφυλακτικοί στην ερμηνεία των πειραματικών ερευνών, δεν είναι η πρώτη φορά που μελέτη δείχνει ότι τα αντιοξειδωτικά κάνουν κακό στους καρκινοπαθείς.

Μελέτες που είχαν γίνει σε ανθρώπους τη δεκαετία του 1980 και του 1990 είχαν δείξει ότι η β-καροτένη, η βιταμίνη Α και η βιταμίνη Ε αυξάνουν ουσιαστικά τη συχνότητα του καρκίνου του πνεύμονα στους καπνιστές.

Folic acid supplements cause cancer

Folic acid supplements cause cancer. Avoid every supplement that contains folic acid. Instead, eat foods high in folate (folate is the natural form of folic acid) like green leafy vegetables.

People pride themselves on popping pills, especially when labeled as “nutritional supplements.” Don’t ask me why. But, just as I’ve reveled in swallowing nine shots of tequila in a dank, Mexican bar, American’s are proud to pop pills. I’m not sure which is worse. But, if I had to bet, I’d say “pill pride,” especially when it comes to nutritional supplements.
When I toss too many back, I know what I’m getting into. My ego goes from being really big to very big in the blink of an eye. This is partly why my book, Over-The-Counter Natural Cures, is so much fun to read (or offensive depending on your point of view). At times, I drank to break up the monotony of writing, and subsequently my ego took pot-shots at the pharmaceutical and supplement industries (essentially, one in the same the same). That’s a predictable outcome, and knowing that is awareness in motion, no matter how stupid the act might be.
In contrast, the outcome associated with popping nutritional supplements can be unpredictable. That’s bad, especially when your livelihood depends on it. Folic acid is a perfect example.
Just as counterfeit Rolex watches are sold to intoxicated teenagers on the streets of Mexico, the drug industry pushes counterfeits of Mother Nature to consumers dizzy with marketing spin. This is the best analogy for the “folic acid fallacy.” Folic acid is a cheap counterfeit isolate of the naturally occurring “folate.”
The term folate (not folic acid) encompasses a slew of naturally occurring chemical cousins – chemists call them isomers – that have a wide range of positive roles in the body. Without full-spectrum natural folate, our body becomes a breeding ground for Alzheimer’s disease, coronary heart disease, osteoporosis, neural tube defects, poor cognitive performance, depression, hearing loss and many types of cancer.
In one of the biggest natural heists in pharmaceutical history, Big Pharma has stolen the real folate from the marketplace and replaced it with their counterfeit: Folic acid. Known to chemists as pteroylglutamic acid monoglutamate, the drug folic acid is one of the best-selling counterfeits infiltrating nutritional supplement products such as multi-vitamins and prenatals. Adding injury to insult, the FDA mandated that grain-based foods such as bread and cereal, be fortified with it in 1996. The only thing missing is a “black box warning,” because the side effects are staggering.
The Unpredictable Outcome of Folic Acid Use
Today, an estimated 274 million people are being exposed to folic acid. Unbeknownst to them, the synthetic compound has proven adverse effects and according to the Food and Drug Administration (FDA), “no long term studies exist to evaluate the risks associated with prolonged use.” Supplement promoters usually hiss and snort when hearing this, insisting that “I’m missing vital studies.” Please. I have piles of research papers bigger than most midget thinkers who push cheap, nutritional supplement propaganda online –Ah, there goes my ego again, and I’m not even drinking.
Prenatal and postnatal supplementation of folic acid in mothers on a standard diet resulted in the occurrence of higher numbers of cancer tumors. The Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening trial linked folic acid intake with 20% to 32% increased risk of breast cancer in women consuming more than 400 microg/d supplemental folic acid.
Moms who supplement with folic acid face a drug induced illness known as MTHFR (methylenetetrahydrofolate polymorphism). Kinda like the shuffling of cards, folic acid can shuffle your genetic map leading to altered DNA activity, putting moms at risk for heart disease as well as colonic cancer and acute leukemia later in life. Writing for Nature magazine, scientists warned in 2005 that the use of folic acid in fortification programs worldwide could have, “the side effect of increasing the prevalence of some of the most significant, human life-threatening diseases.”
The Safe Alternative to Folic Acid
The history of folate dates back to 1931 when chemists concluded that anemia was caused by a dietary deficiency of the vitamin, based on their discovery of it in folate rich foods like liver and yeast. Big Pharma – smelling big money in a synthetic version – moved quickly to counterfeit the natural cure. Folic acid was created in a lab in 1941 and today has replaced natural folate consumption, but not without risk.
Fortunately, wiping out illness associated with a folate deficiency is simply a matter of adhering to “nutrient logic” rather than popping unpredictable pills. You can do this by bolstering your diet with foods rich in folate like liver, leafy green vegetables (such as spinach and turnip greens), fruits (such as citrus fruits and juices), eggs, dried beans and peas, and the forgotten master folate supplement, non-fortified brewer’s yeast.
This, like drinking tequila, has a predictable outcome. But unlike irresponsible tequila consumption (which I don’t condone), it’s an outcome that leads to health and longevity made simple by nature. Admittedly, Big Pharma will have to suffer a pay cut as this nutrient logic becomes a reality and natural folate stages a comeback. Pill trashing will then replace pill popping.

Dr. Fuhrman warns:

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DO NOT take multivitamins
that contain folic acid.
and
If you are pregnant,
DO NOT take prenatal vitamins
that contain folic acid!

Folic acid supplementation is dangerous – especially for pregnant women

Women who take supplemental folic acid increase their breast cancer risk by 20-30%, according to a study in the American Journal of Clinical Nutrition. Researchers collected data on women's folic acid intake from multivitamins over a 10-year period – they found that the women who took multivitamins containing folic acid were more likely to be diagnosed with breast cancer than those that did not. ^1,2
A study published earlier this year found a 163% increased risk of prostate cancer in men taking folic acid supplements.³
A new meta-analysis of folic acid supplementation and colorectal cancer risk found that those who took folic acid for more than three years increased their risk of having a colorectal adenoma by 35%.⁴ In the U.S., Canada, and most recently Chile, colorectal cancer rates have climbed since the advent of mandatory fortification of flour with folic acid.^10-11
Another new study, has found that folic acid supplementation by pregnant women increases the risk of childhood asthma by 26% ⁵, and yet another study linked folic acid supplementation during pregnancy to increased incidence of respiratory tract infections in infants, especially those resulting in hospitalization.⁶
This past month in Norway, where there is no fortification of flour with folic acid, researchers conducting a six-year study on the homocysteine-lowering effects of B vitamins in patients with heart disease made an unexpected finding: the patients whose supplement included folic acid had a greater risk of cancer incidence and cancer mortality.⁷ These patients were 43% more likely to die from cancer.
Most alarming was another study that compared women who took folic acid during their pregnancy to those that did not. Thirty years later those women who followed the typical recommendations to take folic acid were twice as likely to die from breast cancer.⁸ Shocking info huh!

If folic acid can have these dangerous effects, why is it included in most
multivitamins, prenatal vitamins and fortified grain products?

Folic acid is the synthetic form of folate, a member of the family of B vitamins that is involved with DNA synthesis and DNA methylation, which essentially turns genes on and off. Because of these crucial functions, folate plays important roles in fetal development and nerve tissue health as well as cancer initiation and progression.
The protective effects of folate against neural tube defects (NTDs) have received much attention in the past. Unfortunately, this knowledge and public attention did not result in a campaign by the U.S. government encouraging women to get plenty of natural dietary folate from vegetables – instead, pregnant women are pushed to take folic acid supplements.
Folic acid is chemically different from dietary folate, which results in differences in uptake and processing of these two substances by the cells in the intestinal wall. Some folic acid is chemically modified to be more similar to natural folate, but the intestinal cells are limited in how much folic acid they can modify – excess folic acid often enters the circulation unmodified. Scientists do not yet know the implications of circulating synthetic folic acid. Many Americans, through multivitamin use and consumption of fortified foods, are taking in excessive amounts of folic acid, and thus may have unmodified folic acid circulating in their blood – this could contribute to the cancer-promoting effects.^9,10-11
The recommendation that pregnant women take folic acid supplements is especially troubling – these women could safely increase their folate status and prevent neural tube defects (NTDs) by eating green vegetables, but instead they are instructed to take folic acid supplements, which put them at risk for breast cancer later in life. The children are also put at risk –women who take folic acid supplements as a substitute for good nutrition fail to provide their unborn children with the additional nutrients in folate-containing foods. Maternal nutrition is a critical determinant of childhood health – there are inverse associations between maternal vegetable intake and childhood cancers.^12-13
Unlike synthetic folic acid, folate obtained from food sources – especially green vegetables – protects against breast and prostate cancer.
Paradoxically, in people who do not take folic acid supplements there is inverse relationship between dietary folate intake and breast and prostate cancer.^14,3 Folate is an essential nutrient with vital functions. It is probable that folate levels need to be tightly regulated by the body – that the timing and dose of folate is an important determinant of whether folate has positive or negative effects. Folate's actions on DNA may prevent cancer from initiating, but may also promote the proliferation of tumor cells that may already present.¹⁵ Luckily, getting our folate exclusively from food ensures that we do not get too much. It comes naturally packaged in balance with other micronutrients and the body regulates its absorption.⁹

Rich sources of food folate

As a reference point, the U.S. RDA for folate is 400μg.  Below is the approximate folate content for a 100-calorie serving.¹⁶

Spinach, raw	843 μg		Edamame	225 μg
Endive	835 μg		Tomatoes, yellow	200 μg
Romaine lettuce	800 μg		Tomatoes, orange	180 μg
Asparagus, cooked	750 μg		Chickpeas	150 μg
Mustard greens, raw	700 μg		Red peppers, raw	150 μg
Collards, raw	550 μg		Papaya	90 μg
Okra, cooked	520 μg		Snow/Snap peas, raw	100 μg
Bok choy, raw	500 μg		Summer squash	100 μg
Brocolli Rabe, raw	375 μg		Tomatoes, red	85 μg
Arugula, raw	340 μg		Strawberries	75 μg
Artichokes, cooked	330 μg		Oranges	70 μg
Brussels sprouts, cooked	300 μg		Beets, cooked	50 μg
Broccoli, cooked	300 μg		Blackberries	55 μg
Cauliflower, raw	225 μg		Avocado	50 μg
Red leaf lettuce	225 μg		Sunflower seeds	40 μg
Celery, raw	225 μg		Quinoa, cooked	35 μg

Clearly, we do not need synthetic folic acid supplements to meet our daily folate requirements.
Dr. Fuhrman's Multivitamins do not contain folic acid
Because folate is abundant in the nutritarian diet, and synthetic folic acid is so potentially dangerous, folic acid is not included in Dr. Fuhrman's Gentle Care or Gentle Prenatal multivitamin supplements.

Dr. Fuhrman does not recommend prenatal vitamins generally available on the market because of the potentially harmful ingredients that they contain, such as folic acid. Sensitive to the needs of women who are pregnant or of childbearing age, Dr. Fuhrman designed his own prenatal.

Dr. Fuhrman's special recommendations for pregnant women:

- Gentle Prenatal (delivers the iron and extra vitamin D needed by pregnant women)
- Osteo-Sun
- DHA+EPA Purity
- A nutrient dense diet, rich in green vegetables (and folate)

See Dr. Fuhrman's Vitamin Advisor for more recommendations.

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Gentle Care Formula (multivitamin and mineral) Too much of certain nutrients, including folic acid, has been shown to have negative health effects and may also promote breast cancer.^1,2,16 This formulation avoids potentially toxic ingredients, such as vitamin A¹⁷ , beta carotene^18-20, folic acid, copper and iron. All of the ingredients are selected for optimal quality, absorption, and gentleness. This balanced antioxidant blend also offers phytochemical and carotenoid concentrates from green food extracts.
Gentle Prenatal (multivitamin and mineral) contains the same carefully designed combination of vitamins and minerals present in Gentle Care Formula, but has been uniquely tailored to the needs of pregnant women with iron and more vitamin D.

References:
1. Stolzenberg-Solomon RZ et al. Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am J Clin Nutr. 2006 Apr;83(4):895-904.
2. Kim YI. Does a high folate intake increase the risk of breast cancer? Nut Rev; 2006; 64(10PT1) 468-75.
3. Figueiredo JC et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst. 2009 Mar 18;101(6):432-5. Epub 2009 Mar 10.
4. Fife, J et al. Folic Acid Supplementation and Colorectal Cancer Risk; A Meta-analysis. Colorectal Dis. 2009 Oct 27. [Epub ahead of print]
5. Whitrow MJ, Moore VM, Rumbold AR, Davies MJ. Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study. Am J Epidemiol. 2009 Dec 15;170(12):1486-93.
6. Haberg SE, London SJ, Stigum H, Nafstad P, Nystad W. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child. 2009 Mar;94(3):180-4. Epub 2008 Dec 3.
7. Ebbing M et al. Cancer Incidence and Mortality After Treatment With Folic Acid and Vitamin B12. JAMA. 2009;302(19):2119-2126.
8. Charles D et al. Taking folate in pregnancy and risk of maternal breast cancer. BMJ 2004;329:1375–6
9. Harvard School of Public Health; The Nutrition Source: Keep the Multi, Skip the Heavily Fortified Foods; www.hsph.harvard.edu/nutritionsource/what-should-you-eat/folicacid/ Date accessed: 8/29/08.
10. Hirsch S et al. Colon cancer in Chile before and after the start of the flour fortification program with folic acid. Eur J Gastroenterol Hepatol. 2009 Apr;21(4):436-9.
11. http://www.medscape.com/viewarticle/591111
12. Kwan ML et al. Maternal diet and risk of childhood acute lymphoblastic leukemia. Public Health Rep. 2009 Jul-Aug;124(4):503-14.
Tower RL et al. The epidemiology of childhood leukemia with a focus on birth weight and diet. Crit Rev Clin Lab Sci. 2007;44(3):203-42.
Petridou E et al. Maternal diet and acute lymphoblastic leukemia in young children.Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1935-9.
Jensen CD et al. Maternal dietary risk factors in childhood acute lymphoblastic leukemia (United States).Cancer Causes Control. 2004 Aug;15(6):559-70.
13. Huncharek M et al. A meta-analysis of maternal cured meat consumption during pregnancy and the risk of childhood brain tumors. Neuroepidemiology. 2004 Jan-Apr;23(1-2):78-84.
Pogoda JM et al. An international case-control study of maternal diet during pregnancy and childhood brain tumor risk: a histology-specific analysis by food group. Ann Epidemiol. 2009 Mar;19(3):148-60.
14. Sellers TA et al. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology. 2001 Jul;12(4):420-8.
15. Kim YI. Folic acid fortification and supplementation--good for some but not so good for others. Nutr Rev. 2007 Nov;65(11):504-11.
16. http://www.nutritiondata.com/tools/nutrient-search
17. Bjelakovic G, Nikolava D, Gluud LL, et al. Antioxidant supplements for prevention of mortality in healthy participants and patient with various diseases. Cochrane Database Syst Rev 2008;16(2):CD00776.
18. Mayne ST. Beta-carotene, carotenoids, and disease prevention in humans. FASEB. 1996;10(7):690-701.
19. Goodman GE. Prevention of lung cancer. Current Opinion in Oncology 1998;10(2):122-126.
20. Kolata G. Studies Find Beta Carotene, Taken by Millions, Can't Forestall Cancer or Heart Disease. New York Times, Jan 19, 1996.

Folic Acid During Pregnancy May Be Dangerous To Child

There are many misconceptions regarding pregnancy and some require a bit of examination to determine if there is any truth in what a lot of them suggest.
Folic acid has been recommended for many years for the benefit of the growing baby in the womb.
However data from a recent study would seem to suggest that it might in fact create a bigger risk from cancer.
Taken in large doses it could mean that any child goes on to develop tumors in later life.
Diet is important not only in women but also the male population. The latter that consume less vegetables and fruits but have a preference for dairy and meat have a lower sperm count.
This would indicate that both partners should change their life style once they have decided to try for a baby.
Women that are very overweight when pregnant will definitely be affected. Not only will they be more prone to most conditions like high blood pressure and pre-eclampsia but also routine scans will be more difficult to perform.
Accurate pregnancy ultrasound, which is one of the main methods of monitoring the progress of any pregnancy, is difficult.
In India it was found that expectant mother of a short stature were more likely to lose their babies before the age of five than those taller than five feet. This statistic was surprisingly high and the reason must be more than just health but possibly the size of the womb etc.
There are so many versions of what is good for mother and baby, some handed through generations, that it is not surprising that scientists prefer to go on facts rather than what is usually just fiction.

Is supplemental folic acid harmful?

Folate is a member of the B vitamin family and is found naturally in foods, especially green vegetables. Folate is involved with DNA synthesis and DNA methylation, which essentially turns genes on and off.  Because of these crucial functions, folate plays important roles in fetal development and nerve tissue health as well as cancer initiation and progression.
Folic acid is the synthetic form of folate that is added to food or used as an ingredient in vitamin supplements. Folic acid is added to most enriched, refined grain products like bread, rice and pasta in the U.S. and Canada in an attempt to replace the nutrients lost during the processing of the whole grain. Since folic acid is added to so many refined grain products, it is very easy for a typical diet combined with a multivitamin to end up with high levels of folic acid, the synthetic form. Too much folate obtained naturally from food is not a concern.  It comes naturally packaged in balance with other micronutrients and the body regulates its absorption. Folic acid is not found in natural foods.
The protective effects of folate against neural tube defects (NTDs) have received much attention in the past.  Unfortunately, this knowledge and public attention did not result in a campaign by the U.S. government encouraging women to get plenty of natural dietary folate from vegetables.  Instead, because the Standard American Diet (SAD) is so nutritionally inadequate, the U.S. government and most physicians encourage women to take folic acid supplements, assuming that they are folate-deficient.  This actually perpetuates the widespread vegetable deficiency that does exist.
The problem is that folic acid is chemically different from dietary folate, which results in differences in uptake and processing of these two substances by the cells in the intestinal wall. Some folic acid is chemically modified to be more similar to natural folate, but the intestinal cells are limited in how much folic acid they can modify – folic acid often enters the circulation unmodified. Scientists do not yet know the implications of circulating synthetic folic acid. Many Americans, through multivitamin use and consumption of fortified foods, are taking in excessive amounts of folic acid, and thus may have unmodified folic acid circulating in their blood – this could contribute to cancer-promoting effects. ^1-3
Folate is abundant in all green vegetables. We do not need synthetic folic acid supplements to meet our daily folate requirements. Here are a few examples of folate-rich foods (as a reference point, the U.S. RDA for folate is 400µg):⁴

Food Source	Micrograms
Edamame (1 cup cooked)	482 µg
Broccoli (2 cups cooked)	337 µg
Asparagus (1 cup cooked)	268 µg
Romaine lettuce (3 cups raw)	192 µg
Brussels sprouts (2 cups cooked)	187 µg
Spinach (3 cups raw)	175 µg

Recently, there have been some troubling studies connecting folic acid supplementation with breast, prostate, and colorectal cancers:

• Women who followed the typical recommendations to take folic acid during pregnancy and were followed by researchers for thirty years were twice as likely to die from breast cancer.⁵
• Another study following women for ten years concluded that those who took multivitamins containing folic acid increased their breast cancer risk by 20-30%.⁶
• Folic acid supplementation by pregnant women has been associated with incidence of childhood asthma, infant respiratory tract infections, and cardiac birth defects.^7-9
• Men who had taken folic acid supplements for more than three years had a 35% increase in colorectal cancer risk, according to a meta-analysis of several randomized controlled trials.¹⁰
• In a 10-year study, folic acid supplementation was associated with more than double the risk of prostate cancer compared to placebo.¹¹
• In two trials comparing folic acid supplements to placebo, overall cancer incidence and all-cause mortality were increased in the folic acid group over the 9-year study period.¹²

In contrast, food folate is associated with protection from cancer and other benefits:

• Women with lower levels of food folate intake are more likely to be diagnosed with breast cancer.¹³
• Food folate intake is inversely associated with prostate cancer risk.¹¹
• The children of women who consumed more food folate during pregnancy were less likely to develop ADHD.¹⁴

Getting enough folate from natural foods may keep tumors from starting by repairing errors in DNA, but synthetic folic acid may feed tumor development and promote  carcinogenesis. In light of this research, I do not include folic acid in my multivitamin or prenatal.  I do not recommend that pregnant women take a prenatal that contains folic acid.  I do recommend a blood test for folate sufficiency before even contemplating pregnancy, and I do recommend a high-folate diet rich in green vegetables.  A diet rich in green vegetables is the safest way to achieve protection from cancer, heart disease and all-cause mortality.

1. Harvard School of Public Health; The Nutrition Source: Keep the Multi, Skip the Heavily Fortified Foods.  August 29, 2008]; Available from: www.hsph.harvard.edu/nutritionsource/what-should-you-eat/folicacid/.
2. Hirsch, S., et al., Colon cancer in Chile before and after the start of the flour fortification program with folic acid. Eur J Gastroenterol Hepatol, 2009. 21(4): p. 436-9.
3. Chustecka, Z. Folic-Acid Fortification of Flour and Increased Rates of Colon Cancer . 2009  [cited 2009; Available from: http://www.medscape.com/viewarticle/591111.
4. NutritionData.com: Nutrient Search Tool.  2009]; Available from: http://www.nutritiondata.com/tools/nutrient-search.
5. Charles, D., et al., Taking folate in pregnancy and risk of maternal breast cancer. Bmj, 2004. 329(7479): p. 1375-6.
6. Stolzenberg-Solomon, R.Z., et al., Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am J Clin Nutr, 2006. 83(4): p. 895-904.
7. Whitrow, M.J., et al., Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study. Am J Epidemiol, 2009. 170(12): p. 1486-93.
8. Haberg, S.E., et al., Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child, 2009. 94(3): p. 180-4.
9. Kallen, B., Congenital malformations in infants whose mothers reported the use of folic acid in early pregnancy in Sweden. A prospective population study. Congenit Anom (Kyoto), 2007. 47(4): p. 119-24.
10. Fife, J., et al., Folic Acid Supplementation and Colorectal Cancer Risk; A Meta-analysis. Colorectal Dis, 2009.
11. Figueiredo, J.C., et al., Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst, 2009. 101(6): p. 432-5.
12. 12. Ebbing, M., et al., Cancer incidence and mortality after treatment with folic acid and vitamin B12. JAMA, 2009. 302 (19): p. 2119-26.
13. Sellers, T.A., et al., Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology, 2001. 12 (4): p. 420-8.
14. Wiley-Blackwell (2009, October 28). Attention-deficit/hyperactivity Problems Associated With Low Folate Levels In Pregnant Women. ScienceDaily. 2009  February 5, 2010]; Available from: http://www.sciencedaily.com/releases/2009/10/091028134631.htm.

Adding folic acid to all our diets is a recipe for disaster

By PROFESSOR DAVID SMITH
Last updated at 10:42 27 September 2007

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'Fortifying all flour with folic acid is potentially a national health disaster'

Flour could soon be fortified with folic acid to reduce the number of babies born with spina bifida. But here, a pharmacologist and leading authority on folic acid claims many adults could die as a result:

Fortifying all flour with folic acid is potentially a national health disaster. Folic acid is the synthetic version of the B vitamin folate. But although it's vital for health, it has a dark side.
Giving extra amounts to everyone in the country ? whether they need it or not ? could lead to more than 3,000 new cases of colon cancer, a rise in prostate cancer and put as many as 150,000 elderly people at risk of anaemia and memory problems.
There is no question that folic acid is important. Pregnant women who don't get enough of it run the serious risk of their baby being born with spina bifida, a horrible condition which means that the spine hasn't closed up properly so that part of the spinal cord is exposed, leaving the child disabled for life and possibly in need of constant care.
The problem is that at present, only about 50 per cent of pregnant women get enough folic acid. Putting it in flour ? as the Food Standards Agency (FSA) is recommending ? is a fairly cheap and easy way of making sure at the start of a pregnancy that all women have adequate levels.
In America, they have been fortifying flour with folic acid since 1996 and the incidence of spina bifida has dropped by more than 20 per cent. In the UK, it's claimed the same move could prevent up to 160 spina bifida pregnancies a year.
A fortification programme might have other benefits, too. Folic acid can protect you against cancer because your cells need it to repair the daily damage to their DNA, damage that can otherwise lead to the disease.
Folic acid is also needed to reduce levels of a substance called homocysteine in your blood (high levels of homocysteine raise your risk of heart disease and strokes). Extra folic acid may cut the number of strokes by 18 per cent, according to research just published in The Lancet. Certainly, deaths from stroke in America have fallen since fortification of flour.
And there's yet another benefit.
My research suggests that keeping down homocysteine may also be a way of cutting your risk of developing Alzheimer's, and I'm currently running a trial in Oxford, giving extra folic acid to elderly people to try to prove it.
So fortification seems to make a lot of sense. Following a favourable report by the FSA earlier this year, the Government is now considering legislating to force food manufacturers to fortify all flour except wholemeal, which is being excluded to give people a choice.
But while I was once a passionate advocate of folic acid, I am now passionate about alerting people to the potential harm it can cause and about the importance of research to discover who will gain from it and who should not take too much.
The more we learn about folic acid, the more it's clear that giving it to everyone has very real risks.
Nearly all medicines involve a balancing act. If you're not getting enough folic acid (good sources include wholewheat, liver, eggs, beans, fruits and leafy green vegetables) then a boost from your daily bread intake could help.
But if your levels are already adequate, then the extra could be damaging. And that's why fortification is such a bad idea. It's like using a shotgun in a crowded place; bystanders are going to get hurt.
While folic acid can protect you against cancer, once a tumour has already started growing, it can switch sides. Cancer cells are greedy for folic acid; it helps them to keep reproducing.
Knowing that, now consider the fact that 20 per cent of middleaged people have pre-cancerous cells in their colon and that most middle-aged men have them in their prostate, too. Forcing them to eat something that is likely to encourage those cells to grow suddenly doesn't seem such a bright idea.
Indeed, when we look at what has happened in the U.S. and Canada, it seems positively reckless.
According to a study just published, fortifying flour over there has been followed by an extra five people in 100,000 developing colon cancer annually. That may not sound a lot but the same rate of increase in the UK would mean an extra 3,000 cases.
In fact, the rate might be higher since the FSA recommends that we fortify flour with more than twice the American amount.
But extra cancer cases won't be the only fall-out. Folic acid performs another of its Jekyll and Hyde routines with the elderly.
Ten per cent of them have low levels of another B vitamin ? B12. This makes them more likely to develop anaemia (not enough red blood cells). They also become confused and their memory gets worse.
Giving them extra folic acid can hide the blood symptoms of low B12, making it likely their deficiency will be missed. The combination of high folic acid and low B12 may also make those mental problems worse. Scaling down from American figures, we can predict that 150,000 elderly people could have more memory problems as a result of fortification of flour in the UK.
And there is one more problem fortification is likely to cause. A whole class of drugs are designed to block folic acid because it makes conditions such as cancer, rheumatoid arthritis and psoriasis worse.
Forcing extra amounts of folic acid on everyone suffering from these conditions might affect their health It is only in the past few years that the dangers of folic acid fortification have become clear. If the Americans had known in 1996 what we know now, they would never have introduced it.
So it is highly irresponsible for the UK Government to even be thinking about it. More research is needed to identify those who might be harmed by extra folic acid and to assess the balance between benefit and harm.
Fortification sets up a grim equation. We have 800 new cases of spina bifida each year, but there are 30,000 new cases of colon cancer and 30,000 of prostate cancer.
Currently, 500,000 suffer from rheumatoid arthritis and 900,000 from psoriasis.
Half a million people, some of whom might be harmed, would be exposed to extra folic acid for every spina bifida baby saved. It's not worth it.
Instead of this cruel equation, we need to be much more sophisticated.
We need to be a lot more proactive about getting folic acid to those who do need it ? it should be freely available to all women of child-bearing age, for instance ? and do a much better job of warning those who could be harmed against it.
Monitoring older people to see who has too little and who needs B12 could make a huge difference to the quality of life of our elderly population.
Just adding folic acid to flour is far too crude. It may seem like a cheap option to gain some health benefits but it could end up costing thousands of people dear.
If it happens, my family will be sticking to wholemeal bread.
INTERVIEW: Jerome Burne.

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Folic Acid is Hazardous to Your Health.  What About Food Folate?

By Robert Thiel, Ph.D., Naturopath and Scientist
Folic acid gets a lot of press coverage.  There are many reports that folic acid should be taken by pregnant women and may prevent birth defects.  Folic acid has also been claimed to help prevent cardio- and cerebral-vascular diseases.  Yet few reports have mentioned that folic acid is unnatural, folic acid is synthetic, and that the body cannot properly convert much folic acid into a usable folate form.  Furthermore, concerns about folic acid feeding cancer are now a real concern in the 21st Century—too much folic acid may kill you.
“Folic acid is a synthetic folate form” [1] and was not developed until the 20th Century [2].  Folic acid is chemically known as pteroylglutamic acid (PGA) and is a crystalline substance (no food vitamins are naturally crystalline in structure) [2,3].  Folate, once also known as vitamin B9, exists in foods, yet crystalline folic acid does not [1-4].  Folates also differ from folic acid “in the extent of the reduction state of the pteroyl group, the nature of the substituents on the pteridine ring and the number of glutamyl residues attached to the pteroyl group” [1].
An Irish study found that the body has trouble converting more than 266 mcg of folic acid per day [2]. “(C)onsumption of more than 266 mcg of synthetic folic acid (PGA) results in absorption of unreduced PGA, which may interfere with folate metabolism for a period of years” [2].  A 2004 paper from the British Medical Journal confirmed what many natural health professional have known all along: since folic acid is unnatural and the body cannot fully convert large amounts of it into usable folate, this artificial substance can be absorbed and may have unknown negative consequences in the human body [4].  One of the biggest scientific concerns about folic acid is that even in amounts close to official daily recommendations, some of it is absorbed in unreduced form into the bloodstream with potentially dangerous results [2,4].  Also, “(i)n vitro studies do show that PGA derivatives act to inhibit certain enzymes, including those associated with nucleotide biosynthesis” [4].  In spite of this, the U.S. Food and Drug Administration has required that uncooked cereal grains and flour products be fortified with folic acid [1].
A JAMA study recently concluded that “studies have suggested that folate intake decreases risk of cardiovascular diseases. However…[f]olic acid supplementation has not been shown to reduce risk of cardiovascular diseases” [5].  This is because studies using folate (the natural form) show it works, yet folic acid (the synthetic form) does not.  Food folate is clearly superior.
Since food folate is natural and is absorbed through a different pathway than folic acid [2], long-term consumption of folate does not result in an accumulation of a foreign substance in the body, but instead has many benefits. 
Initially, food folate was given for people with a pregnancy-related anemia in the form of autolyzed yeast; later the synthetic form, folic acid, was developed [2].  Folic acid, as it exists in most supplements, is not found in foods, folates are [2].  USDA reports show that broccoli and alfalfa sprouts contain food folate [6,7] and they are considered to be the best food supplement source by some.  Furthermore, “folates are ubiquitous in nature, being present in nearly all natural foods…50 to 95% of folate in food may be destroyed by protracted cooking or other processing” [2].  Yeast, dark green leafy vegetables, and oranges have the highest folate content [1,2].
Folate is an important nutrient for healthy blood; the absence of any of it can trigger various forms of anemia (especially pernicious anemia) [2,8].  Subclinical deficiencies of folate may impair cognitive function [9].  Folate deficiency is the most important determinant in high homocysteine levels [9], and supplemental folate is effective in reducing homocysteine [10,11].  (Homocysteine is highly implicated in vascular diseases such as cardiovascular and other vascular disorders.)  “The major forms of folates found in food are methylTHF and formylTHF” [12]. 
While insufficient folate can result in fatigue, depression, confusion, anemia, reduced immune function, loss of intestinal villi, and an increase in infections [1,2,8], it is not totally clear what dangers long-term consumption of folic acid will cause [2,4].  Certain scientists believe that excessive consumption of folic acid may actually interfere with folate metabolism [2]—this could be expected to worsen conditions that would have otherwise benefited from real food folate.  Furthermore, “(v)ery large amounts of folic acid in its pharmacological oxidized (PGA) form may be noxious to the nervous system…and have provoked seizures in patients otherwise under control on anticonvulsant therapy” [2].
Excessive Folic Acid is Becoming a Health Concern
A 2010 report states, “"The more we learn about folic acid, the more it's clear that giving it to everyone has very real risks," says folic acid researcher David Smith, PhD, a professor of pharmacology at the University of Oxford in England…The risk experts worry about most: colon cancer. Last year, health officials in Chile reported that 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. In 2007, Joel Mason, MD, director of the Vitamins and Carcinogenesis Laboratory at the Tufts University School of Medicine, described a study of the United States and Canada suggesting that rates of colon cancer rose — following years of steady decline — in the late 1990s (around the time our food was being fortified)” [13].
The same report also states, “Other research links high doses to lung and prostate cancers. In one study conducted in Norway, which doesn't fortify foods, supplementation with 800 mcg of folic acid (plus B12 and B6) daily for more than 3 years raised the risk of developing lung cancer by 21 percent. Another, 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. And a new worry recently came to light when scientists discovered the liver has limited ability to metabolize folic acid into folate — which means any excess continues circulating in the bloodstream. "Unlike folate, folic acid isn't found in nature, so we don't know the effect of the excess," says Smith. Indeed, many scientists have grown increasingly concerned about mounting research — including a study published last winter in the Journal of the American Medical Association — suggesting that all the extra folic acid might increase your odds of developing cancer” [13].
Even foods “fortified” with folic acid may cause serious neurological problems in patients deficient in vitamin B12 [12].  Furthermore, “no folic acid dose can be considered as truly safe in the presence of untreated cobalamin deficiency” [12].
Laura Bell correctly reported, “We all need the natural folate found in leafy greens, orange juice, and other foods, and diets high in these foods are perfectly healthy; many researchers, though, believe that folic acid may be both friend and foe. When cells in the body are healthy, folate helps shepherd along the normal replication of DNA. But when cells are malignant or in danger of becoming so — and as many as half of adults older than 60 could already have precancerous colon polyps, while most middle-aged men have precancerous cells in their prostates — animal studies suggest excess folate in the form of folic acid may act like gas on the fire… lowering your intake to 400 mcg won't hurt — and might help save your life” [13].
It is clear that since folic acid is unnatural, is synthetic, is chemically different, is structurally different, and is not absorbed in the same pathways as folate, long-term folic acid consumption may be hazardous to human health.  Folate in foods is what is safe and is the preferred form of folate for human consumption. Excessive folic acid may make cancer worse. And unlike folic acid, humans have been safely consuming food folate for thousands of years. 
I have been warning people against folic acid for many years [3,14].  Now it is becoming clearer and clearer that those warnings should have been heeded by more people.  Everyone should be concerned about taking synthetic/isolated USP vitamins like those containing folic acid.
 
References
[1] Hendler SS, Rorvik D, eds.  PDR for Nutritional Supplements.  Medical Economics, Montvale (NJ), 2001
[2] Shils ME, Olson JA, Shike M.  Modern Nutrition in Health and Disease, 9th ed.  Williams & Wilkins, Balt., 1999
[3] Thiel R.  Natural vitamins may be superior to synthetic ones.  Med Hypo, 2000;55(6):461-469
[4] Lucock M.  Is folic acid the ultimate functional food component for disease prevention?  BMJ, 2004;328:211-214
[5] Bazzano LA, Reynolds K, Holder KN, He J.  Effect of folic acid supplementation on risk of cardiovascular diseases: a meta-analysis of randomized controlled trials.  JAMA. 2006;296(22):2720-2726
[6] Broccoli, raw. USDA National Nutrient Database for Standard Reference, Release 18 (2005)
[7] Alfalfa seeds, sprouted raw.  USDA National Nutrient Database for Standard Reference, Release 16-1, 2004
[8] Whitney EN, Hamilton EMN.  Understanding Nutrition, 4th ed.  West Publishing, NY, 1987
[9] Gonzalez-Gross M, Marcos A, Pietrzik K.  Nutrition and cognitive impairment in the elderly.  Br J Nutr 2001;86:313-321
[10] Verhoef P.  Homocysteine metabolism and risk of myocardial infarction: Relation with vitamin B6, B12, and Folate.  Am J Epidemiol 1996;143(9):845-859
[11] Brattstrom L.  Vitamins as homocysteine-lowering agents: A mini review.  Presentation at The Experimental Biology 1995 AIN Colloquium, April 13, 1995, Atlanta Georgia
[12] Carmel R.  Folic Acid.  In Modern Nutrition in Health and Disease, 10th ed.  Lippincott Williams & Wilkins, Baltimore, 2006:470-481
[13] Bell L. Is your breakfast giving you cancer? Research links too much folic acid to certain cancers.  Prevention. March. 29, 2010.  http://www.msnbc.msn.com/id/35874922/ns/health-diet_and_nutrition// 
[14] Thiel R. Is Folic Acid Hazardous to Your Health?  The Original Internist, 2004;11(2):39-40
Above article is expected to be published as Thiel R.  Is Folic Acid is Hazardous to Your Health.  What About Food Folate?  The Original Internist, June 2010.
Some of these studies (or citations) may not conform to peer review standards, therefore, the results are not conclusive.  Professionals can, and often do, come to different conclusions when reviewing scientific data.  None of these statements have been reviewed by the FDA.  
Doctors’ Research, Inc.  ”Nutrition from food, what a concept!”
1248 E. Grand Avenue, Suite A, Arroyo Grande, CA 93420 WEB: www.doctorsresearch.com   FAX: 1-805-489-0334

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B vitamin supplements

Folic acid may increase cancer risk, study shows

Carly Weeks

From Wednesday's Globe and Mail

Published Tuesday, Nov. 17 2009, 7:26 PM EST
Last updated Wednesday, Mar. 16 2011, 11:43 AM EDT

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More questions are being raised about the safety of folic acid supplementation after new research has found links between the B vitamin and increased cancer risk.
Researchers in Norway found that heart-disease patients treated with a combination of folic acid and vitamin B12 had an increased risk of cancer and death compared to patients who didn't receive the vitamins as treatment.
Unlike Canada and the United States, Norway doesn't require folic acid to be added to any food. The market for vitamin supplements is also relatively small and study participants were discouraged from taking them, which gave researchers a unique ability to assess the effect folic acid could have on a group who receive it in high doses. The study, appearing Nov. 18 in the Journal of the American Medical Association, fuels fears that mandatory fortification of the food supply with folic acid could yield unintended consequences.
“Folic acid fortification and supplementation may not necessarily be as safe as previously assumed,” Marta Ebbing, the study's lead author and a physician at Haukeland University Hospital, said in an interview yesterday.
The issue has come under increasing scrutiny and debate in the medical community in recent years as a growing number of studies have suggested that high amounts of folic acid can potentially speed up the progression of cancer in genetically predisposed individuals.
The debate is complicated by the fact that folic acid, when taken by expectant mothers, significantly reduces the risk of children being born with neural tube defects, such as spina bifida.
Researchers caution that much more work needs to be done to understand the potential risks and whether any changes in public health policy are needed.
Folic acid is the synthetic form of folate, a vitamin found naturally in leafy greens and other fruits and vegetables. The federal government has required food manufacturers to add folic acid to white flour, enriched pasta and cornmeal products since 1998 as a way of ensuring women receive enough of the vitamin to curb the incidence of neural tube defects in the population. But some food makers may also add folic acid to other items, such as cereals, on a voluntary basis.
Although the amounts added to food aren't very high, some researchers are worried Canadians who also consume multivitamins or supplements containing folic acid may be getting too much.
“We are concerned about folic acid supplementation actually promoting existing cancer,” said Young-In Kim, professor of medicine and nutritional sciences at the University of Toronto and gastroenterologist at St. Michael's Hospital. “[But] we need to be careful because fortification did wonderful things.”
The new research combines two studies of more than 6,000 heart disease patients who received some combination of folic acid and B vitamins or patients who received a placebo. Patients who took vitamins received 0.8 milligrams of folic acid, 0.4 milligrams of vitamin B12 and 40 milligrams of vitamin B6 a day. While some patients received a combination of vitamins, others took vitamin B6 or folic acid alone.
After more than six years of follow up, the researchers found a heightened incidence of cancer and death among those who received folic acid and vitamin B12. Vitamin B6 wasn't associated with any increased risk of health problems.
Dr. Ebbing said the findings suggest that folic acid – and not vitamin B12 – is likely responsible for any increased cancer risk because it was present in higher concentrations.
After the follow-up period was over, researchers found that 10 per cent of those who received folic acid had been diagnosed with cancer, compared to 8.4 per cent of the group that didn't take any B vitamin.
Most of the increased cancer risk was attributed to higher rates of lung cancer. Researchers found that 56 people who took folic acid were diagnosed with lung cancer, compared to 36 people in the group that didn't receive that vitamin.
Canadian women who could become pregnant are told to consume at least 0.4 milligrams a day, although some women's health advocates are urging the government to recommend even higher levels.
But it's not hard for average Canadians to meet or even exceed the 0.8-milligram dose of folic acid given in the study, Dr. Kim said. He is concerned about people who take supplements that typically contain 0.4 milligrams of folic acid. Add to that the folic acid contained in grain products, and an individual could easily consume the dose used in the study.
Although the increase in cancer incidence noted in the study may appear small, the rates are significant when applied across a country's entire population. It's one of the reasons a growing number of experts are sounding the alarm about folic-acid fortification and potential for overconsumption.
“You can't fix everything just by taking a pill,” Dr. Ebbing said. “It's not always as simple as more of a good thing will be a good thing.”

Is Too Much Folic Acid Giving You Cancer?

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Nutrition Advice

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Chances are, you started your day with a generous helping of folic acid. For more than a decade, the government has required enriched grains -- most notably white flour and white rice--to be fortified with folic acid, the synthetic form of the B vitamin folate. Many food manufacturers take it further, giving breakfast cereals, nutrition bars, and beverages a folic acid boost too. The extra nutrient isn't meant for you, though -- it's added to protect fetuses from developing rare but tragic birth defects. The fortification effort appears successful: Since 1998, the number of these birth defects dropped by about 19%. But for women past the years of having children, as well as for men of any age, unnatural dosages of this nutrient don't seem to be helpful--and may even be harmful. Indeed, many scientists have grown increasingly concerned about mounting research--including a study published last winter in the Journal of the American Medical Association--suggesting that all the extra folic acid might increase your odds of developing cancer. "The more we learn about folic acid, the more it's clear that giving it to everyone has very real risks," says folic acid researcher David Smith, PhD, a professor of pharmacology at the University of Oxford in England.

If there's a nutrient it's easy to overdose on, it's folic acid. The vitamin is all around us, slipped into the cereal we eat for breakfast, the bread we eat for lunch, the energy bars we snack on, and the supplements that over one-third of us take regularly. Women are supposed to get 400 mcg a day, the amount that protects fetuses. Some cereals, though, contain more or have a serving size that makes it easy to pour a double dose. Add to that a vitamin washed down with your vitamin-fortified drink, and you may get a megadose before walking out the door.

Read more: http://www.prevention.com/food/healthy-eating-tips/your-breakfast-giving-you-cancer#ixzz2EPPr1A6p

http://www.prevention.com/food/healthy-eating-tips/your-breakfast-giving-you-cancer

Do supplements with folic acid cause cancer? Should they be avoided?

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So I want to take Vitamin B12 supplements and I can't find a single one without folic acid. Here's some claims that says taking supplements which contain folic acid causes cancer. I'm 22, male and follow a vegan diet and I have not been taking any supplements. I might change my diet in the future. Is this true ? If yes, are there vitamin B12 supplements without folic acid ? Here's a passage from the book Eat to live by Dr. Joel Fuhrman http://www.amazon.com/dp/031612091X/ Avoid taking supplements that contain these ingredients: vitamin A, high-dose (200 IU or greater) isolated vitamin E, folic acid, beta-carotene, and copper. Ingesting vitamin A or beta-carotene from supplements instead of food may interfere with the absorption of other crucially important carotenoids, such as lutein and lycopene, thus potentially increasing your cancer risk. (1) Folic acid is the synthetic form of folate added to food or used as an ingredient in vitamin supplements. Folate is found naturally in fruits, vegetables, grains, and other foods. Too much folate obtained naturally from food is not a concern. It comes naturally packaged in balance with other micronutrients, and the body regulates its absorption. (2) Everyone, including pregnant women, should be getting adequate amounts of folate from natural plant sources. Recently, there have been some troubling studies connecting folic acid supplementation and cancer. More and more evidence suggests that folic acid supplementation may significantly increase the risk of cancer. (3) (1) Mayne ST. Beta-carotene, carotenoids, and disease prevention in humans. FASEB J. 1996;10(7): 690–701; Goodman GE. Prevention of lung cancer. Curr Opin Oncol. 1998;10(2):122–26; Kolata G. Studies find beta carotene, taken by millions, can’t forestall cancer or heart disease. New York Times. 1996 Jan 19. Omenn GS, Goodman GE, Thornquist MD, et al. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Eng J Med. 1996;334(18);1150–55; Hennekens CH, Buring JE, Manson JE, et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Eng J Med. 1996;334(18):1145–49; Albanes D, Heinonen OP, Taylor PR, et al. Alpha-tocopherol and beta-carotene supplements and lung cancer incidence in the alpha-tocopherol, beta-carotene cancer prevention study: effects of baseline characteristics and study compliance. J Natl Cancer Inst. 1996; 88(21):1560–70; Rapola JM, Virtamo J, Ripatti S, et al. Randomized trial of alpha-tocopherol and beta-carotene supplements on incidence of major coronary events in men with previous myocardial infarction. Lancet. 1997;349(9067): 1715–20; Bjelakovic G, Nikolova D, Gluud LL, et al. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2008 Adr 16;(2):CD007176. (2) Harvard School of Public Health. The Nutrition Source. Keep the Multi, Skip the Heavily Fortified Foods. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/folic-acid/. (3) Yi K. Does a high folate intake increase the risk of breast cancer? Nutr Rev. 2006; 64(10 Pt 1): 468–75; Cole B, Baron J, Sandler R, et al. Folic acid for the prevention of colorectal adenomas. JAMA. 2007; 297(21):2351–59; Stolzenberg-Solomon R, Chang S, Leitzman M. Folate intake, alcohol use and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Am J Clin Nutr. 2006;83:895–904; Smith AD, Kim Y, Refsuh H. Is folic acid good for everyone? Am J Clin Nutr. 2008;87(3):517; Kim Y. Role of folate in colon cancer development and progression. J Nutr. 2003;133(11) (suppl 1):S3731–39; Guelpen BV, Hultdin J, Johansson I, et al. Low folate levels may protect against colorectal cancer. Gut. 2006;55:1461–66. Here's another passage by Steven Novella on Vitamins and Mortality. But it seems to contradict with what Joel Fuhrman says. http://www.sciencebasedmedicine.org/index.php/vitamins-and-mortality/ In the latest issue of The Archives of Internal Medicine is a population based observational study looking at health outcomes and vitamin use as part of the larger Iowa Women’s Health Study. The authors looked at 38,772 older women and asked them to self-report their vitamin use. This is a long term study and their vitamin use was reports in 1986, 1997, and 2004, and mortality was followed through 2008. They found a small but statistically significant increase in mortality for those taking multivitamins, B6, folic acid, iron, copper, magnesium and zinc. There was also a small decrease in mortality for those taking calcium. The strength of this study is that it is large with a long term follow up. There are many weaknesses, however. Vitamin use was self-reported. Further, this is a correlational study only. Therefore possible confounding factors could not be controlled for. For example, it is possible that women who have an underlying health issue that increases their mortality were more likely to take vitamins or to report taking vitamins.In fact, other studies suggest there is such a “sick-user effect” with vitamins. It is therefore not possible from this study to draw any conclusions about cause and effect – that vitamin use increases mortality. But it does provide a cautionary reminder that it is not reasonable to assume that vitamin supplementation is without any risk. We still need to follow the evidence for the use of specific vitamins at specific doses for specific conditions and outcomes. More references: http://www.sciencedaily.com/releases/2009/11/091117161013.htm http://www.webmd.com/cancer/news/20091117/folic-acid-b12-may-increase-cancer-risk

 

Too much folic acid a cancer risk

LISA PRIEST

The Globe and Mail

Published Friday, Feb. 11 2011, 8:32 PM EST
Last updated Thursday, Aug. 23 2012, 5:01 PM EDT

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A vitamin considered so beneficial that pregnant women are instructed to take it and many foods are laced with it, may be too much of a good thing: scientists have found folic acid at elevated levels can cause cancer in a rat's offspring.
"There's a concern," said Young-In Kim, staff gastroenterologist at St. Michael's Hospital in Toronto. "But we don't want to panic the general public about this."

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Published in the February edition of the journal Cancer Research, the study found that rats given folic acid supplements before conception, during pregnancy and while breastfeeding, produced female offspring with breast cancer rates that were twice as high as the control group.
"We actually assumed that giving folic acid to moms will reduce the level of breast cancer in their offspring," said Dr. Kim, a University of Toronto medical professor. "To our surprise, a folic acid supplementation to mothers is the opposite of what we expected."
Indeed, the female rat offspring also had more tumours and faster-growing tumours, suggesting the folic acid supplement created a rat susceptible to cancer.
"That's what science is all about," said Dr. Kim. "You have unexpected findings."
Though it is a study of rats, not people, Dr. Kim said he is concerned enough to suggest women of childbearing age be careful not to ingest too high a level of the B vitamin.
Earlier research has shown that at modest levels, folic acid prevents birth defects and some cancers, such as neuroblastoma and pediatric leukemia in humans, in addition to colon cancer in rats. At higher levels, however, Dr. Kim's research found it can actually promote the growth of breast cancer in rats.
"Folic acid supplementation can do two things: It can protect against certain cancers, but it can promote other cancers," said Dr. Kim. "It has a dual effect, depending on when you take it."
The findings have broad implications not only for pregnant women but also to a general public that may be unwittingly overdosing on it through multivitamins, protein bars, vitamin drinks and breads, cereals and pastas. Even some cancer survivors are told to take folic acid, the synthetic form of folate, a B vitamin that occurs naturally in leafy greens, grains and other foods.
Dr. Kim's study adds to a growing body of evidence and feeds concerns that a large number of Canadians are being needlessly exposed to high levels of a vitamin that could have deleterious health effects. A Norwegian study published in the Journal of the American Medical Association two years ago found heart disease patients treated with folic acid and B12 were more likely to be diagnosed and die from cancer than patients who did not receive those vitamins as treatment.
How the superstar vitamin made its way into boxes of enriched pasta, bags of white flour and packages of cornmeal can be traced back to 1998 when the Canadian and U.S. governments required food producers to add it to those products. That was done to ensure that women of child-bearing age consumed enough of the vitamin to prevent neural-tube defects such as spina bifida in their offspring.
With half of pregnancies unplanned and defects occurring in the first trimester, folic acid fortification was a smashing success, dramatically reducing neural-tube defects. That's because women who didn't know they were pregnant were consuming adequate levels of a vitamin they didn't know they needed.
As for what Canadians should do, Dr. Kim said they should consume folic acid at the recommended dose: 400 micrograms a day from all sources, whether natural or a supplement, adding that "anything above that, I'd be quite concerned about."
Part of the problem, however, can be trying to reach that recommended number. Some prenatal vitamins, for example, contain one milligram of folic acid, which is 2½ times the recommended daily dose and the same amount used in the animal study.

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Folic Acid, B12 May Increase Cancer Risk

Study Shows Slight Increase in Cancer Risk From Large Doses of Supplements

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By Salynn Boyles
WebMD Health News

Reviewed by Louise Chang, MD

Nov. 17, 2009 -- There is new evidence that folic acid, taken in large doses, may promote some cancers.
Heart patients in Norway who took folic acid and vitamin B12 supplements were found to have a slightly increased risk for cancer and death from all causes, compared to heart patients who did not take the supplements in a study published in TheJournal of the American Medical Association.
Unlike the U.S., Norway does not fortify flour and grain food products with folic acid, which is the synthetic form of the B vitamin folate.
Because of this, Norwegians tend to have much lower blood folate levels than Americans, making the population a good one for studying the impact of folic acid supplementation on cancer risk, study researcher Marta Ebbing, MD, of Norway's Haukeland University Hospital tells WebMD.

Folic Acid, B12, and Lung Cancer

Ebbing and colleagues analyzed data from two studies that included almost 7,000 heart patients treated with B vitamin supplements or placebo for an average of three and one-half years between 1998 and 2005.
The original intent of the studies was to determine if taking vitamin B supplements improved cardiovascular outcomes, which it didn't do.
During treatment, blood folate levels among patients who took 0.8 milligrams a day of folic acid plus 0.4 milligrams a day of vitamin B12 increased more than sixfold.
The patients were followed for an average of three years after supplementation ended, during which time 341 patients who took folic acid and B12 (10%) and 288 patients who did not (8.4%) were diagnosed with cancer.
Folic acid and B12 supplementation was associated with a 21% increased risk for cancer, a 38% increased risk for dying from the disease, and an 18% increase in deaths from all causes.
This finding was mainly driven by an increase in lung cancer incidence among the folic acid and B12-treated patients.
Seventy-five (32%) of the 236 cancer-related deaths among the study participants were due to lung cancer, and the cancer incidence among the study group was 25% higher than in the population of Norway as a whole.
Roughly 70% of all the patients in the study were either current or former smokers, including more than 90% of those who developed lung cancer.

Other Views

In a statement issued in response to the study, a spokesman for the supplement-industry trade association Council for Responsible Nutrition (CRN) noted that the lung cancer finding has not been seen in other studies.
"The real headline of this study should be that smoking increases the risk of lung cancer -- the study found that a total of 94% of the subjects who developed lung cancer were either current or former smokers," CRN Vice President for Scientific and Regulatory Affairs Andrew Shao, PhD, says in a news release.
In the U.S., mandatory folic acid fortification of flour and grains has been in effect for just over a decade, and fortification has succeeded in dramatically lowering the incidence of neural tube birth defects.
Shao says the fact that lung cancer rates have also dropped during this time in both men and women suggest folic acid and B12 do not promote lung cancer.
Bettina F. Drake, PhD, of Washington University in St. Louis School of Medicine, says it is not likely that fortification has led to an increase in cancers in the U.S. In fact, several studies suggest just the opposite.
"We would expect to see an excess in cancers within a few years after folic acid fortification began, and we have not seen that," she tells WebMD.
Drake says it is possible that folic acid protects against cancer at certain points in life and promotes the growth of cancers at other times. It may also be true that too little folate in the blood or too much of the B vitamin are both associated with an increased risk for cancer.
In an editorial published with the study, Drake and Graham A. Colditz, MD, write that it may take decades to fully understand how folic acid fortification affects health.

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Folic Acid in Dietary Supplements Could Increase Risk of Breast Cancer, Swedish Research Suggests

Apr. 7, 2010 — In most women folate, a type of B vitamin, reduces the risk of breast cancer. However, in women with a certain genetic make-up it has shown to be the opposite: folate raises the risk of breast cancer.

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"Therefore I think it is too soon to introduce a general fortification of foodstuffs with folic acid," says nutrition researcher Ulrika Ericson of Lund University. Neither does she think it is a good idea to take multivitamin tablets and other dietary supplements containing folic acid (the synthetic form of folate) without special reason.
"It is better to eat a diet containing a lot of fruit, vegetables, legumes and wholemeal products. Then you get sufficient quantities of the natural form of folate, other vitamins and dietary fibre."
In her doctoral thesis, Ulrika Ericson has taken as her starting point the major study from the 1990s, Malmö Diet and Cancer, which gathered information and blood samples from over 17 000 women. At the end of 2004, just over 500 of these women had developed breast cancer. Folate levels, genetic make-up and food habits in the breast cancer patients have then been compared with the corresponding data from the healthy women.
Those women whose intake of folate corresponded to the level recommended in Sweden had only half as great a risk of getting breast cancer as those who had the lowest intake of folate. This was the overall finding, which shows that folate generally protects against breast cancer. However, the breast cancer risk increased in line with folate levels for a specific sub-group among the women -- those who had inherited a certain variant of an enzyme that affects how folate is used in the body. The ten per cent of the women who had inherited this variant from both of their parents had the highest risk of breast cancer, particularly if they also took vitamin tablets containing folic acid.
"No-one knows which genetic variant of this enzyme they have. This is why I think people should only take dietary supplements if there is a particular reason to do so, not just because 'it's probably a good idea'," says Ulrika Ericson.
She considers that there are two groups who could have a particular reason to take a folic acid supplement. These are people with a certain type of anaemia and low folate levels and women who are trying to become pregnant (folate reduces the risk of naural tube defects in babies). To be on the safe side, others should avoid vitamin tablets containing folic acid while it is still unclear what the link is between folate and different types of cancer. Mandatory folic acid fortification of foodstuffs, which has been discussed in many countries including Sweden, is not appropriate in the current situation, according to Ulrika Ericson.