Milling & Baking News - March 2, 2004 - 22

N U T R I T I O N

A N D

H E A L T H

Spectacular range of folic acid
benefits revealed in white paper
Continued from Page 1
education program of the American Bakers Association.
While the benefits of folic acid such as
reducing neuroblastoma and reducing
neural tube birth defects have been published piecemeal in scientific journals in
the past, the white paper was written
to show all of the benefits in a single
document. The 12-page paper provides
background on folic acid and the risks
to health of not getting enough. It lists
the many serious health conditions that
adequate folic acid intake may help
stave off.
"This is an important way to tell nutritionists, the medical community and the
media about the importance of enriched
and fortified grain foods," said Judi Adams, W.F.C. president. "White papers
put research into layman's terms so
people can better understand what this
science means to their daily lives - that
enriched and fortified grain foods are essential to a healthful diet."
Over 7,700 copies of the brochure
are being printed. An Acrobat version
will be posted on the W.F.C. web site
- www.wheatfoods.org.
It was the role of folic acid in the
prevention of neural tube birth defects
that prompted the F.D.A. to mandate
the fortification of enriched grains,
and N.T.D.'s are the subject of the first
pages of the white paper. One in 2,000
newborns in the United States has spina
bifida, a condition that accounts for
90% of N.T.D.'s, Dr. Kratina said. Spina
bifida involves incomplete formation of
the spine during the first four weeks of
pregnancy. Permanent nerve damage
often results, as do many other serious
conditions. About 30% of spina bifida
patients suffer from mental retardation.
A significant percentage of spina bifida cases could be "easily prevented by
the consumption of foods fortified with
folic acid, a B vitamin, or by supplementing the diet with 400 micrograms of folic
acid," Dr. Kratina noted. Educational efforts to promote daily intake of folic acid
supplements by women of reproductive age have not resulted in increased
supplement use, she said.
Since fortification was mandated,
data have demonstrated a near tripling
of the mean serum folate concentration
for women aged 15 to 44 who did not
use supplements. "Apparently in response to this increased level of serum
folate, incidence of neural tube defects
has decreased dramatically," Dr. Kratina said. Estimates of the N.T.D. drop
22 / Milling & Baking News, March 2, 2004

vary widely: 19%, 47%, 51%, 15% and
30%, depending in part on whether the
figures are adjusted for stillbirths and
terminated pregnancies. "Folic acid
fortification of enriched grain foods has
ensured 900 additional healthy babies in
the United States each year," she said.
Expanding on the lowering of the neuroblastoma incidence, Dr. Kratina noted
that the disease is
the second most
common
pediatric tumor. An
extracranial solid
tumor, neuroblastoma is extremely
aggressive. It is
the leading cause
of cancer death
among small chilKratina
dren even though
most cases are
identified during the first two years of
life.
Unlike many vitamins which enjoy
better absorption when consumed in
the foods in which they naturally occur,
folic acid is better absorbed either as a
supplement or in fortified foods, Dr. Kratina said. A water soluble B vitamin (B9),
folic acid is a synthetic version of folate,
which is found in certain foods. "While
folate is found widely distributed in the
diet, there is no particularly good source,
with the exception of liver, legumes and
oranges," Dr. Kratina said.
She said there are few nutrients for
which even a slightly low intake may cause
such serious consequences as folic acid. In
addition to birth defects, low birth weight
babies and other pregnancy problems, Dr.
Kratina said intake of too little folic acid has
been implicated in cardiovascular disease,
stroke, osteoporosis, cancer, dementia,
Alzheimer's disease, Parkinson's disease,
depression, cleft lip and palate, cervical
dysplasia and hearing and memory loss.
"The list of conditions involving folic acid
deficiency is growing day by day, as is clinical evidence that most of these conditions
can be reversed by increased consumption
of folic acid, either though fortified foods
or a daily supplement," Dr. Kratina said.
"It has been estimated that fortification of
folic acid might save as much as $6 billion
in hospital care costs each year."
The role of folic acid deficiencies in
health disorders is not surprising, Dr. Kratina said. "Folic acid plays a vital role in
both cell growth and development," she
said. "Before a cell divides, its DNA must
replicate, a process requiring folate."
The easy-to-read white paper is broken

down into a number of short sections,
beginning with important background
and then transitioning into a questionand-answer format with headings that
include, "What causes folate deficiency?
What are the signs of folate deficiency?
How much folate does the body need?"
Each heading is followed by a brief, thoroughly referenced explanation.
While the current R.D.A. for folate is
400 mcg (micrograms) for adults and 600
mcg for pregnant women, enriched grain
products such as bread and pasta are fortified at a level of 140 mcg per 100 grams
(3.5 ounces). Excessive intake of folic acid
can mask vitamin B12 deficiency.
While a major reduction in N.T.D.'s due
to folic acid fortification has been clearly
demonstrated , the same may not be said
uniformly for several other benefits. For
example, high homocysteine levels are
associated with coronary artery disease,
and folic acid has been demonstrated to
lower homocysteine levels. "At this time,
it is unclear if these improvements will
translate into reduced incidence of vascular disease," Dr. Kratina said.
Perhaps more compelling, researchers
at Harvard University have found a 75%
reduction in the risk of colon cancer for
women with high folic acid intake (400
mcg or more) for 15 years or longer, Dr.
Kratina said. "This is particularly significant when considering colon cancer
is the second-deadliest cancer in the
United States," she said.
Other researchers have found a "clear
correlation between folic acid intake and
the reduction of breast cancer risk," Dr.
Kratina said. The mechanism of how
folic acid fights cancer has not been established, she said.
Dr. Kratina emphasized that enriched
grain-based foods products or supplements likely are the best source of folic
acid. "Although some vitamins are better obtained from food sources, folic acid
does not appear to be one of them," she
said. "It is misleading to rely on the consumption of folate-rich foods to ensure
adequate folate status, particularly for
women of childbearing age."
Expanding further on positive information in the research, Ms. Adams said
the grain-based foods industry should be
highlighting the healthfulness of grainbased foods. "Folic acid fortification to
enriched grains has been the single most
effective government-mandated health
initiative in years," Ms. Adams said.
"Since 1998 it has decreased neural tube
birth defects by 23 percent. The industry
should be taking advantage of that statistic in their advertising and using the
health claim on their packages. This is
something the industry can tout in times
of white bread bashing." MBN
bakingbusiness.com/world-grain.com
http://www.wheatfoods.org http://www.bakingbusiness.com/world-grain.com
Milling & Baking News - March 2, 2004

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