Milling & Baking News - June 19, 2007 - 44

Nutrition and Health

Study casts shadow over folic
acid health halo
WASHINGTON - A new study
published in the June 6 issue of the
Journal of the American Medical Association suggests high doses of folic
acid do not prevent precancerous colon polyps in people prone to them and
may actually increase
the risk of developing the
growths.
The study follows earlier
research that has shown diets
low in folic acid led to a higher
risk of colon cancer.
Researchers
now
speculate that some folic acid helps
- as long as the colon is free of
microscopic cancer cells. But once
cancer starts, folic acid may feed its
growth.
As part of the study, researchers
conducted a double-blind, placebo-controlled randomized trial between 1994 and 2004 on 1,021 men
and women with a recent history of
colorectal adenomas and no previ-

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44 / June 19, 2007

Milling & Baking News

find folate intake to be inversely associated with risks of colorectal cancer and adenomas.' The benefits of
folic acid in these primary studies
ous invasive large intestine carcino- were evident through both diet and
ma. They then examined data from supplemental forms.
"Overall, the benefits of folic acid
987 adults who underwent colonoscopic
follow- are well-documented, particularly in
up. According to the area of reducing the risk of neuthe study, 44.1% of ral tube birth defects. Additionally,
there is scientific
evidence for folic
'Primary research has
acid in reducing
the risk of congendemonstrated folic acid's
ital cardiovascular
role in protecting against the
defects,
stroke,
development of cancer.'
and Alzheimer 's
- Grain Foods Foundation
disease. If you are
a healthy individual, it is important
those who took 1 milligram of folic not to eliminate any nutrient in the
acid per day (more than double the diet (such as folic acid in enriched
recommended daily allowance for grains) because of the research that
folic acid) developed precancerous has demonstrated its primary dispolyps, which compared with 42.4% ease prevention benefits."
Daniel Fabricant, Ph.D., vice-presof the placebo pill group.
"You really should not take folic ident of scientific regulatory affairs
acid to prevent colorectal adenomas," for the Natural Products Associasaid co-author Bernard Cole of Dart- tion, also urged caution in reviewmouth-Hitchcock Medical Center. ing the study's findings.
"This study is not about preven"It's ineffective for that purpose."
While the difference in the first tion at all, because every one of the
round of screenings was not sta- subjects in this study already had
tistically significant, the results of this condition," Dr. Fabricant said.
a second round of colonoscopies a "What this study might address is a
few years later were. Among the fo- prevention of a reoccurence, which
lic-acid takers, 11.6% had advanced is a distinction with an enormous
adenomas while 6.9% of the pla- difference. It would be grossly incebo-pill group did. And folic acid accurate to suggest or report that
more than doubled the risk of hav- folic acid is therefore ineffective for
ing three or more precancerous pol- primary prevention of colorectal adenomas based on this study.
yps, the study found.
"Secondly, the study failed to acResearchers did not see any real
difference in rates of colon can- count for other basis factors that
cer, just in the precancerous colon may be at work here, including
calcium and vitamin D intake from
growths.
Responding to the study, though, diet, for instance. Without this esthe Grain Foods Foundation (G.F.F.) sential knowledge, it is impossible
pointed out that even the authors to draw clear conclusions about the
said evidence for an increased risk effects of folic acid on this particular
of adenomas is equivocal and re- condition.
"This might explain why the auquires further research.
"It is important to note that this thors themselves seem confused.
study involves a relatively small They initially state that 'on the
number of subjects with a pre-exist- whole, the biological and epideing cancerous colon and therefore it miological evidence supports the
is difficult to apply the study results potential for folate supplementato a generally healthy population," tion to prevent colorectal neoplasia
the G.F.F. said. "Additionally, this in humans.' Then, they do an about
is a secondary prevention study. face in their conclusion and specuPrimary research has demonstrated late regarding an increased risk for
folic acid's role in protecting against colorectal neoplasia, despite stating
the development of cancer. Even that 'evidence for an increased risk
the authors state that 'overall, epi- is equivocal."
Grants from the National Instidemiological data from cohort and
case-control studies have tended to tutes of Health funded the study. MBN
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Milling & Baking News - June 19, 2007

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