A new study published in the November 18, 2009, issue of the Journal of the American Medical Association (JAMA) raised concerns that high folic acid supplementation may increase the risk of developing cancer and already the general media has picked up the story with fear-promoting headlines, such as “Folic Acid Supplements Carry Cancer Risk.” From a sales perspective, B vitamins are the most popular letter vitamins in the United States and achieved sales of $1.1 billion in 2008, according to Nutrition Business Journal estimates. Many in the industry are likely wondering whether this study will have the same negative effect on consumer purchasing habits that previous negative research has had on vitamin E, which has experienced continual sales declines in recent years.
The latest JAMA study was based on two randomized, double-blind,placebo-controlled clinical trials during which almost 7,000 patients with ischemic heart disease were given vitamin B12, vitamin B6, or placebo between 1998 and 2005. The trials took place in Norway, a country that does not fortify its products with folic acid. Basing the trials in Norway was significant because it allowed researchers to better gauge the impacts of folic acid supplementation. In the study, 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.
The Council for Responsible Nutrition (CRN) responded to the research by noting that the majority of the participants were former smokers, and many of the cancer deaths in the study were related to lung cancer. “The real headline of this study should be that smoking increases the risk of lung cancer—the study found that a total of 94 percent of the subjects who developed lung cancer were either current or former smokers,” Andrew Shao, PhD, vice president of scientific and regulatory affairs for CRN, said in a prepared statement. “For years, the vast body of scientific evidence has shown that individuals who have smoked at any point in their lives are at a significantly increased risk of developing lung cancer. Most health experts would agree that the number one way to prevent lung cancer is to abstain from smoking.”
Shao also pointed out that the results of this Norway study are “inconsistent with the larger body of data and that this effect has not been observed previously.” According to the study authors, “Epidemiological studies have demonstrated no associations between intakes of folate or folic acid and lung cancer risk.”
It is also important to note that the general rate for cancer has gone down in the United States, where folic acid fortification has been mandatory since 1998. “If high doses of folic acid have a paradoxical effect on lung cancer, then we likely would not have seen these drastic reductions in lung cancer incidence over the past two decades,” Shao added. “It is inappropriate at this point to reach firm conclusions based on such limited data, especially in the face of vast evidence showing benefit for folic acid supplementation.”
The most important message for consumers, Shao added, “is that they should continue to feel confident in the safety and efficacy of consuming the recommended amounts of folic acid as part of an overall healthy lifestyle.”
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