Folic acid study flawed, says industry

A study that questioned the benefits of folic acid consumption has been slammed by the supplements industry. The study, "Folic Acid for the Prevention of Colorectal Adenomas," was published this month in the Journal of the American Medical Association, and found high doses of folic acid did little to reduce precancerous colon polyps in those prone to them and may actually increase the risk of developing such growths.

It is generally thought low folate intake can lead to such growths, or adenomas, and the study did suggest folate consumption could be beneficial in preventing polyps in those who did not already have them. It also called for further research into the area.

Noting that the study's participants were prone to polyps, Daniel Fabricant, PhD, vice president of scientific regulatory affairs at the Washington, DC-based Natural Products Association commented: "This study is not about prevention at all, because every one of the subjects in this study already had this condition. What this study might address is a prevention of a reoccurrence, which is a distinction with an enormous difference. It would be grossly inaccurate to suggest or report that folic acid is therefore ineffective for primary prevention of colorectal adenomas based on this study."

He added: "Secondly, the study failed to account for other basic factors which may be at work here, including calcium and vitamin D intake from diet, for instance. Without this essential knowledge, it is impossible to draw clear conclusions about the effects of folic acid on this particular condition."

The Council for Responsible Nutrition, also based in Washington, DC, urged "the scientific research community, the media, and the government not to jump to conclusions" about the study. "The benefits of folic acid are well-documented, particularly in the area of reducing the risk of neural tube birth defects," said Andrew Shao, PhD, CRN's vice president, scientific and regulatory affairs. "There is also promising scientific evidence for folic acid in reducing the risk of congenital cardiovascular defects, stroke, and Alzheimer's disease. It would be a huge public disservice potentially resulting in extremely negative health consequences if scientists, the media or government rushed to judgment based on this study."

In a move backed by the Federation of Bakers, the UK Food Standards Agency recently recommended fortifying flour with folic acid as is the case in Canada, the US and Chile, where a 50 per cent drop in neural tube defects has been observed as a result. But UK-based nutritionist, Patrick Holford, questioned the suggested action. "Given the potential benefit from increasing the nation's folate status I recommend careful consideration as to how to mitigate these potential risk in the elderly, vegans and certain cancer patients," he said.

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