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European Folic Acid NewsUpdate

June 2009



World-first research proves folate reduces bowel cancer risks

In a world first, a team of researchers from the University of Western Australia (UWA) and the Western Australian Institute for Medical Research (WAIMR) has shown that a common version of the MTHFR* gene - carried by about half the population - increases a person's chance of developing colon cancer by nearly a third. Lead author Professor Barry Iacopetta, from the UWA School of Surgery, said the study also provided clear evidence that tumours arising in different parts of the large bowel had different risk factors. The MTHFR gene variant increased the risk of developing cancers only in the right side of the large bowel. Report co-author and WAIMR Associate Professor Lin Fritschi said the study found the risk of colon cancer in the right side of the bowel jumped to 70 per cent if there was not enough folate in a person's diet. "But, in a fascinating discovery, we've also found that by boosting their folate intake, people with the high-risk version of the MTHFR gene might be able to lower that 70 per cent risk down to nothing," Prof Fritschi said.

*MTHFR=Methylenetetrahydrofolate reductase

Read more on the website of the University of Western Australia

Read the abstract of the study in the International Journal of Cancer


Folate, cancer risk, and the Greek god, Proteus: a tale of two chameleons

Joel B. Mason, MD, Associate Professor of Medicine and Nutrition at Tufts University, has written a "Special Article" that was published in the April issue of "Nutrition Reviews", vol. 67(4):206-212. In the article he explains that folate has two faces, one protective against cancer and the second increasing the risk of cancer. Especially elder people who already have (pre)cancerous cells in the colon and who digest abundant amounts of Folic Acid could run the risk that these cells will start growing even faster. Folic acid might affect the process in a manner that is distinct from natural forms of the vitamin, although this remains a speculative concept. Mason concluded that the benefits of mandatory fortification are “compelling and irrefutable” in regard to the occurrence of anemia and neural tube defects, but he added that countries which implement national standards for folic acid fortification need adequate monitoring systems for cancer rates.

Read the abstract of Dr Mason's article on the "Nutrition Reviews" webpage.

Professor John Scott


Professor John Scott speaks at IF Workshop

On 11 March 2009, the Implementation Group on Folic Acid Food Fortification to the Department of Health and Children released a report in which they advised that the decision to introduce mandatory fortification of bread in Ireland should be put on hold. The safety of this initiative should first be supported by definitive data. On May 7th Professor John Scott from Trinity College, Dublin, one of the members of the Implementation Group, made a special contribution to the IF Workshop in Ireland to explain the currently available scientific research that led to this decision:

  • Indications of a possible cancer risk with high intakes of Folic Acid (Folic Acid for the Prevention of Colorectal Adenomas, Cole et al (2007), JAMA;297:2351-2359)
  • Red Cell Folate levels in the Irish population have already improved because of voluntary fortification by manufacturers (Trends Over Time In RCF Status In Irish Women (2006, 1998, 1986) – J. Scott et al preliminary data 2008)
  • Already reduced prevalence of Neural Tube Defects (International retrospective cohort study of neural tube defects in relation to folic acid recommendations: are the recommendations working? - Botto et al 2005)

The positive effects of Folic Acid on the prevention of Neural Tube Defects have been well researched and documented. The Implementation Group does therefore agree that women who plan to get pregnant should take a daily supplement of 0,4 mg Folic Acid. Just a healthy diet will not provide enough folate during a pregnancy.

Read the report of the Implementation Group.


Reduction in the prevalence of severe congenital heart defects after folic acid fortification of grain products in Canada

Canadian researchers investigated whether the 1998 government policy for mandatory fortification of flour and pasta products with folate was followed by a reduction in the prevalence of severe congenital heart defects. They analyzed 1.3 million births in Quebec between 1990-2005. Time trend analysis showed no change in the birth prevalence of severe birth defects in the nine years before fortification, while in the seven years after fortification there was a significant 6% decrease per year.

The researches conclude that public health measures to increase folic acid intake were followed by a decrease in the birth prevalence of severe congenital heart defects. These findings support the hypothesis that folic acid has a preventive effect on heart defects.

Read the research by Ionescu et al (2009) on the British Medical Journal website.


Preconceptional Folate Supplementation and the Risk of Spontaneous Preterm Birth: A Cohort Study

PLoS Medicine, a peer-reviewed, international, open-access medical journal from the Public Library of Science, recently published the results of a cohort study by Bukowski R, Malone FD, Porter FT, Nyberg DA, Comstock CH, et al. (2009). The researchers analyzed the data of 35,000 pregnancies. The evidence strongly suggests a relationship between the intake of Folic Acid supplements and a considerable decrease in spontaneous premature births. Taking Folic Acid supplements for a year before conception seems to reduce the risk of very early preterm deliveries by 70%. Duration was found to be more critical than dosage.

The researchers acknowledge that taking folate supplements may be a marker of healthy behavior and the women taking the supplements might have been doing something else that was reducing their risk of preterm birth. However, despite this and other limitations of this study, these findings suggest that long-term folate supplementation before conception is worth investigating further as a potential way to prevent preterm births.

Read the study by Bukowski et al (2009) on the PLoS website.

Professor Sir Nicholas Wald


Promoting FA awareness in the UK

In the United Kingdom the Department of Health's folic acid awareness campaign got underway to highlight how women planning a pregnancy should take a supplement before and after conception. The campaign comes as recent research, published in the British Medical Journal, revealed that very few women planning a pregnancy take enough folic acid at the right time to make it effective. Especially for the UK Association for Spina Bifida and Hydrocephalus (ASBAH) Sir Nicholas Wald, a long-time supporter of the flour fortification campaign, kindly agreed to be interviewed, answering the most frequently asked questions about folic acid.

Watch the video interviews with Sir Nicholas Wald on the ASBAH website

Read the research "Women’s compliance with nutrition and lifestyle recommendations before pregnancy" - Inskip et al (2009)

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