Folate Friction

By Jim McVeagh 23/10/2009 1

New research on folic acid has largely dismissed the cancer concerns that led to the Government’s going cold on plans for its mandatory addition to bread.

Ah yes, these would be the cancer concerns that every doctor and scientist (as opposed to journalist, baker  and blogger) said were blown out of all proportion and were a major over-interpretation of some epidemiological data. But apparently, the government preferred to listen to the bakers, journalists and bloggers and folded their plans to add folate to bread. A classic case of political expediency overcoming common sense.

Folate has been added to bread in the US and Canada for more than a decade. Recent research has shown that there is good evidence that it does, indeed prevent neural tube defects (spina bifida and the like), virtually halving the rate. It is true that colorectal cancers suddenly climbed in the US and Canada at around the time folate was added to bread and then leveled off about two years later. As the addition of folate to bread in both countries coincided with a increase rate of colonoscopy due to a change in medical practice, not much inference can be drawn from this.

The study from Chile which caused all the excitement showed a 162% increase in the incidence of cancer of the colon (190% over the age of 65). Unfortunately, it used hospital discharge diagnoses, rather than direct cancer incidence statistics. Hospital discharge diagnoses are often dependent on funding (saying a colorectal adenoma – a common benign tumour – was a cancer would get them considerably more funding). Also increased discharge diagnoses may reflect differing treatment protocols. Patients with colon cancer may have been more regularly admitted for chemotherapy, or pain control in the later group.

All in all, the results from this study have not been borne out in other studies and interpretation of these results is problematic. Interestingly, Rats may get an increase in prostate cancer if treated with folate, But this has not been demonstrated to be statistically significant in humans. However, there is evidence that humans may actually prevent colon cancer with high doses of folate. Confused yet? I know I am.

The point is that the link between folate supplementation and any sort of cancer is dubious at best but the link between fortification and reduced neural tube defects is pretty solid. There is therefore no point in waiting for some politically arbitrary date to decide whether folate fortification of bread is worthwhile. It should be done as soon as possible.

And the bleating of bakers should be ignored…

One Response to “Folate Friction”

  • Food Safety Minister Kate Wilkinson should have got advice and immediately refuted the claims with good science, instead what we got was the government running scared at any hint of controversy. What really matters is the science and what was going to be done to both manage fortification and monitor it’s effect, there’s been plenty of international experience with food fortification to inform on this topic. Shame this didn’t happen here..