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Folic Acid Inundation Not Such a Good Thing After All - Especially for Vegetarians/Vegans

You know, about 9 years ago the US govt mandated that all grain foods in the US be fortified with the B vitamin folic acid. Their reasons seemed sound enough: it had been learned that a shortage of folic acid around the time of conception can damage fetuses. Specifically, babies were more likely to be born with open neural tube defects, such as spina bifida. But I remember at the time being concerned about the wisdom of supplementing an entire population in order to address a problem that, although devastating, affects such a tiny fraction of the population. (Even prior to the supplementation, the risk of spina bifida was less than 1 percent.) It seems that my concerns have been born out, especially for those of us who do not eat meat.
No one would argue against the premise that birth defects are awful, and that if they could be prevented, they should be. However, there has always been something very peculiar, in my mind, with the mandatory folic acid supplementation scheme. First, it smacks of the offensive paternalism with which pregnant women are generally treated in this culture. Along with snotty strangers making unsolicited comments at us if they see us sipping apple juice in public ("is that whiskey?" "Don't you know what that can do to your unborn baby?"), well meaning in-laws who badger us about staying up too late, getting upset, or being around smokers, there have also been some very offensive legal precedents in which the courts presume to assert control over a pregnant woman's body. Now, we have the US government supplementing us all with a vitamin that the vast majority of us do not need to have supplemented, presumably because we are all too flighty and irresponsible to take the stuff on our own if we are considering conceiving a baby.

Now, one could argue that the measure was necessary because lots of women become pregnant without planning to, and a folic acid deficiency effects a fetus so early in development that a woman generally doesn't even know she's pregnant yet. Still, it seemed an extreme response. Besides, another thing that always bothered me about this scheme was the fact that there are SO many more prevalent, and even more devastating birth defects that are caused by environmental factors that no one is doing anything about. I used to work with very young children with birth defects, and so I saw a fairly good slice of what can go wrong and why. The vast majority of the babies that I worked with suffered from environmental toxins that could have been easily prevented, but were not. In some cases, it was maternal negligence, to be sure. There were babies affected by fetal alcohol syndrome, for example. There were two brothers who were born blind, probably because their mother was addicted to meth. No one had ever told her that meth can damage an unborn baby's optic nerve. But she had been on a long waiting list for treatment for her addiction, since before the birth of her first baby, but she was STILL on that list when I met her. She had never received treatment, because she could not afford it. So if some priority had gone into getting treatment and education to young mothers, that could have been more useful than a folic acid supplement.

More disturbing still, many of the environmental toxins had to do with things that were beyond the mothers' control, but not beyond the control of the US government. Mercury poisoning, for example, causes one of the ghastliest syndromes I have ever seen among babies. It causes a damage so complete that the baby is limp, listless, unaware, and totally unconnected from the outside world. Down in the SW United States, where I worked, this poisoning is rampant. Industrial and defense industry fallout settles on the wheat fields down there and poisons whole populations. Because so many members of these populations are poor people of color (mostly Native Americans), little attention has been paid. The US govt could easily address this with strict controls on mercury emissions. But they did not. Instead, they doused an entire population with folic acid. It does nothing for babies poisoned with mercury.

So there is a lot that the US government could do to help prevent needless birth defects. But they have done next to nothing. Except supplement us all with folic acid.

There have been dark concerns about mass folic acid supplementation for some time. Many researchers worry that the unintended consequences of giving so much folic acid to so many people may very well include an increased cancer risk. It seems that folic acid can promote the growth of pre-existing tumors, and may even cause tumors in some circumstances. The jury is still out on that, but it must certainly be cause for some very serious concern.

This month, it was reported in the American Journal of Nutrition that researchers now have even more reason to be concerned about the excess folic acid in the US diet. It seems that, although the nutrient was thought to be beneficial for neurological health (and often, it does confer many benefits), an excess of folic acid can be very dangerous to the neurological health of some segments of the population, particularly people who do not get enough B12. Those at highest risk of damage from the excess folic acid swimming around in our national food supply are vegetarians, vegans, and older people. While a vegetarian/vegan diet is notably more healthful than a meat-based diet, people who do not eat animal products tend to consume much less vitamin b12 than people who do. Combined with an excess of folic acid, this can create problems. And older people do not absorb vitamin B12 as efficiently as younger people, which again, can cause trouble when the person consumes too much folic acid.

Epidemiologists at Tufts University found that about 23 percent of volunteers whom they tested had low levels of B12. Within that group, those with the highest levels of folic acid were nearly 3 times as likely to exhibit symptoms of cognitive impairment. Those with the highest concentration of folic acid in their blood were also more than 3 times as likely to have anemia, which can lead to irreversible neurological damage. (Those with healthy levels of vitamin B12 did not appear to be negatively effected.)

As with any nutrient, one cannot assume that because a little is good, a lot more would be better. That's a myth happily encouraged by the pharmaceutical industry, but it is dangerously incorrect. Our diet requires a balance that we might be able to achieve instinctively, if not forced into so many faddish dietary schemes that throw us off balance. The folic acid supplementation in our diets put us at risk for neurological damage and cognitive impairments, and I believe that is an unacceptable cost for a very questionable project such as this one.

Confusing 20.Jan.2007 16:08

gk

Vitamins and supplement recommendations can be very confusing as they keep changing. I was told folic acid, 400 mcg daily, was good. Now I question it. As an older female and vegetarian, 1,000 mcg of B12 is ok, as an excess would be excreted. For vegetarians, it looks like B 12 is imperative, but not folic acid. ?

ex vegan 20.Jan.2007 17:11

super health

B vitamins are crucial for repair and maintenance of the nervous system.

b-12 which is produced in the intestinal tract by consuming animal products, is the most important of all the B vitamins. b-12 is extremely hard to absorb through supplementation. the use of cyanide in the manufacturing of b-12 should also be a concern to vegans, pregnant women and nursing moms.
Even the "natural" b-12 are usually based in some sort of cyanide.

it also happens that the take up of most EFA's is decided by whether enough b-12 is stored in the liver. once the liver is depleted over time, the body is no longer able to use EFA's effectively. this hinders not only basic brain functions, but the rebuilding of brain and nerve tissue cells.

to the vegans: don't wash your local organic veggies, because the little bugs maybe your only source of absorb-able b-12.

vegan ism is our society's answer to the plight of animals and the overconsumption of animal products, but like meat eating, vegan ism without thought can lead down the same unhealthy road that meat heads have taken. most ancient cultures around the world practice either part-vegetarianism or 100% vegetarianism.

blah, blah...

vegan vs vegetarian B12 20.Jan.2007 17:32

.

Ex vegan points out some concerns around B12, which are far from insurmoutable. With a little effort, veganism is a very healthy diet. However, I also want to clarify, for those who do not know, that this issue is far less of a concern for vegetarians than vegans, though the excess folic acid in our diets makes it worse.

Generally, it's possible for a person to get all the nutrients they need from a healthy, varied diet that avoids meat, artificial ingredients, and additives. If you stay away from these things, and try to curb any sugar addiction you may have, your body will generally tell you what it needs and you will not need supplements. But when they pour them into our food supply and foist them on us anyway, then we risk an imbalance that can throw us off like this. Sigh. I guess I will start taking B12 supplements, something that I never needed to do and never wanted to do, since too much B12 can throw off other b vitamins....

see "The China Study" 21.Jan.2007 11:14

the other side

for why the vegan diet may be the healthiest diet for humans. This is an in-depth, well-researched, long-range study concluding that animal products are probably not beneficial to human health:

 link to www.amazon.com

I agree with OP that it is 21.Jan.2007 11:30

on the other side

disturbing that so many foods are unwillingly supplemented - especially because many people, including omnivores, have absorption problems with B-12. We were told that the B vitamins not needed just wash away, but that may not be the case. I just take a little B-12 dot a few times a week. Even when I was a meat eater, my B-12 was low (according to blood tests).

Maybe I am gender impaired 21.Jan.2007 11:45

reader 2

I don't know - maybe it's because I am gender impaired that I do not appreciate having to wade through half a dozen paragraphs reviewing women's issues unrelated to the subject matter in order to get to the final 2 or 3 relatively brief paragraphs that should have been placed at the beginning of the article!

This health alert really comes down to the Tufts University study. Where is the link to professional review of that study? As reported here, the higher levels of folic within the 23% that had low levels of B12 could have been entirely due to that people with cognitive impairment (and, even more, those with anemia - and what is the correlation there? because this article doesn't get to that) are more likely to take a folic acid supplement (especially if they are residents of nursing homes).

So, altogether, this article argues more for greater care respecting folic acid supplements taken outside the normal diet than it does for elimination of folic acid supplementation of grain products.

(BTW: I am not taking a position for or against the folic acid supplementation of grain - just commenting on this article.)

Currently there is an epidemic of misdiagnosed B12 deficiency. 21.Jan.2007 16:54

Sally Pacholok, R.N., BSN sally-b12@comcast.net

I have co-authored the book "Could It Be B12? An Epidemic of Misdiagnoses," Quill Driver Books, 2005 which clearly explains the knowledge deficit in the medical and health care community regarding diagnosing vitamin b12 deficiency. Vitamin B12 deficiency and folic acid deficiency can cause a macrocytic anemia, but not always. If a person consumes enough folic acid it can mask the macrocytosis (enlarged red blood cells) and can improve the anemia for a while--- while the B12 deficiency continues which causes great nerve and brain damage. However, everyone is missing the major point. Doctors SHOULD NOT rely on red blood cell changes to suspect B12 deficiency. It has beeen known for a century and was again reported in 1988 in the New England Journal of Medicine that one-third of people with severe B12 deficiency which caused neurologic problems (and in some cases permanent injury)these patients did not have enlarged red blood cells. Therefore, doctors must become reeducated on how to diagnose B12 deficiency, and must test those at risk as well as anyone symptomatic. Waiting for a person to become macrocytic or anemic is sub-standard care and poor practice. Therefore, it doesn't matter if we fortify all the cereals and grains with extra folic acid---- because doctors should become reeducated on how to diagnose B12 deficiency. Most of the people I see on a daily basis who have a true B12 deficiency are not macrocytic. When one is symptomatic of B12 deficiency a doctor should order a methylmalonic acid test--- this test is more sensitive than the serum B12 test.
Read on Amazon.com (12 reviews) 3 from physicians.

Sally Pacholok, R.N.

to the gender impaired reader 2 21.Jan.2007 18:12

unimpaired and more respectful person

If you want to see an article that says something different than what this one says, write it yourself. That's what indymedia is all about. It's annoyingly oafish to critique someone else's article instead of just writing your own. That's what the button in the corner is for.

Also, if you feel over-burdened "wading through half a dozen paragraphs reviewing women's issues" (what an odd thing to bitch about) that don't pertain to you, then perhaps you will understand the author's point that dosing the entire population with a drug targeted at only a very few is inappropriate. That is, if you can climb off your high horse long enough to appreciate the point.

to Gender Impaired Reader, Ex Vegan & Indy Medical Reporter 22.Jan.2007 07:51

Easy Reader

I'm a woman and I have to agree for the most part with Gender Impaired (minus the sexist remark). I too was starting to get majorly frustrated. I vote for paragraphs 1, 6, 8 and 9.

Also, Ex Vegan, the proper way to introduce an acronym is, the first time mentioned, "Essential Fatty Acids (EFA's)"; and go on from there just using the acronym. I had to google "EFA acronym" and there are 26 possible definitions for EFA.

Vitamin B12 Sources 22.Jan.2007 10:12

Doug

As I understand it, nutritional yeast is a perfectly viable source of B-vitamins (around 100% of B12) for vegetarians and vegans. Some brands fortify their yeast with more B vitamins, but you can find pure ones fairly easily. They're tasty and an easy way to naturally obtain vitamin B12. Vegans make sure to check if they add honey or not.

Nutritional yeast? 22.Jan.2007 10:45

?

Cool! Does anyone know if that creates difficulty with candidiasis or not? (I had heard that one should avoid yeast if bothered by such things, but not sure if that includes this kind.)

some important things to remember... 22.Jan.2007 15:51

this is from http://www.second-opinions.co.uk/vegetarian.htm

The most important deficiency for the vegan is of vitamin B-12. By definition vitamin B-12 is essential to human life. It is essential for the synthesis of nucleic acids, the maintenance of the myelin sheath (the insulation around nerves which when damaged causes Multiple Sclerosis); indeed its presence or deficiency affects nearly all body tissues, particularly those with rapidly dividing cells. Without it we suffer from pernicious anaemia which, as its name suggests, is deadly, and a degeneration of the nervous system.

Vitamin B-12 is unique among vitamins in that while it is found universally in foods of animal origin, where it is derived ultimately from bacteria, there is no active vitamin B-12 in anything which grows out of the ground. Where vitamin B-12 is found on plants it is there only fortuitously in bacterial contamination.

Bacteria in the human colon make prodigious amounts of vitamin B-12. Unfortunately, this is useless as it is not absorbed through the colon wall. Dr. Sheila Callender (14) tells of treating vegans who had severe vitamin B-12 deficiency by making water extracts of their stools which she fed to them, thus affecting a cure. An Iranian vegan sect unwittingly also makes use of the fact that human stools contain vitamin B-12. Investigators could not understand how members of this sect remained healthy until their investigations showed that they grew their vegetables in human manure - and then ate the vegetables without being too fussy about washing them first (15) .

To enable vegans to survive, vitamin B-12 is added artificially to breakfast cereals in Britain and may be bought in pill form. This is hardly a natural way to get food and in many cases it is self-defeating. Vitamin B-12 is also unlike all other vitamins in that it occurs as a number of analogues, only one of which, cyanocobalamin , is active for humans. In collecting human stools for analysis Dr. Victor Herbert found that of each one hundred micrograms of vitamin B-12 extracted, only five micrograms was of the cyanocobalamin analogue (16) . Thus even in this most prodigious source of the vitamin ninety-five percent was composed of analogues which were useless.

Several fermented products such as tempeh, a soya bean product, and spirulinas, used by strict vegans as a source of vitamin B-12, either do not contain appreciable amounts of the vitamin or contain analogues of the vitamin which are not active for humans (17) . Vitamin B-12 status was assessed in a group of 110 adults and 42 children from a macrobiotic community in New England. Over half of the adults had low concentrations of vitamin B-12. Children were short in stature and low in weight. The community relied on sea vegetables for the vitamin. However, the researchers say: " We could not show that individuals who reported more of these sea vegetables had increased vitamin B-12 status..." "Similar null results were obtained with the other sea vegetables, tempeh, and miso, foods considered to contain significant amounts of vitamin B-12 by many individuals in the macrobiotic community. . .On the other hand, it is possible that the vitamin B-12 measured in these sea vegetables has no biological activity for humans....only a small fraction of total corrinoids in Spirulina, a genus of blue-green algae contains cobalamin and that the remainder is in the form of analogues that are not biologically active for humans. In these cases the analogues can block metabolism by the body of the ones that are of use ."

Dr Herbert suspects that vegans taking the spirulinas as a source of vitamin B-12 actually bring on the symptoms of deficiency quicker. Yeast is also believed by vegetarians to contain vitamin B-12 - and it does. But even if the yeast is grown on a medium rich in vitamin B-12, unless some of the growing medium is mixed with the yeast, it is unlikely to contain the cyanocobalamin analogue that is the active form for humans.

The amount of vitamin B-12 we need is very small: about five micrograms per day. Eating more than is needed results in a reserve being built up in the body. When a person becomes a vegan, those stores are depleted - but only gradually. Thus it is possible to live for several years on such a diet before the onset of symptoms of deficiency. In England a carefully conducted study (18) carried out on vegans showed that they all got vitamin B-12 deficiency eventually.

The first manifestation of vitamin B-12 deficiency is usually mental disturbances. These range from abnormal mood swings, mental slowness and memory problems, through hallucinations and depression to severe psychosis. Physical symptoms include: rapid heartbeat, cardiac pain, facial swellings, jaundice, weakness and fatigue and loss of weight. While a dose of active vitamin B-12 given by injection can cure symptoms very quickly, there is a hidden danger. A largely vegetable-based diet provides large quantities of folic acid, which works in conjunction with vitamin B-12. In a diet which contains folic acid but is devoid of vitamin B-12 the folic acid can disguise the vitamin's deficiency. In such a case, irreparable damage to nerves and the spinal cord can take place such that by the time symptoms become apparent, death is inevitable.

folic acid in foods 22.Jan.2007 19:40

CaptainPlanet

One can barely avoid getting plenty of folic acid if they eat a diverse diet including enough vegetables. Many green vegetables, sunflower seeds, some fruits, all are good sources:

 http://en.wikipedia.org/wiki/Folic_acid

It would appear to be totally unnecessary to mandate fortifying foods, except in very poor cultures where most food calories come from just a few food sources.

A lot of junk science there 22.Jan.2007 19:48

hyperbole control

Yes, vitamin B12 is very important. However, there is a lot of controversy and pure junk science in the "important things to remember" above. Actually, such dire consequences as those mentioned in the comment are almost unheard of among US vegans. And the jury is WAY out on whether you can get enough B12 (in a form your body can use) from plants. Anecdotal evidence (including the Iranian vegan cohort the piece mentions) suggests that vegans can, in fact, get adequate B12 without resorting to consuming animal products. The study that "proves" that vegans need animal products was probably paid for by a pharmaceutical firm that profits from selling animal-based supplements, or perhaps the meat industry. Either way, there is NO agreement in the medical community that vegan sources of B12 are not usable by humans. The truth is, vegans (and to some extent, vegetarians) need to be aware of this issue, and to make sure that they get enough B12. But you don't need to eat meat to do it.

to hyperbole control; and on biochemical individuality... 23.Jan.2007 09:53

proofreader control

"And the jury is WAY out on whether you can get enough B12 (in a form your body can use) from plants."

um. that's what i read above already?

"Anecdotal evidence (including the Iranian vegan cohort the piece mentions) suggests that vegans can, in fact, get adequate B12 without resorting to consuming animal products."

What it said (hypothesis) in reference to this was that it was coming from the human gut in their case originally (unwashed human manure vegetables) instead of the vegetables themselves. And so the hypothesis there was that this example was 'meat derived', just it was the bacteria in the guts of human meat. :-)

I hate to spoil the fun about "the one proper diet" mantra that almost all above have some opinion on. What if that conjecture is a mistake? Actually, human nutrition is a biochemical individuality issue, with individual optimums.

Lots of links for you here in one section of books about this:


Biochemical Individuality

The Modern Nutritional Diseases: And How to Prevent Them : Heart Disease, Stroke, Type-2 Diabetes, Obesity, Cancer
Biobalance: The Acid/Alkaline Solution to the Food-Mood-Health Puzzle
The Acid Alkaline Balance Diet : An Innovative Program for Ridding Your Body of Acidic Wastes
The pH Miracle: Balance Your Diet, Reclaim Your Health
Biochemical Individuality
The Nutrition Solution: A Guide to Your Metabolic Type
The Metabolic Typing Diet: Customize Your Diet to Your Own Unique Body Chemistry
_Cracking the Metabolic Code
_Genetic Nutritioneering
_Dr. Abravanel's Body Type Diet and...
_Different Bodies, Different Diets: Introducing the Revolutionary 25 Body Type System

Blood

Cook Right for Your Type : The Practical Kitchen Companion to Eat Right 4 Your Type, Including More Than 200 Original Recipes...
The Eat Right for Your Type Complete Blood Type Encyclopedia
_Blood Type A: Food, Beverage and Supplement Lists
_Blood Type B: Food,...
_Blood Type AB: Food,...
_Blood Type O: Food,...
_Diabetes: Fight It with the Blood...
_Arthritis: Fight it with the Blood...
_The Food Combining/Blood Type Diet Solution
_The Answer Is in Your Bloodtype: Research Linking Your Blood Type and How It Affects...
_Bloodtypes, Bodytypes and You

all linked from this list if you are curious:
 link to www.amazon.com

nutritional yeast 24.Jan.2007 08:41

another ex-vegan

nutritional yeast, as well as other processed yeast AND soy products contain MSG (that's monosodium glutamate), a neurotoxin (it causes brain lesions in lab rats) and NUTRITIONALLY useless food additive. MSG and other free glutamates are formed in the natural production of nutritional yeasts and other products, and thus are not labelled. check out Red Star's corporate history and several websites documenting this.

and, in response to this whole article/series of posts: is anyone surprised that something our government is doing has proven not to be helpful and benevolent, but harmful and calculated? hello?! switch to a local/organic/whole foods diet!!!