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.
contribute to this article
contribute to this article
add comment to discussion
view discussion from this article