Good News, Bad News for Folic Acid

STOCKHOLM, Sweden & ATLANTA--Researchers from the Centers for Disease Control (CDC) and University of Alabama, Birmingham, discovered grain fortified with folic acid has helped lower the incidence of both spina bifida and anencephaly. Published in the September issue of Pediatrics (116, 3:580-6, 2005), the study reviewed the incidence of the two birth defects in three different races--Hispanics, non-Hispanic whites and non-Hispanic blacks. Since 1995, a year before folic acid fortification in grain was authorized, incidence of the two birth defects, especially spina bifida, have significantly declined in Hispanic and white populations. However, researchers found no significant difference in birth defects among the black population.

Educational efforts regarding the importance of consumption of folic acid-containing supplements and food high in folic acid and natural folate among women of all racial/ethnic groups should be continued, concluded the researchers. A follow-up commentary from two doctors published in the same journal issue claimed the folate level in enriched grain products is still too low.

A separate trial, presented at the recent meeting of the European Society of Cardiology, reported folic acid and B vitamin supplementation may not prevent heart attack and stroke, and may even be harmful when taken in combination. Researchers noted both supplements did lower homocysteine levels, suggesting the role of homocysteine in heart disease may now be in question. However, 11 additional studies are underway to investigate the value of folic acid fortification in flour to boost heart health in various countries.

In the latest study, 4,749 heart attack survivors were divided into four groups--one taking folic acid, one taking a B vitamin supplement, one taking both supplements combined, and a final group taking placebo pills. There was no significant difference in heart attacks among those taking either supplement or placebo; however, incidence of recurrent heart attack and stroke increased 20 percent in those taking the combined supplements. Subjects with kidney problems and those also taking other vitamin supplements fared the worst, according to researchers.

Ray Gibbons, M.D., professor of medicine at the Mayo Clinic and president-elect of the American Heart Association (AHA) jumped on the negative results. I am going to purposely educate everyone I see that the folic acid they are taking has just been tested, and the single large study to test it didnt find any benefit at all, he said. Im going to ask them if they are taking vitamin B6 or a multivitamin containing B6--as many of them are--and Im going to point out that this study showed that this combination is harmful.