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Recent News and Articles on the Keywords: folic acid + public health + fortification  Related to the article below (Last Update: 7/8/2008)

Harvard professor slams supplements
NutraIngredients-usa.com, France - Jul 7, 2008
He highlighted vitamin C and folic acid as two nutrients that were readily abundant in the diet, even for the less healthy members of society, ...
South Africa: Food Additives Cut Rate of Birth Defect
AllAfrica.com, Washington - Jun 12, 2008
The government's food fortification programme has led to a 40% decline in spina bifida, a birth defect linked to folic acid deficiency, new research by ...
The fight against malnutrition
Xinhua, China - Jul 2, 2008
The fortification of maize meal with folic acid in South Africa - one of the projects supported by the Global Alliance for Improved Nutrition (GAIN) - was ...
Flavour challenges key for folic acid in dairy
FoodNavigator.com, France - Jun 16, 2008
This connection led to the 1998 introduction of public health measures in the US and Canada, where all grain products are fortified with folic acid - the ...

UNICEF (press release)
New UNICEF report reveals progress made in reducing iodine deficiency
UNICEF (press release), NY - Jun 26, 2008
And its example has led to countries seeing the benefits of other types of food fortification, such as adding iron and folic acid to flour. ...
GAIN releases Annual Report 2006/2007
Organisation de la Presse Africaine (Communiqu?s de presse), Switzerland - Jun 30, 2008
In South Africa, spina bifida in new-born babies was reduced by 40%, which means 400 lives saved a year, following the addition of folic acid to wheat flour ...
Does Preventive Care Save Money?
New England Journal of Medicine (subscription), MA - Jun 25, 2008
... or QALY 1 ) and sometimes cost-saving (eg, folic acid fortification of grains 2 and condom distribution 3 ). Other interventions cost the health care ...
Source: Google News

Impact of Folic Acid Fortification of the US Food Supply on the Occurrence of Neural Tube Defects -
MA Honein, LJ Paulozzi, TJ Mathews, JD Erickson, … - JAMA, 2001 - Am Med Assoc
... The impact of universal folic acid fortification as a public health intervention
was assessed by evaluating birth certificate data on NTDs to determine its ...

… Bifida and Anencephaly During the Transition to Mandatory Folic Acid Fortification in the United … -
LJ Williams, CT Mai, LD Edmonds, GM Shaw, RS Kirby … - Obstetrical & Gynecological Survey, 2003 - obgynsurvey.com
... 1992 the United States Public Health Service recommended ... enriched grain products
to require additional folic acid. ... The product fortification level of 140 ?g ...

Prevention of Neural-Tube Defects With Folic Acid in China. -
RJ Berry, Z Li, JD Erickson, S Li, CA Moore, H … - Obstetrical & Gynecological Survey, 2000 - obgynsurvey.com
... Low compliance with recommendations on folic acid use in relation to pregnancy:
is there a need for fortification?. Public Health Nutrition. ...

fortification of flour: Governments that do not ensure fortification are committing public health -
GP Oakley - BMJ: British Medical Journal, 2002 - pubmedcentral.nih.gov
... Copyright ? 2002, BMJ. Delaying folic acid fortification of flour. Governments that
do not ensure fortification are committing public health malpractice. ...

Incidence of open neural tube defects in Nova Scotia after folic acid fortification -
VL Persad, MC Van den Hof, JM Dube, P Zimmer - Canadian Medical Association Journal, 2002 - Can Med Assoc
... initiatives were begun and 1995?1997 as the period when public health measures on
folic acid supplementation were in place but fortification had not yet begun ...

Will mandatory folic acid fortification prevent or promote cancer? -
YI Kim - American Journal of Clinical Nutrition, 2004 - Am Soc Nutrition
... The success of folic acid fortification in improving folate status and in reducing
NTD rates is truly a public health triumph and provides a paradigm of ...

Inertia on folic acid fortification: public health malpractice. -
GP Oakley Jr - Teratology, 2002 - ncbi.nlm.nih.gov
Teratology. 2002 Jul;66(1):44-54. Click here to read Inertia on folic acid
fortification: public health malpractice. Oakley GP Jr. ...

Association of neural tube defects and folic acid food fortification in Canada -
JG Ray, C Meier, MJ Vermeulen, S Boss, PR Wyatt, … - The Lancet, 2002 - Elsevier
... was supported by funding from the Public Health Branch, Ontario Ministry of Health
and Long Term ... and LY Wong, Impact of folic acid fortification of the ...

Evaluating food fortification options: general principles revisited with folic acid. -
NT Crane, DB Wilson, DA Cook, CJ Lewis, EA Yetley, … - American Journal of Public Health, 1995 - pubmedcentral.nih.gov
... This article uses folic acid as an example to ... principles that emerge when evaluating
fortification of the food ... means to address a public health recommendation. ...

… rate of folate insufficiency among adults following increased folic acid food fortification in … -
JG Ray, MJ Vermeulen, SC Boss, DE Cole - Can J Public Health, 2002 - ncbi.nlm.nih.gov
... J Public Health. 2002 Jul-Aug;93(4):249-53. Comment in: ... Declining rate of folate
insufficiency among adults following increased folic acid food fortification ...

Source: Google Scholar

Research Needed Into LongTerm Public Health Effects Of Folic Acid Fortification

Since the institution of nationwide folic acid fortification of enriched grains in the mid 1990s, the number of infants born in the United States and Canada with neural tube defects has declined by 20 percent to 50 percent. Concurrent with the institution of fortification, however, the rate at which new cases of colorectal cancer were diagnosed in men and women increased, report researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University. Joel Mason, MD, director of the USDA HNRCA's Vitamins and Carcinogenesis Laboratory, and colleagues analyze the temporal association between folic acid fortification and the rise in colorectal cancer rates, and present their resulting hypothesis in an article in the July issue of Cancer Epidemiology Biomarkers & Prevention.
"Nationwide fortification of enriched grains is generally considered one of the greatest advances in public health policy," says Mason, who is also an associate professor at the Friedman School of Nutrition Science and Policy at Tufts. "But since the time that the food supply in North America was fortified with folic acid, we have been experiencing four to six additional cases of colorectal cancer for every 100,000 individuals each year compared to the trends that existed before fortification.

"Our analysis suggests that this increase is not explained by chance or by increased cancer screening. Therefore, it is important to analyze risks and benefits of fortification, and encourage scientific debate in countries that are considering instituting or enhancing folic acid fortification."

Mason and colleagues analyzed data from national cancer registries, one in the United States and another in Canada. The US data were derived from the nationwide Surveillance Epidemiology and End Results (SEER) registry that publishes cancer occurrence rates and survival data, covering approximately 26 percent of the population. The Canadian data were obtained from Canadian Cancer Statistics, an annual publication by the Canadian Cancer Society and the National Cancer Institute of Canada.

In 1996 and 1998, there were abrupt reversals in the 15-year downward trends in colorectal cancer rates in the United States and Canada, respectively. Since peaking in 1998 in the United States and in 2000 in Canada, the rates have not returned to their earlier levels. Although folic acid fortification of enriched grains -- including bread, cereal, flour, rice, and pasta -- did not become mandatory until 1998, large food companies began voluntary fortification in 1996, first in the United States and later in Canada.

Folic acid is the synthetic form of folate, a B vitamin that is essential for cell growth. After intestinal absorption, folic acid is converted to methyltetrahydrofolate, found naturally in foods such as leafy green vegetables, legumes and citrus fruits. "The body's response to folic acid appears to be complex," says Mason. "While fortification of the food supply is clearly beneficial for women of child-bearing age and their offspring, it is possible that it may, coincidentally, be linked to the increase in colorectal cancer rates. Our report is intended to create a foundation upon which to further explore that possibility."
As Mason and colleagues note, there is a compelling body of scientific evidence suggesting that habitually high intakes of dietary folate are protective against colorectal cancer. Mason explains, however, that "There are several reasons why we may have inadvertently created the opposite effect with folic acid fortification. First, folate's pivotal role in DNA synthesis also makes it a potential growth factor for cancerous or pre-cancerous cells, and when administered in large quantities to individuals who unknowingly harbor cancer cells, it could paradoxically enhance cancer development. The addition of substantial quantities of folic acid into the foodstream may have facilitated the transformation of benign growths into cancers, or small cancers into larger ones," he says. "Second, the fact that a synthetic form of folate is used for fortification may be important," suggests Mason. "As the total amount of folic acid ingested increases, the mechanism that converts folic acid to methyltetrahydrofolate can become saturated. The leftover folic acid in the circulation might have detrimental effects, as it is not a natural form of the vitamin."

At a time when many countries are debating whether or not to institute or enhance folic acid fortification, Mason and colleagues urge caution and debate. "We must examine the effects of folic acid fortification on the population as a whole, which includes better defining the nature of the relationship between folic acid fortification and colorectal cancer," says Mason. "Improved monitoring and further research in this field is important to our understanding of the long-term public health effects of fortification."


Mason JB, Dickstein A, Jacques PF, Haggarty P, Selhub J, Dallal G, Rosenberg IH. Cancer Epidemiology Biomarkers & Prevention. 2007 (July); 16(7):1-5. "A Temporal Association between Folic Acid Fortification and a Rise in Colorectal Cancer Rates May be Illuminating Important Biological Principles: a Hypothesis."

The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school's eight centers, which focus on questions relating to famine, hunger, poverty, and communications, are renowned for the application of scientific research to national and international policy. For two decades, the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University has studied the relationship between good nutrition and good health in aging populations. Tufts research scientists work with federal agencies to establish the USDA Dietary Guidelines, the Dietary Reference Intakes, and other significant public policies.

Source: Siobhan Gallagher
Tufts University, Health Sciences
 
 
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