Recently we were advised to take lots of folic acid to help prevent Alzheimer's. (Of course, that study, when scrutinized, showed itself to be highly flawed.) Now, we are supposed to avoid folic acid like the plague because it will cause cancer:

High doses of folic acid do not prevent precancerous colon polyps in people prone to them and may actually increase the risk of developing the growths, a new study finds.

This study (Cole et al., 2007. Folic acid for the prevention of colorectal adenomas: A randomized clinical trial. JAMA. 297:2351-2359) actually finds a lot of non-statistical differences between groups of about 500, one taking folic acid supplements for several years, and one not. The only probable real difference in the groups (considering the large number of comparisons they made) was in those people with 3 or more adenomas (pre-cancerous growths) found 6-8 years after the study began.

One issue muddying the water in the study, which was not the fault of the authors, was the addition of folic acid supplements to quite a lot of the American food supply by the FDA, starting in 1998, two years after the study began. This presumably helped to obscure potential differences between the treatment and control groups because all were essentially taking folic acid supplements, with the treatment groups taking more. Additionally, the supplemented amounts were more than double (1 milligram) the "recommended daily value" of 400 micrograms - and that is ignoring the folate they were getting from whatever plants they were eating, and piles of folic acid they started getting in their diet after the FDA's intervention. Six years is a long time to be pounding your body with a huge excess of any one nutrient.

The mainstream media love a more sensational representation of the latest medical news, however:

Cancer patients should discuss taking vitamins with their doctors, and anyone over 50 who takes vitamins should have a colorectal screening test, said Cornelia Ulrich of Seattle's Fred Hutchinson Cancer Research Center, who co-wrote an accompanying editorial.

Apparently, suddenly all our doctors are going to have all this knowledge about what supplements their patients should take, because of this one paper telling us that infusing our systems with one particular compound for six years is probably a bad idea. (And cancer doctors aren't exactly who I would pinpoint to be nutrition fairies - most of the cancer patients I have known would have been better off without being poisoned slowly by doctors using the euphamism "chemotherapy.") Shouldn't everyone (who can afford it) over 50 get a colorectal screening test? Colorectal cancer is one of the easiest cancers to prevent by snipping off the adenomas within the colon. Who cares about vitamins?

Our obsession with supplements has gotten entirely out of control. Instead of taking policy steps that would help people consume good foods to obtain the nutrients our bodies need at levels to which they are adapted, our government and media imply there is always an easy fix by taking some supplement or other in absurd dosages. Certainly they give lip service to eating a balanced diet, but government policies actually subsidize, and thus promote, the production of cheap processed foods that are little but empty calories. On the NIH page linked to above explaining the folic acid food supplementation, it is actually stated, after a list of the easily obtained, unprocessed plant foods that contain natural folate (as opposed to the synthetic folic acid):

The March of Dimes Birth Defects Foundation warns women not to rely on these foods for enough folic acid to prevent serious birth defects in their future babies (March of Dimes 1997).

We know the March of Dimes is focused solely on preventing every possible birth defect, but doesn't this seem a bit extreme? Certainly it is possible, and in some societies routine - to give birth to a healthy baby without taking a lot of supplements; yet we are issued a "warning" to take supplements, implying an "or else."

Fortunately, a subset of Americans is taking back control over their diet, by creating more farmer's markets, and supporting organic, and more important, local food production so more of us can eat better without resorting to cheap junk. Unfortunately, the medical community is still all about fixing us after there's something wrong. That's why even when considering prevention, they think in terms of medication, rather than the inculcation of lifestyle changes which are known to keep us healthy in the first place. Certainly in this world today the former way of thinking is much easier to promote. This has led to a plethora of studies on drugs and supplements, giving people substances our bodies are not adapted to, or abnormal amounts of substances our bodies do normally encounter, with results that have really not been very helpful in the long term. As one doctor says:

"Right now it would not be appropriate to blindly go forth and further increase the levels of folic acid without better understanding the potential risks," Mason said. "And whether we continue folic acid fortification should be an open debate over the next few years."

Amen to that. How about instead we spend some money finding a way to make it a lot easier for people to eat what they are designed to eat?

Labels: brain, health, humans, vitamins