The "next best thing to sliced bread" is not adding folic acid

The “next best thing to sliced bread” is not adding folic acid

I am not a fan of adding a man-made version of a natural nutrient into our national bread supply.  Why?  Man-made folic acid (PteGlu) is very different from folates (Vitamin B9) that occur in food and acts very differently in the human body.  I am fully supportive of all measures that prevent spina bifida and hydrocephalus and support a healthier population at large.  I do not believe this is the best way to go about it.  We are not looking closely enough at the bigger picture here.  The modern diet and lifestyle is the problem and the cause of the lack of natural folates in our population.   

Folic acid vs. natural folates
A variety of natural folates exists in leafy green vegetables, hence their name ‘foliage’.  Folate is abundant in green vegetables like spinach, silverbeet, kale, collards, bok choy, artichokes, and broccoli.  It is also in many low-cost foods such as Haricot beans, brown rice, citrus fruits, red kidney beans, melons, sunflower seeds, avocado, courgettes, eggs, oats and more.  Educating people to eat more of these while pregnant is the smartest, simplest, cheapest and most common sense and effective solution we have.  Just like Ireland has done so successfully.  This is the simple and obvious solution.  Educate pregnant women to include folate-rich foods in their diets.  Ireland stopped plans to add man-made folic acid to bread after a voluntary scheme was shown to successfully raise women’s natural folate levels.  Otherwise we just excuse eating poorly and slowly end up adding man-made vitamins to all foods over time.  This is a very slippery slope indeed.  Natural sourdough bread has double the folate levels of commercial white bread.  If you ferment bread for just six hours rather than zero hours then the amount of natural folate doubles.  This alone would solve the ‘folic acid’ issue immediately by supplying much healthier bread that had very rich natural levels of folates.

Natural folate improvement is all about the diet and lifestyle
You cannot remove leafy green vegetables from the diet and then recommend that people replace the missing nutrients with man-made pills.  Vitamin and mineral pills are very helpful and appropriate for periods of time (if used alongside dietary changes to reverse the nutritional deficiency while new healthy habits are put in place such as a fresh, plant-based, wholefood diet rich in properly prepared fruits, vegetables, nuts, seeds, wholegrains and legumes).  However the mistake people make is thinking they can eat badly, remain stressed, avoid exercise or natural sunlight, smoke or drink in large amounts, not get enough sleep and rest, eat a processed, highly constipating die and avoid fruits and vegetables - and then take a pill that will fix everything.  It won’t.  Having to ingest a mandatory dose of a man-made vitamin in every day foods for the rest of your life is a completely different ball game to intelligent supplementing of vitamins when appropriate.  

Natural folates from green vegetables are unique, irreplaceable and are digested in the gut. 

Man-made folic acid is metabolised in the liver. 

Why not follow Ireland’s successful, effective and safe solution?
In 2007 the NZ Government suggested adding man-made folic acid into almost every loaf of bread eaten in NZ.  This would have been an unproven mass medication of four million people to potentially stop around 50 cases a year of spina bifida and hydrocephalus.  This is an overkill strategy.  Will it work?  No, simple logic tells you that many women will not eat the “required X slices of bread per day” to get the dose so folic acid pills would still be needed.  This would mean that all New Zealander’s who eat bread have to ingest the added man-made folic acid, while the very small group who actually need it, will probably not even receive the benefits.  This makes no sense at all regardless of how you look at it.  Why not put the energy and resources into actually talking to and educating the women that need it most?    

Experts are still concerned about the long term effects
There are long-term concerns about continuously processing our foods to the point of them requiring us to add back in man-made chemicals.  In Britain; plans to fortify all bread were put on hold after the Chief Medical Officer warned it could raise rates of bowel and breast cancer.  One important function of folate is assisting in the formation of genetic material in each and every cell of the body.  This affects your health in every area and your fertility and your children.  We know that natural folates in foods are very healthy and protective for human health.  With our hindsight now (and this is going to sound ridiculous), if they had adopted the same mentality in the 1960s, when we were told that thalidomide was “completely safe” by the country’s top scientists, they might have fortified bread with thalidomide to “prevent morning sickness in pregnant women…”

What removes folate from the body?
Stress, refined sugar, extruded breakfast cereals, white flour, white rice, alcohol, smoking, antibiotics, birth control pills, preservatives, and coffee all strip the body of B vitamins.  Drugs, toxins, malnutrition and too much cooked foods also cause problems.  B vitamins are lost when foods are milled (like white flour and white rice) or are cooked too long. 

The best sources of folate
Leafy green vegetables such as spinach, silverbeet, kale, collards, bok choy, artichokes, and broccoli.  It is also in many low-cost foods such as Haricot beans, red kidney beans, melons, sunflower seeds, avocado, courgettes, eggs, oats, wholegrains, brown rice, dried yeast, citrus fruits, beetroot, celery, mushrooms, turnip, watercress, salmon, avocado, Brazil nuts, fish, peanuts, almonds, potato, dried beans, watermelon, carrots, bananas, acorn squash and prune juice. 

The simple solution that works for everyone
We educate all pregnant mothers to increase their intake of folate-rich foods and to decrease their intake of folate-depleting foods.  This has been proven to work already, is cheaper, more effective, easily done, safer for all and smarter as a “folate-rich diet” is also a “healthier-pregnancy-in-all-ways diet”.  This way everybody wins and there is no downside.  We have healthier mothers and children and we genuinely get to the root cause of the issue and not just sprinkle something palatable on top to make it all seem like it is 'solved'.  We have seen many studies showing how a healthy and balanced, plant-based, folate-rich diet can reduce incidence of heart disease, which is the #1 killer of women.  Eating this way has also been shown to dramatically lower breast cancer and diabetes risk for the mother and decrease the chances of their children developing ADHD, mental disorders, diabetes or childhood cancers.

Our diet and lifestyle are 100% the cause of this problem.  Changing them is the only solution. 

References:

Study by Boushey, CJ, et. al., “A Quantitative Assessment of Plasma

Homocysteine as a risk factor for vascular disease” as published in the Journal of the American Medical Association 1995:274:1049-57.

Study by Song J, Sohn KJ, Medline A, Ash C, Gallinger S, Kim YI.  “Chemopreventive effects of dietary folate on intestinal polyps in Apc+/–Msh2–/– mice” as published in Cancer Res 2000;60:3191–9.

Study by Jensen CD et al. “Maternal dietary risk factors in childhood acute lymphoblastic leukemia” (United States).Cancer Causes Control. 2004 Aug;15(6):559-70.

Study published in the American Journal of Clinical Nutrition, Volume 86, Pages 434-443, "High folate intake is associated with lower breast cancer incidence in postmenopausal women in the Malmo Diet and Cancer cohort” Authors: U. Ericson, E. Sonestedt, B. Gullberg, H. Olsson, and E. Wirfalt. 

Study by Kwan ML et al. “Maternal diet and risk of childhood acute lymphoblastic leukemia”. Public Health Rep. 2009 Jul-Aug;124(4):503-14.

Study by Kim YI. “Does a high folate intake increase the risk of breast cancer?” Nutr Rev. 2006 Oct;64(10 Pt 1):468-75.

Study by Stolzenberg-Solomon RZ et al. “Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial”. Am J Clin Nutr. 2006 Apr;83(4):895-904.

Study by Petridou E et al. “Maternal diet and acute lymphoblastic leukemia in young children” as published in Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1935-9.

Study by Wiley-Blackwell (2009, October 28). “Attention-deficit/hyperactivity Problems Associated With Low Folate Levels In Pregnant Women” as published in ScienceDaily.

Study by Tower RL et al. “The epidemiology of childhood leukemia with a focus on birth weight and diet”. Crit Rev Clin Lab Sci. 2007;44(3):203-42.

Study by Rosenberg IH. “Virtual folate: virtual success?” Am J Clin Nutr 1999;70:177–8. 

Study by Sellers TA et al. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology. 2001 Jul;12(4):420-8.

Study by Song J, Medline A, Mason JB, Gallinger S, Kim YI. “Effects of dietary folate on intestinal tumorigenesis in the apcMin mouse” as published in Cancer Res 2000;60:5434–40.

Posted: Monday 7 May 2012

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