Write a short 2-3 paragraph summary about your article.FOLIC ACID: ONCE OVERLOOKED, NOW A NUTRIENT ON THE BRINK OF STARDOMCheck the fine print. The wrapper around that enriched loaf of wheat in your bread box is sporting a new label. As of January 1, manufacturers must add folic acid to all enriched products, including flour, bread, rolls, grits, corn meal, farina, rice, pasta and noodles.Folic acid joins fellow B vitamins, thiamin, riboflavin and niacin, and the mineral iron, all of which have been enriching refined wheat products for over 50 years. (Note: Folic acid is the form of the vitamin found most often in your body and the form added to foods and supplements. Folate is the form found naturally in foods. Folacin is a collective term for these and other forms of the vitamin.)Why fortify with folic acid? We now know that not getting enough of this vitamin in the early days of pregnancy increases the risk of giving birth to a child with a neural tube defect. Neural tube defects, such as spine bifida, occur when the spinal column fails to close during fetal development. But because women need the extra folic acid in the first weeks after conception, before they know they are pregnant, it is important for all women of childbearing age to consume 400 micrograms of folic acid daily. Yet most Americans take in only about 200 a day. Fortification is expected to add about 100 micrograms to that.”[We have] the opportunity to prevent about half of these birth defects with folic acid fortification of foods,” says Barbara Bowman, Ph.D., of the Centers for Disease Control and Prevention. That’s impressive.But that’s not all. There may be side benefits from fortification for all Americans, not just those who might become pregnant. Evidence is fast accumulating that folic acid may also cut the risk of heart disease, certain cancers and possibly stroke.The Homocysteine-Heart Link.Researchers now think by increasing folate consumption, from foods such as orange juice, green leafy vegetables and dried beans, we may be able to help ward off heart disease. Folic acid helps reduce blood levels of the amino acid homocysteine; high levels are a strong predictor for heart disease and stroke–even stronger than blood cholesterol levels. Research suggests homocysteine is equally dangerous for men and women, and for middle-aged and older people.One probable cause for elevated homocysteine? Suboptimal folic acid intake. But folic acid isn’t your heart’s only protector. To keep homocysteine levels low also requires an adequate intake of vitamins B6 and B12. The 20-year ongoing Framingham Heart Study has found that most people with elevated homocysteine have low blood levels of one or more of these three vitamins. Getting enough of these B vitamins can normalize homocysteine levels and reduce the risk of heart disease and stroke.”It is important to increase your intake of foods containing folate and B6, such as fruits, vegetables and legumes,” says Katherine Tucker, Ph.D., of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston. However, she adds, “taking a B-complex supplement or a multivitamin designed for seniors is advisable for everyone over the age of 50,” to get the key trio of B vitamins, not just folic acid.The Cancer Connection. That folic acid might help reduce the risk of cancer is a fairly new and promising proposition. Preliminary evidence suggests the vitamin may reduce the risk of colon polyps and colorectal cancer. Explains Patrick Stover, Ph.D., of Cornell University in Ithaca, New York, folic acid is thought to prevent the onset of cancer by preventing damage to DNA. Stover advises that everyone take a supplement containing folic acid; if you’re older, he says, be sure it contains B12 as well.A connection between low folic acid and cervical cancer has also been suggested. According to a study led by Charles Butterworth, Jr., Ph.D., at the University of Alabama in Birmingham, women with low levels of folic acid who had been exposed to the human papilloma virus were five times more likely to develop cervical cancer than those with normal folic acid levels.Getting Enough Folacin. Besides not getting enough in the diet, there are a number of reasons why someone might be low in folic acid. Chronic diseases, such as rheumatoid arthritis, alcoholism and malabsorption syndrome, can contribute to subpar body stores. Moreover, medications can wreak havoc with folic acid levels.”Older people often take medications that can reduce folic acid absorption,” says Carlene Russell, M.S., R.D., “such as antacids, sulfasalazine, ranitidine, cimetidine, cholestryamine and metformin.” Moreover, if the production of stomach acid has decreased, as it sometimes does with age, folic acid absorption decreases.New research suggests that certain people are genetically prone to low folic acid because they inherit an increased need for the vitamin. So despite the new enrichment program, many people will still fall short of folic acid needs. Moreover, typically only refined grains are enriched, so anyone who eats whole wheat bread, whole wheat pasta and brown rice isn’t necessarily eating enriched products (check the ingredient list to be sure). But don’t switch from these healthy grains to enriched ones just to get more folic acid. Instead, up your intake of naturally folate-rich foods. (See box.) And consider taking a multivitamin/mineral supplement (or cereal) that contains 100% of the Daily Value for folic acid.Risky Move for Some? Even with all the potential benefits, folic acid fortification has its critics. Some scientists worry the extra folic acid will create a new risk for older people, who are more likely to lack enough acidity in the stomach to absorb vitamin B12. And too much folic acid can hide the symptoms of pernicious anemia, a deficiency of B12. If not caught and treated, it can lead to irreversible nerve damage. But the amount of folic acid added for enrichment is not likely to cause problems, say experts.One solution is to add B12 to foods, along with folic acid. Because this is still being hotly debated, EN urges our older readers to have their B12 status checked, as well as ensure they get enough B vitamins in their diet.Finding Folate in FoodAlthough the RecommendedDietary Allowance (RDA)for folacin is only 180micrograms for womenand 200 micrograms formen, experts now adviseeveryone get at least 400micrograms daily.As much as 50% of folate is destroyedduring food processing, storage andpreparation. To preserve as much asyou can:Avoid cutting food into small piecesprior to cooking.Steam or simmer foods using as littlewater as possible.Avoid overcooking foods.Alternate raw fruits andvegetables with cookedin your diet.Food Folate(micrograms)Lentils, boiled (1/2 cup) 179Oatmeal, instant (1 packet, prepared) 150Pinto beans, boiled (1/2 cup) 147Asparagus, boiled (6 spears) 131Spinach, boiled (1/2 cup) 131Navy beans, boiled (1/2 cup) 128Spinach, raw, chopped (1 cup) 108Orange juice, from frozenconcentrate (3/4 cup) 82Avacado, Florida (1/2 medium) 81Chick peas, canned (1/2 cup) 80Orange, navel (1 medium) 44Peanuts, dry roasted (1 ounce) 41Broccoli, boiled (1/2 cup) 39Broccoli, raw (1/2 cup) 31All values are from Bowes & Church’sFood Values of Portions CommonlyUsed – 17th edition, (Lippincott-RavenPublishers, 1998).~~~~~~~~By Andrea D. Platzman, M.S., R.D.
