The article was published in advance of the FSAB reevaluation (which upheld mandatory fortification) first summarizes the history of folic acid's use on a public-health scale to prevent NTDs, proposes two potential mechanisms by which folic acid could possibly promote cancer, and reports (as I did above) surveillance data on NTDs.Anyway, I'd say that this is something of which to be cognizant, but the OMGCANCER stuff might be a little premature, especially if you're still in that 400 microgram range.
It continues by giving the recommended daily folate allowance of 400 micrograms (240 micrograms synthetic), and sets an upper limit at 1000 micrograms. It then quotes a study that found the average folic acid intake in the USA to be 220 micrograms, roughly double where it was before mandatory fortification.
The article then gets to the heart of the issue-- "trends of increasing incidence rates of colorectal cancer in several countries that had adopted mandatory fortification with folic acid, including the USA, Candada, and Chile," qualifying almost immediately that "[c]onversely, death rates from cardiovascular disease have fallen... during the past decade," and then qualifying their qualification by noting that this drop was concurrent with decline in smoking rates, transfat bans, HTN treatment, and folate fortification.
The article concludes that long-term followup studies are needed to assess the safety of high folate intake, and that countries should forestall further mandates until the data is available, offering alternative strategies such as the "addition of folate to oral contraceptives" as a way to bridge the gap.
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posted by Madamina at 1:42 PM on March 29, 2010 [12 favorites]