| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
COMMENTARY |
1 From the Departments of Medicine and Nutritional Sciences, University of Toronto, and the Division of Gastroenterology, St Michael’s Hospital, Toronto
An overwhelming body of evidence for a protective effect of periconceptional folic acid supplementation against neural tube defects (NTDs) led to mandatory folic acid fortification in the United States. The effectiveness of folic acid fortification in improving folate status has already been shown to be quite striking, with a dramatic increase in blood measurements of folate in the United States. Preliminary reports also suggest a significant reduction (
15–50%) in NTDs in the United States. 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 collaboration between science and public health policy. Although folic acid is generally regarded as safe, there continues to be concern that folic acid fortification may have adverse effects in subpopulation groups not originally targeted for fortification. In this regard, an emerging body of evidence suggests that folic acid supplementation may enhance the development and progression of already existing, undiagnosed premalignant and malignant lesions. Over the past few years, the US population has been exposed to a significant increase in folate intake, for which essentially no data on safety exist. The potential cancer-promoting effect of folic acid supplementation needs to be considered in carefully monitoring the long-term effect of folic acid fortification on the vast majority of the US population, who are not at risk of NTDs.
Key Words: Folic acid fortification • folate • cancer • carcinogenesis • DNA methylation • neural tube defects
This article has been cited by other articles:
|
|
 |
|
  Y.-I. Kim Folic Acid Supplementation and Cancer Risk: Point Cancer Epidemiol. Biomarkers Prev., September 1, 2008; 17(9): 2220 - 2225. [Full Text] [PDF]
|
|
|
|
 |
|
 R. M Winkels, I. A Brouwer, R. Clarke, M. B Katan, and P. Verhoef Bread cofortified with folic acid and vitamin B-12 improves the folate and vitamin B-12 status of healthy older people: a randomized controlled trial Am. J. Clinical Nutrition, August 1, 2008; 88(2): 348 - 355. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. W. Reding, J. R. Daling, D. R. Doody, C. A. O'Brien, P. L. Porter, and K. E. Malone Effect of Prediagnostic Alcohol Consumption on Survival after Breast Cancer in Young Women Cancer Epidemiol. Biomarkers Prev., August 1, 2008; 17(8): 1988 - 1996. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Q.-H. Yang, L. D Botto, M. Gallagher, J. Friedman, C. L Sanders, D. Koontz, S. Nikolova, J D. Erickson, and K. Steinberg Prevalence and effects of gene-gene and gene-nutrient interactions on serum folate and serum total homocysteine concentrations in the United States: findings from the third National Health and Nutrition Examination Survey DNA Bank Am. J. Clinical Nutrition, July 1, 2008; 88(1): 232 - 246. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ulrich, M. Neuhouser, A. Y. Liu, A. Boynton, J. F. Gregory III, B. Shane, S. J. James, M. C. Reed, and H. F. Nijhout Mathematical Modeling of Folate Metabolism: Predicted Effects of Genetic Polymorphisms on Mechanisms and Biomarkers Relevant to Carcinogenesis Cancer Epidemiol. Biomarkers Prev., July 1, 2008; 17(7): 1822 - 1831. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. G. Luebeck, S. H. Moolgavkar, A. Y. Liu, A. Boynton, and C. M. Ulrich Does Folic Acid Supplementation Prevent or Promote Colorectal Cancer? Results from Model-Based Predictions Cancer Epidemiol. Biomarkers Prev., June 1, 2008; 17(6): 1360 - 1367. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. L. Moens, C. J. Vrints, M. J. Claeys, J.-P. Timmermans, H. C. Champion, and D. A. Kass Mechanisms and potential therapeutic targets for folic acid in cardiovascular disease Am J Physiol Heart Circ Physiol, May 1, 2008; 294(5): H1971 - H1977. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A D. Smith, Y.-I. Kim, and H. Refsum Is folic acid good for everyone? Am. J. Clinical Nutrition, March 1, 2008; 87(3): 517 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Lin, I-M. Lee, N. R Cook, J. Selhub, J. E Manson, J. E Buring, and S. M Zhang Plasma folate, vitamin B-6, vitamin B-12, and risk of breast cancer in women Am. J. Clinical Nutrition, March 1, 2008; 87(3): 734 - 743. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Wang, A. J. Sasco, C. Fu, H. Xue, G. Guo, Z. Hua, Q. Zhou, Q. Jiang, and B. Xu Aberrant DNA Methylation of P16, MGMT, and hMLH1 Genes in Combination with MTHFR C677T Genetic Polymorphism in Esophageal Squamous Cell Carcinoma Cancer Epidemiol. Biomarkers Prev., January 1, 2008; 17(1): 118 - 125. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Vollset, J. Igland, M. Jenab, A. Fredriksen, K. Meyer, S. Eussen, H. K. Gjessing, P. M. Ueland, G. Pera, N. Sala, et al. The Association of Gastric Cancer Risk with Plasma Folate, Cobalamin, and Methylenetetrahydrofolate Reductase Polymorphisms in the European Prospective Investigation into Cancer and Nutrition Cancer Epidemiol. Biomarkers Prev., November 1, 2007; 16(11): 2416 - 2424. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P.K. Myint, K.E.S. Poole, and E.A. Warburton Hip fractures after stroke and their prevention QJM, September 1, 2007; 100(9): 539 - 545. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Mason, A. Dickstein, P. F. Jacques, P. Haggarty, J. Selhub, G. Dallal, and I. H. Rosenberg A Temporal Association between Folic Acid Fortification and an Increase in Colorectal Cancer Rates May Be Illuminating Important Biological Principles: A Hypothesis Cancer Epidemiol. Biomarkers Prev., July 1, 2007; 16(7): 1325 - 1329. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Capel and R. Corcoy What Dose of Folic Acid Should Be Used for Pregnant Diabetic Women? Diabetes Care, July 1, 2007; 30(7): e63 - e63. [Full Text] [PDF]
|
|
|
|
|
|
A D. Smith Folic acid fortification: the good, the bad, and the puzzle of vitamin B-12 Am. J. Clinical Nutrition, January 1, 2007; 85(1): 3 - 5. [Full Text] [PDF]
|
|
|
|
 |
|
 S. de Vogel, M. van Engeland, M. Luchtenborg, A. P. de Bruine, G. M. J. M. Roemen, M. H. F. M. Lentjes, R. A. Goldbohm, P. A. van den Brandt, A. F. P. M. de Goeij, and M. P. Weijenberg Dietary Folate and APC Mutations in Sporadic Colorectal Cancer J. Nutr., December 1, 2006; 136(12): 3015 - 3021. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. B. Ambrosone, T. R. Rebbeck, G. J. Morgan, K. S. Albain, E. E. Calle, W. E. Evans, D. F. Hayes, L. H. Kushi, H. L. McLeod, J. H. Rowland, et al. New Developments in the Epidemiology of Cancer Prognosis: Traditional and Molecular Predictors of Treatment Response and Survival. Cancer Epidemiol. Biomarkers Prev., November 1, 2006; 15(11): 2042 - 2046. [Full Text] [PDF]
|
|
|
|
|
|
G. R. Wasson, A. P. McGlynn, H. McNulty, S. L. O'Reilly, V. J. McKelvey-Martin, G. McKerr, J. J. Strain, J. Scott, and C. S. Downes Global DNA and p53 Region-Specific Hypomethylation in Human Colonic Cells Is Induced by Folate Depletion and Reversed by Folate Supplementation J. Nutr., November 1, 2006; 136(11): 2748 - 2753. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L. Sherwood, L. A. Houghton, V. Tarasuk, and D. L. O'Connor One-Third of Pregnant and Lactating Women May Not Be Meeting Their Folate Requirements from Diet Alone Based on Mandated Levels of Folic Acid Fortification J. Nutr., November 1, 2006; 136(11): 2820 - 2826. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y-I Kim Folate: a magic bullet or a double edged sword for colorectal cancer prevention? Gut, October 1, 2006; 55(10): 1387 - 1389. [Full Text] [PDF]
|
|
|
|
|
|
B Van Guelpen, J Hultdin, I Johansson, G Hallmans, R Stenling, E Riboli, A Winkvist, and R Palmqvist Low folate levels may protect against colorectal cancer Gut, October 1, 2006; 55(10): 1461 - 1466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Hubner, K. R. Muir, J.-F. Liu, G. S. Sellick, R. F.A. Logan, M. Grainge, N. Armitage, I. Chau, R. S. Houlston, and The United Kingdom Colorectal Adenoma Prevention C Folate metabolism polymorphisms influence risk of colorectal adenoma recurrence. Cancer Epidemiol. Biomarkers Prev., September 1, 2006; 15(9): 1607 - 1613. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. McCarty and K. I. Block Toward a core nutraceutical program for cancer management. Integr Cancer Ther, June 1, 2006; 5(2): 150 - 171. [Abstract] [PDF]
|
|
|
|
|
|
T. Tamura and M. F. Picciano Folate and human reproduction Am. J. Clinical Nutrition, May 1, 2006; 83(5): 993 - 1016. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Z Stolzenberg-Solomon, S.-C. Chang, M. F Leitzmann, K. A Johnson, C. Johnson, S. S Buys, R. N Hoover, and R. G Ziegler Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am. J. Clinical Nutrition, April 1, 2006; 83(4): 895 - 904. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Larsson, N. Hakansson, E. Giovannucci, and A. Wolk Folate intake and pancreatic cancer incidence: a prospective study of Swedish women and men. J Natl Cancer Inst, March 15, 2006; 98(6): 407 - 413. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ulrich and J. D. Potter Folate supplementation: too much of a good thing? Cancer Epidemiol. Biomarkers Prev., February 1, 2006; 15(2): 189 - 193. [Full Text] [PDF]
|
|
|
|
|
|
A. M. Troen, B. Mitchell, B. Sorensen, M. H. Wener, A. Johnston, B. Wood, J. Selhub, A. McTiernan, Y. Yasui, E. Oral, et al. Unmetabolized Folic Acid in Plasma Is Associated with Reduced Natural Killer Cell Cytotoxicity among Postmenopausal Women J. Nutr., January 1, 2006; 136(1): 189 - 194. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ulrich Nutrigenetics in Cancer Research--Folate Metabolism and Colorectal Cancer J. Nutr., November 1, 2005; 135(11): 2698 - 2702. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-I. Kim Nutritional Epigenetics: Impact of Folate Deficiency on DNA Methylation and Colon Cancer Susceptibility J. Nutr., November 1, 2005; 135(11): 2703 - 2709. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Abramsky, A. Busby, and H. Dolk Promotion of periconceptional folic acid has had limited success The Journal of the Royal Society for the Promotion of Health, September 1, 2005; 125(5): 206 - 209. [PDF]
|
|
|
|
 |
|
 J. Kotsopoulos, A. Medline, R. Renlund, K.-J. Sohn, R. Martin, S. W. Hwang, S. Lu, M. C. Archer, and Y.-I. Kim Effects of dietary folate on the development and progression of mammary tumors in rats Carcinogenesis, September 1, 2005; 26(9): 1603 - 1612. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Vollset and P. M. Ueland B vitamins and cognitive function: do we need more and larger trials? Am. J. Clinical Nutrition, May 1, 2005; 81(5): 951 - 952. [Full Text] [PDF]
|
|
|
|
|
|
D. C. Thomas The Need for a Systematic Approach to Complex Pathways in Molecular Epidemiology Cancer Epidemiol. Biomarkers Prev., March 1, 2005; 14(3): 557 - 559. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
