The news was awash recently with the story concerning the consideration by the Scottish Government to add folic acid to flour, in an attempt to thwart a potential rise in birth defects.
Folic acid plays a role in preventing brain and spine defects including spina bifida; however 85% of women don’t have an adequate intake, which has been recommended as 400mcg per day.
There seems to be the absence of an important distinction in all the recent media coverage; demonstrating that the health and medical professionals don’t seem to appreciate that folic acid and folate are two quite different substances or molecules.
So what are folic acid and folate?
Folic acid is basically a synthetic (made in a lab) form of vitamin B9, often used in cheap dietary supplements or in food and beverage fortification. In contrast folate is the natural B9 metabolite found in natural food sources, including leafy green plants and liver.
What is the difference?
The importance of favouring folate over folic acid can be recognised by how the body metabolises (or breaks down) both versions.
Natural plant based folate is broken down to tetrahydrofolate in the gut lining of the small intestine, whereas the synthetic folic acid form starts it’s breakdown in the liver. However the problem is that the enzyme (dihydrofolate reductase) required in breaking it down, is in short supply in the liver.
The lack of enzymatic breakdown combined with a high intake of folic acid through supplementation or fortification, may result in unnatural levels of non-metabolised folic acid entering the circulation; this has been demonstrated in several studies.
Our bodies are very smart machines, which have evolved over millions of years; hence the reason they are too smart to be fooled by synthetic substances, posing as legitimate natural plant derivatives. Natural plants and their constituents represent the true essence of the human diet, and simply won’t be replaced by laboratory chemicals masquerading as nutrients.
What are the health implications?
Although the incidence of neural tube defects (NTDs) in the United States has been significantly reduced due to the introduction of folic acid fortification in 1998, there have nevertheless been concerns about the safety of chronic dosing of high levels of folic acid from fortified foods, drinks and dietary supplements. See here.
Believe it or not there is an increased risk of cancer from excessive consumption of folic acid; see here. In some counties, including the USA, Canada and Chile, there was an increased rate of colon cancer associated with the introduction of folic acid supplementation programmes. See here and here.
In another study, which involved a randomised control, researchers found that supplementing with 1mg of folic acid resulted in an associated higher risk of prostate cancer.
One of the mechanisms in which high folic acid levels promoted cancers was proposed in one study, where it was postulated that folic acid destroys natural killer cells (NKCs); NKCs play a key role in our immune arsenal, responsible for the destruction of cancer cells and tumours. See here.
A high intake of folic acid can mask detection of vitamin B12 deficiency, leading to a deterioration of the central nervous system in the elderly. See here.
Benefits of folate
Folate represents the best option for preventing brain and spinal conditions in your child, whether you are thinking about starting a family or are pregnant. It is important to boost your folate intake well in advance of pregnancy.
Not only are folate containing foods protective for your foetus and baby, but they also offer many other health benefits including the correct source of fibre (not from grains), a good variety of vitamins and minerals and chemo (cancer) protective compounds.
What types of foods are rich in folate?
Excellent sources of dietary folate include; Romaine lettuce, spinach, asparagus, turnip greens, mustard greens, parsley, collard greens, broccoli, cauliflower, beets, lentils and liver. Liver has by far the highest amounts; about 250mcg per 100g of liver; liver is often referred to as “nature’s multivitamin”.
It is possible to top up your folate intake if your dietary intake is inadequate. Just make sure you avoid folic acid and choose brands that stipulate “5-methyltetrahydrofolate” or “5-MTHF” on the label.
NB Most multivitamins contain the folic acid version of B9, which is as previously discussed, fraught with dangers.
What are the correct dosages?
Well in terms of folate, our healthy alternative to synthetic folic acid, anywhere between the 800mcg and 1,200mcg range on a daily basis is about right for women planning a pregnancy and they should ideally start a few months before becoming pregnant. During pregnancy the same dosage applies.
Now this is quite a lot to glean from foods alone unless you are regularly consuming the aforementioned foods, especially liver at least a couple of times per week and plenty leafy greens.
Therefore if you’re pregnant or trying to get pregnant, I would suggest supplementing with 600-800mcg of folate per day, depending on your dietary intake.
For everyone else other than pregnant women, they should be able obtain plenty of folate in a diet rich with vegetables including leafy greens, and shouldn’t really need to supplement.
Other problems with fortification
Specifically in the case of folic acid, the Scottish Government’s consideration on adding it to flour is concerning on many levels. Flours, which are mainly used in breads and baked goods have many detrimental health issues. We cite three below and their impact on mother and foetus (and child).
Bromine – Flours and their products like breads contain bromine, which is added to modern day flours as a flour improver, apparently. Unfortunately bromine is toxic and not only that, it depletes iodine in the body; iodine is a critical nutrient and one that has seen widespread deficiencies in the Western World. Iodine deficiency is linked to thyroid disease, increasing rates of cancer of the thyroid, stomach, breast and prostate. See here.
Iodine is essential to every cell in your body, but it’s especially important to your thyroid gland, which makes the hormones, T3 and T4 that regulate your entire body’s metabolism.
Iodine levels in the UK and the U.S. have dropped 50% in the last 30 years. During the same period, breast cancer rates have tripled, and the percentage of pregnant women with low iodine levels has increased 690%. Many studies have shown that children born to these mothers run a significant risk of being born with lowered intellectual ability. One such study measured a 13.5 point difference in IQ scores. In utero iodine deficiency has been associated with a host of childhood ailments including ADD/ADHD, depression, cretinism, dwarfism and mental retardation. See here and here.
Blood sugar and insulin response – The Scottish Government’s recently launched website dedicated to informing better food choices ran a radio ad campaign which claimed that, “A wholemeal wrap boosts energy levels and keeps you fuller for longer.”
This is basically nonsense; regardless of whether the breads are white or brown, theyproduce similar insulin responses (very high), which leads to a quick surge of energy, followed by a crash; hence the term “afternoon crash” or “3pm slump”.
Opposite shows a graph of blood insulin responses after oral glucose, white bread, wholewheat bread, and bread made from a finely ground flour that the researchers called “ultra-fine ground whole-grain wheat flour.”
The study was carried out by a group at the USDA to study whether the particle size of wheat made any difference on blood sugar, insulin and other measures; however I think it demonstrates something different.
Here’s the effect of these four study foods on insulin, which is often referred to as “the fat storing hormone”.
All four study foods increased insulin approximately four fold or by 400%. That’s a huge insulin spike, and did you notice what food increased insulin the most? Surprisingly to most people, it was the whole wheat bread, even without the fine grind.
The health impact of chronically high insulin and associated glucose levels are huge; in short it leads to a higher risk of cancers, obesity (including dangerous visceral fat accumulation), diabetes, Alzheimer’s (often referred to as type 3 diabetes) and heart disease to name a very few. See here, here, here and here.
A 2012 study found a link between the maternal size of women, before and during pregnancy and obesity and other associated health risks e.g. heart conditions in their young adult offspring.
Also highly processed foods including wheat flour products fuel the growth of the yeast, Candida, which can be passed from mother to foetus; this can lead to autism in utero or after birth. See here.
Gluten – Finally gluten, it could be argued is even worse than sugar and is contained in most flours including wheat, which we have just demonstrated above is a disaster for blood sugar, insulin and general health.
Taking a snapshot of gluten and it’s damaging effects to health.
- Gluten causes autoimmune diseases including type 1 diabetes and Hashimoto’s thyroiditis.
- Gluten causes leaky gut syndrome, which in turn is associated with over 200 disease conditions. See here.
- Gluten sensitivity is enough to produce antibodies (allergic reaction) andstudies have been published, concluding that everyone has gluten sensitivity to some degree. See here.
- Gluten is a known neurotoxin. See here.
- Gluten has been confirmed to cause weight gain. See here.
- Gluten is linked to depression. See here.
- Gluten is linked to Alzheimer’s. See here.
- Gluten can make you infertile. See here.
- Gluten contains addictive opiates (exorphins), stimulating hunger and increased consumption. See here.
I realise that the Government have the best of intentions here. However that doesn’t excuse the lack of understanding of the many issues and health implications of adopting this policy.
The first problem is the decision to consider folic acid (the synthetic, unnatural and low absorption form) and not folate (the natural, high absorption form found in plant and other foods such as liver), which as we have alluded to above is a major issue on its own.
If we then consider that this problematic form of B9 is being considered for fortification with bread flours, we have the potential for opening up a Pandora’s Box of other health problems for mother, foetus and child.
By encouraging women to consume more nutrient deficient wheat flour, which is among the most damaging “foods” on the planet, they are exposing them to a host of health issues including high blood sugar and insulin levels, bromine and gluten.
As if it was not bad enough that women may consciously choose to eat more wheat to meet their daily folic acid needs, they are subconsciously being hooked on it, due to the fact that wheat contains gluten exorphins, which are opiate like peptides, responsible for increased hunger, cravings and consumption.
We are seeing a parallel between the fortification of flour issue and the Scottish Government’s consideration and subsequent decision not to fluoridate the public water supply.
Regarding the fluoridation issue, common sense, proper risk and scientific analysis and putting the onus on the public to take control of their own health, all prevailed.
There is an opportunity to apply the same criteria used in declining the option to fluoridate, to declining the option to fortify the flour (a damaging ingredient on its own) supplies with a synthetic and potentially damaging chemical, folic acid.
The question is whether the same result as the fluoridation issue produced will be replicated.
England and Wales made a huge mistake adopting water fluoridation; now they have an opportunity to make some amends by rejecting the Scottish Government’s request for UK wide fortification of flour.