Folic Acid Fortification, a extra tidbit

It seems topical to discuss folic acid fortification as it has recently been in the news and by the end of the year it will be a legal requirement that breads contain approximately 135µg of folate per 100g. I will actually not wade into the debate directly, fortuitously a study was published mid last month on one of the potential benefits of folate supplementation. The study looked at the effect of supplementation on the number of very preterm births and found that it had a protective effect.

First a little background might be in order, Folic acid is one of the B vitamins and is important in cellular metabolism. As a vitamin it is a nutrient that we must obtain through our diet. Food stuffs such as leafy vegetables and liver (mmm, liver) are good sources of folate however it is still a part of our diet that tends to be lacking. Because of this many western countries now mandate fortification of grain products with the vitamin. This is because of the important role it also plays in pregnancy and in particular the prevention of Neural Tube Defects, notably Spina bifida.

The study looking at folate supplementation and preterm births found that the important factor seemed to be duration of supplementation prior to pregnancy rather than the dosage of supplementation. In particular durations of greater than 12 months seemed to be most beneficial. However as the study was undertaken in the US the supplementation was taking place in conjunction with an existing fortification of bread products, this implies that the fortification alone was not sufficient to prevent all preterm births and that women that are planning pregnancies should continue to supplement with folate even after fortification is introduced.

In addition the folate supplementation was self reported by the women in the study at enrolment and after pregnancy had begun rather than being proscribed prior to attempts to conceive. This seems to mean that we must rely on the memory of the women to be accurate regarding the duration of supplementation. Despite this limitation there still seems to be a good correlation between supplementation and reduction in preterm births. Bottom line appears to be that supplementation in addition to fortification is a good idea for the childbearing among us.

Matthias Rath – steal this chapter

A longer post than usual, luckily I didn’t have to write it. This post was written by Ben Goldacre of Bad Science blog fame, enjoy.

This is an extract from
BAD SCIENCE by Ben Goldacre
Published by Harper Perennial 2009.

You are free to copy it, paste it, bake it, reprint it, read it aloud, as long as you don’t change it – including this bit – so that people know that they can find more ideas for free at www.badscience.net

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The Doctor Will Sue You Now

This chapter did not appear in the original edition of this book, because for fifteen months leading up to September 2008 the vitamin-pill entrepreneur Matthias Rath was suing me personally, and the Guardian, for libel. This strategy brought only mixed success. For all that nutritionists may fantasise in public that any critic is somehow a pawn of big pharma, in private they would do well to remember that, like many my age who work in the public sector, I don’t own a flat. The Guardian generously paid for the lawyers, and in September 2008 Rath dropped his case, which had cost in excess of £500,000 to defend. Rath has paid £220,000 already, and the rest will hopefully follow.  Nobody will ever repay me for the endless meetings, the time off work, or the days spent poring over tables filled with endlessly cross-referenced court documents.

Vitamin C

That cold season is upon us, is abundantly clear so I thought that it would be appropriate to look at the use of Vitamin C to stave off the dreaded common cold. It is a recognised fact that humans need this chemical in our diets to survive, or it wouldn’t be a Vitamin. It is also interesting to note that most mammals manufacture their own and while we have a copy of the gene for this it was deactivated millions of years ago and is a trait we share with the rest of the primates. But I digress.

The recommended daily allowance of Vit. C is 90mg for an adult male and a slightly lower 75mg for a female, about the amount in a glass of orange juice. I must say we have two bottles of Vitamin C tablets at home, each tablet contains 500mg of active ingredient and the instructions recommend taking 2-8 a day. Up to 4g of Vitamin C, that’s 45 times the amount you need. Such large amounts is called mega-dosing and is the suggested way to get the supposed added benefits of vitamin C, over and above keeping scurvy at bay I mean.

Most people have heard that taking the vitamin will help prevent colds but I’m afraid that the medical literature just does not back this up. At most the duration of a cold may be marginally reduced, by perhaps 10%. In addition to this the very act of taking these high doses can actually stimulate the kidneys to flush it from your body, so it seems that the money spent on buying the tablets is quite literally going down the toilet. I’ve occasionally been accused of pissing my money away but this is ridiculous.

Resources

http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/colds.html

http://www.bmj.com/cgi/content/full/309/6956/719?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Vitamin+C&searchid=1&FIRSTINDEX=10&resourcetype=HWCIT

http://healthlink.mcw.edu/article/959704173.html

http://www.hortresearch.co.nz/index/news/503