Folic Acid – What Dose is Safe?
The question over fortification and supplementation with the synthetic form – monoglutamate folic acid in isolation has been brought up in context international interest in food fortification and some confusion regarding supplement recommendations.
Folic acid supplementation, the synthetic form of folate has been thrown a curve ball in the last few years because of its apparent association with an increase in colorectal cancer. In particular three papers have been flagged up; the first is by Cole[1] and his colleagues and the second by Mason[2] and the third by Hirsch.[3]
The first paper describes the results of a randomised trial of folic acid in the prevention of colonic adenoma (a type of benign colon tumour that can become malignant), where the subjects had previously had adenomas removed. In this paper the results have been incorrectly interpreted. The study does not show that folic acid supplementation poses a cancer hazard, it relates to adenomas not carcinomas – the malignant form. The actual incidence of adenomas in those who were supplemented vs. those who were not are virtually identical in the following two 3-4 year follow ups. The relative risks were 1.04 (p=0.58) and 1.13 (p=0.23).
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Sun or Supplements – The Vit D Controversy
Vitamin D is increasingly understood to be an essential component of many aspects of human health and although technically not a “vitamin,” vitamin D is in a class by itself. Its metabolic product, calcitriol, is actually a secosteroid (A compound derived from a steroid in which there has been a ring cleavage) hormone that binds to over 2000 gene receptors (about 10% of the human genome) in the human body. There are 3 recognised ways for adults to ensure adequate levels of vitamin D:
These are:
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Multivitamins & Breast Cancer – Is It Too Little Rather Than Too Much?
Multivitamins have recently been flagged in a March 2010 American Journal of Clinical Nutrition article to raise the risk of developing breast cancer amongst a group of Swedish Women.[1] Naturally this paper sounds both alarming and contradictory and merits deeper investigation. Particularly as it is directly opposed by a paper out just 3 month previously in the Public Health Nutrition Journal when a group of nearly 3,000 women with breast cancer were compared to a similar number of controls in relation to the potential risk for breast cancer and multivitamins.[2] This study concluded:
The current study found no association between multivitamin supplement use and breast cancer risk in women.
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Disease Incidence Prevention by Serum 25(OH)D Level
In the last few years a considerable consensus across the scientific community has begun to emerge concerning the fat soluble nutrient Vitamin D.
Vitamin D is unique – unlike ALL other vitamins very little comes from our food. Almost all of our Vitamin D is produced by the upper surface of our skin during direct exposure to UV radiation in strong sunlight. However in the UK and most of the USA the sun is too low in the sky from November until March to produce any Vitamin D from sunlight exposure. The fat soluble nutrient supplies are meant to rely on a summer exposure to increase our stores to supply what we need during the winter.
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Antioxidants Improve End Stage Cancer Survival
There remains controversy in the medical fields about the value of antioxidants, or risk of antioxidants in patients with cancer. In the Journal of International Medical research a pilot trial followed 41 patients over a 9 year period who had been diagnosed with end stage cancer. During this time they were given a mix of antioxidants including; Coenzyme Q10, vitamin C, selenium, folic acid and betacarotene.
The treatments were well tolerated and produced a > 40% increase in survival time with 76% of the patients surviving far longer than predicted. Whilst the study accounted for all participants and the disease course was well illustrated in all of the patients, there is a lack of retrospective design, matched controls and no blinding.
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Soft Drink Intake Linked to Pancreatic Cancer Risk
The February issue of Cancer Epidemiology, Biomarkers & Prevention published a paper showing a staggering 87% increase in the risk of developing pancreatic cancer associated with an intake of 2 or more sugary soft drinks per week. The group of scientists were careful to exclude other lifestyle risks such as smoking, caloric intake and type II diabetes to extrapolate this risk association.
The proposed mechanism is related to the increased surge of insulin – a known pancreatic cancer promoter after the consumption of sugar laden soft drinks. Fruit juice, another sweet beverage was also tested but the researchers did not find any link with increased risk for pancreatic cancer.
This may be due to the small group looked at for the study, additional nutrients found in juice as opposed to the sugary beverage and the fact that fruit juice is often consumed by people who follow a healthier lifestyle.
However, the study group are confident that the ingestion of the high sugar soft drinks play an independent role in the development of pancreatic cancer, one of the most aggressive and difficult to manage of all cancers.
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Vitamin D Vs Crohn’s (IBD) & Cancer
Crohns disease is an inflammatory disease of the intestines that may affect any part of the gastrointestinal tract from anus to mouth, causing a wide variety of symptoms. It primarily causes abdominal pain, diarrhoea (which may be bloody), vomiting, or weight loss, but may also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis and inflammation of the eye.[1]
A new study has found that Vitamin D, readily available in supplements or cod liver oil, can counter the effects of Crohn’s disease.[2]
The data collated in this study suggests, for the first time, that Vitamin D deficiency can contribute to Crohn’s disease. Epidemiologically it had already been noted that people from northern countries, which receive less sunlight, necessary for the fabrication of Vitamin D by the human body, are particularly vulnerable to Crohn’s disease.[3]
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Minerals and Vitamins Reduce the Risk of Bladder Cancer
Micronutrient deficiencies could provide a possible explanation for why an estimated 25% of the US population who consume the least fruit and vegetables have double the cancer rate.[1] The aim of our study was to investigate the association between major dietary minerals and vitamins and the risk of bladder cancer in a US population from a region with a high incidence rate.[2]
Objective: Although the effect of fruit and vegetables on the risk of bladder cancer has been widely studied, little is known about their micronutrient components. Our aim was to investigate associations between minerals and vitamins and bladder cancer.
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Fatty Diet Suppresses Immune System
Fresh evidence that fatty food is bad for our health has come to light: mice fed a lard-based diet over a long period got worse at fighting bacteria in the blood, reveals a thesis from the Sahlgrenska Academy based at the University of Gothenberg in Sweden.
The mice fed the lard-based diet derived 60 per cent of their total calories from fat. They were compared with mice fed a low-fat diet, where no more than ten per cent of their calories came from fat. As expected, the mice on the high-fat diet got fatter. A more surprising result was that their immune system was less active. The white blood cells got worse at dealing with bacteria in the blood, which could have contributed to many dying of sepsis.
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All Immunity is Mucosal – The GUT is No 1
The Gut is The Formula 1 of Immunity
Properly regulated mucosal immunity is critical to overall health and well being. The cells found in the mucosal surfaces of the body meet on a daily basis, local challenges from foods, microbes and environmental pollutants. The result is a series of immunological decisions that on a single day exceed those made by the systemic immune system in a lifetime.
The immune system bound up in these tissues – mostly the ‘innate immune system’, must translate this infornatic onslaught to the ‘systemic immune system’ affecting the body as a whole. Immune tolerance or homeostasis in these tissues will help ensure adequate nourishment from passing ‘foreign’ food stuffs and so maintain bacterial/commensal balance. It is this bacterial balance that will ensure immunological tolerance so keeping the balance of power in the hands of health promoters (commensals) via this yin and yang relationship.
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