This really doesn't surprise me, as pregnant women and women who are considering pregnancy have been inundated with conflicting advice regarding nutrition, to the point where we don't know WHAT the hell to eat anymore.

My doctor had a pretty sensible take on it. He said to try to get as broad and varied a diet as possible, and to not eat excessive quantities of any one thing, and that by doing that, a normal, healthy woman should not need to take folic acid supplements proir to and during pregnancy.

I think I'll listen to him -- he's stressing me out a lot less than all these studies and headlines do.

Everything in moderation, m'kay?

Or drinking enough water

Just as there can be too much folic acid, there can be too much water. "enough" doesn't mean "all you can hold". Hyponatremia can result and can be a very serious problem.

Some time ago Rebecca Traister, writing in Broadsheet, howled at those who want women of childbearing age to take folic acid supplements, in case of pregnancy.

However, in light of this information, it's even more important for women of childbearing age to take folic acid supplements. If young women step up to the plate on this, then folic acid fortification in foods for the general population could be ended. This would target the folic acid toward those whom it benefits, and away from those for whom it is risky.

if it is mostly devoid of nutritional value. I eat a small amount of white flour, but if it's ALL you eat, you're setting yourself up for colon cancer to begin with. I do think science is important, but even scientific knowledge is incomplete because we don't really understand how a lot of things work - and by the time that knowledge gets filtered through pharmaceutical interests, medical paranoia, and media narratives, much of it is nearly worthless.

Kind of like processed food. For goodness' sake. Just eat REAL FOOD. You'll feel so much better. Trying to tweak your food intake based on popular science is a great idea, but take it all with a grain of salt (even if you have high blood pressure, because that whole think is a freakin' CROCK (of healthful Parkay...)), get yourself off anything you're dependent on (coffee, sugar, alcohol, whatever) so you can trust your body, and then eat what makes you feel good and get some exercise every day. No one has to specially package a damned thing in fear-based messages for that stuff to work. You're a hominid! Act like one!

the B vitamins are metabolically active; it's not completely out of the question that overdoses could have side effects. for instance, a lot of folks are taking a lot of niacin these days and that can have side effects from hot flashes to clobbering your liver.

"a normal, healthy woman should not need to take folic acid supplements proir to and during pregnancy."

Indeed, so very often it's shown that supplements of vitamins etc. are nutritionally inferior to just eating the food with the vitamins in it. usually something cabbagey, or maybe berries.

"This effect was documented in the 1940s, when leukemia patients who were given high doses of folic acid showed accelerated cancer growth. "

They did this test on people?? I'm curious: what was the purpose/hypothesis of this study?

"Most doctors seem to think not -- partly because the folic acid in fortified flour and pasta makes up only a small amount of most people's intake of folic acid"

Are we sure about this? My pasta says it has 80% of the RDI of folic acid. I find it hard to believe that I get way significantly more than that from other foods.

We've known folates are necessary for cell division for years. Methotrexate is a mainstay of leukemia treatment and has been since the 1950's. It's an anti-folate, or an inhibitor of enzymes in the folate metabolism pathways. Those pathways are responsible for the production of nucleotides that allow DNA to be replicated. So of course it makes sense that cancerous cells which are rapidly dividing will flourish in a folate-rich environment. This isn't a shocking reversal of scientific knowledge.

But there's no evidence that folates can in any way initiate cancer and the degree to which the levels of folate fortification in food affect might affect the rate of cancer growth is still completely unknown. The important thing is that this type of effect on cancer rates is completely different from the effect of a compound that might be a mutagen. If you stop taking folates, the risk goes away. It's not a long-term issue like say, UV exposure.

If you read the Sun article carefully, the concern of most of these scientists is not food fortification, which rarely results in elevated levels of folate above the recommended 400 micrograms. It's older people taking large doses of folic acid supplements that can take in as much as 1mg daily.

Oddly, the article never mentions the much more common, established danger of taking high doses of folic acid supplements: the fact that these high doses can mask the symptoms of Vitamin B12 deficiency. Vitamin B12 absorption in elderly people is known to be poor, and this presents a real public health danger.

In short, if you're a young woman who might become pregnant, taking extra folate in addition to that found in food would not be dangerous. Once you're older and are more concerned about vitamin B12 deficiency and pre-cancerous polyops, stop taking the extra folate.

marge twain,

In the 1940's doctors knew very little about how cancer worked. In the 1930's Dr. Lucy Wills demonstrated that folic acid (in brewer's yeast) was effective at preventing anemia. Pure folic acid was extracted in 1941. Since leukemia is a blood cancer, Dr Farber experimented with treatments for other blood diseases. When folates made the cancer worse, he asked the lab to produce an antifolate--methotrexate.

One point I mean to make above is that it's long been known that folic acid supplements make methotrexate less effective. So someone who has been diagnosed with cancer and is being treated with methotrexate would probably want to avoid folate-fortified food. I'm not an oncologist, so I'm not sure what the official recommendation for that is. But that's a different issue from how folates might cause or accelerate cancer.