Folic Acid May Be Next Miracle Nutrient

Will folic acid turn out to be the latest miracle nutrient, following in a long line of other miracles that never quite lived up to their advance billing? (Beta carotene and vitamin C come immediately to mind.)

Or will folic acid prove to have staying power after the initial rush to buy it?

Folic acid, one of the B vitamins, does have more going for it than many other dietary supplements, because clinical trials appear to show that it reduces the risk of two birth defects. The Food and Drug Administration will now require the fortification of certain grains with folic acid and will permit these foods, as well as dietary supplements with folic acid, to make health claims.

Also pumping up the value of folic acid is increasing evidence - though no clinical trials have been performed - that it may reduce the risk of heart disease and colon cancer.

Lost in all of this rush is the fact that folic acid, in the form of folate, is plentiful in fruits, vegetables and dried beans.

“I really do think folic acid is an important nutrient, a rising star,” said Dr. Irwin H. Rosenberg, director of the Agriculture Department’s Human Nutrition Center on Aging at Tufts University.

However, he added, “Once a nutrient becomes a rising star, people quickly lose interest in its place in a good diet.” In other words, it is much easier to pop a pill than to eat the foods it occurs in.

There is an important caveat: No one yet knows all the possible risks associated with too much folic acid. Scientists are already aware that too much of it can mask the symptoms of pernicious anemia, a problem prevalent among the elderly.

Dr. Marion Nestle, chairwoman of the department of nutrition and food studies at New York University, says that fortifying foods is a mistake, partly because of the lack of “an upper limit of safe intake.”

In a paper published in the November-December 1994 issue of The Journal of Nutrition Education, Dr. Nestle writes that there are so many uncertainties in the data and concerns about safety that the governments of Canada and the Netherlands recommend supplementation only for women of childbearing age who are at special risk of giving birth to babies with neural tube defects.

Nutritionists who disagree have been trying to get all women of childbearing age to take folic acid supplements to prevent the two neural tube defects - spina bifida and anencephaly - without much success. Unlike supplements that promise renewed sexual drive, a painless way to lose weight or a more youthful appearance, folic acid is a dowdy relative. But a combination of government plans to promote folic acid to prevent birth defects, and the more recent findings about its role in combating heart disease and cancer, are likely to make sales of the supplement take off.

As of Jan. 1, federal regulations will require that the following foods be fortified with folic acid: enriched bread, rolls and buns; all enriched flour; enriched corn grits and cornmeal, farina and rice, and all enriched macaroni and noodle products. The level of fortification is intended to keep the daily intake of folic acid below 1 milligram, because researchers say intakes above that amount could mask the symptoms of pernicious anemia.

In addition, breakfast cereals can add folic acid up to the government’s recommended dietary intake of 400 micrograms a day.

And under the new rules, manufacturers will be allowed to state on the labels of both food and dietary supplements that an adequate intake of folic acid has been shown to reduce the risk of neural tube defects.

Of course, fortification and supplementation would be unnecessary if Americans ate adequate amounts of the foods in which folate occurs naturally: citrus fruits, dark green leafy vegetables, broccoli and asparagus, dried beans and peas, peanuts, wheat germ, yeast, mung bean sprouts and liver. The trouble is, Americans are not especially fond of these foods.

Bonnie Liebman, the director of nutrition for the Center for Science in the Public Interest, wants people to eat fruits and vegetables, but she also wants the insurance of supplements.

“We should push both fruits and vegetables and supplements,” she said. “We’re talking about such a huge risk, you want to do whatever you can to lower that risk. I don’t see the harm in that.”