Home > People Being People, Social Issues, The Body Politic > Folic Acid vs Vitamin B9

Folic Acid vs Vitamin B9

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Folic Acid

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Definition

Folic acid is a water-soluable vitamin belonging to the B-complex group of vitamins. These vitamins help the body break down complex carbohydrates into simple sugars to be used for energy. Excess B vitamins are excreted from the body rather than stored for later use. This is why sufficient daily intake of folic acid is necessary.

Description

Folic acid is also known as folate, or folacin. It is one of the nutrients most often found to be deficient in the Western diet, and there is evidence that deficiency is a problem on a worldwide scale. Folic acid is found in leafy green vegetables, beans, peas and lentils, liver, beets, brussel sprouts, poultry, nutritional yeast, tuna, wheat germ, mushrooms, oranges, asparagus, broccoli, spinach, bananas, strawberries, and cantaloupes. In 1998, the U.S. Food and Drug Administration (FDA) required food manufacturers to add folic acid to enriched bread and grain products to boost intake and to help prevent neural tube defects (NTD).

Purpose

Folic acid works together with vitamin B12 and vitamin C to metabolize protein in the body. It is important for the formation of red and white blood cells. It is necessary for the proper differentiation and growth of cells and for the development of the fetus. It is also used to form the nucleic acid of DNA and RNA. It increases the appetite and stimulates the production of stomach acid for digestion and it aids in maintaining a healthy liver. A deficiency of folic acid may lead to anemia, in which there is decreased production of red blood cells. This reduces the amounts of oxygen and nutrients that are able to get to the tissues. Symptoms may include fatigue, reduced secretion of digestive acids, confusion, and forgetfulness. During pregnancy, a folic acid deficiency may lead to preeclampsia, premature birth, and increased bleeding after birth.
People who are at high risk of strokes and heart disease may greatly benefit by taking folic acid supplements. An elevated blood level of the amino acid homocysteine has been identified as a risk factor for some of these diseases. High levels of homocysteine have also been found to contribute to problems with osteoporosis. Folic acid, together with vitamins B6 and B12, helps break down homocysteine, and may help reverse the problems associated with elevated levels.
Pregnant women have an increased need for folic acid, both for themselves and their child. Folic acid is necessary for the proper growth and development of the fetus. Adequate intake of folic acid is vital for the prevention of several types of birth defects, particularly NTDs. The neural tube of the embryo develops into the brain, spinal cord, spinal column, and the skull. If this tube forms incompletely during the first few months of pregnancy a serious, and often fatal, defect results in spina bifida or anencephaly. Folic acid, taken from  one year to one month before conception through the first four months of pregnancy, can reduce the risk of NTDs by 50-70%.It also helps prevent a cleft lip and palate.
Research shows that folic acid can be used to successfully treat cervical dysplasia, a condition diagnosed by a Pap smear, of having abnormal cells in the cervix. This condition is considered to be a possible precursor to cervical cancer, and is diagnosed as an abnormal Pap smear. Daily consumption of 1,000 mcg of folic acid for three or more months has resulted in improved cervical cells upon repeat Pap smears.
Studies suggest that long-term use of folic acid supplements may also help prevent lung and colon cancer. Researchers have also found that alcoholics who have low folic acid levels face a greatly increased possibility of developing colon cancer.

Preparations

To correct a folic acid deficiency, supplements are taken in addition to food. Since the functioning of the B vitamins is interrelated, it is generally recommended that the appropriate dose of B-complex vitamins be taken in place of single B vitamin supplements. The Recommended Dietary Allowances (RDA) for folate is 400 mcg per day for adults, 600 mcg per day for pregnant women, and 500 mcg for nursing women. Medicinal dosages of up to 1,000-2,000 mcg per day may be prescribed.

Precautions

Folic acid is not stable. It is easily destroyed by exposure to light, air, water, and cooking. Therefore, the supplement should be stored in a dark container in a cold, dry place, such as a refrigerator. Many medications interfere with the body’s absorption and use of folic acid. This includes sulfa drugs, sleeping pills, estrogen, anti-convulsants, birth control pills, antacids, quinine, and some antibiotics. Using large amounts of folic acid (e.g., over 5,000 mcg per day) can mask a vitamin B12 deficiency and thereby risk of irreversible nerve damage.

Side effects

At levels of 5,000 mcg or less, folic acid is generally safe for use. Side effects are uncommon. However, large doses may cause nausea, decreased appetite, bloating, gas, decreased ability to concentrate, and insomnia. Large doses may also decrease the effects of phenytoin (Dilantin), a seizure medication.

Source:  The Free Dictionary

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Overdose risks

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The risk of toxicity from folic acid is low, because folate is a water-soluble vitamin and is regularly removed from the body through urine.

Source: Vitamins and minerals: efficacy and safety, U.S. National Library of Medicine

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Folic Acid. Folate. Vitamin B9. Vitamin Bc. Folacin. Pteroyl-L-glutamic acid.  Pteroyl-L-glutamate. Pteroylmonoglutamic acid. Take your pick.

All different names to one of many naturally occurring compounds which our (and other animals) bodies need to survive.

Before western society decided to process the hell out of our foods, we ingested Folic Acid/Vitamin B9 in vegetables such as spinach, asparagus, turnip greens, lettuce, cabbage, brussel sprouts, broccoli, beans, peas,  lentils, bananas, oranges, peaches, Sunflower seeds, and meats such as liver and poultry, etc.

See:  Foods rich in folic acid and vitamin B12

So it’s not exactly some weird concoction, brewed up  by a mad scientist slaving over bubbling beakers and arcing electrodes in Victor von Frankenstein’s basement,

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When the issue first arose in 2009, the debate whether to add Folic Acid/Folate/Vitamin B9/Vitamin Bc/Folacin/Pteroyl-L-glutamic acid/Pteroyl-L-glutamate/Pteroylmonoglutamic acid to all breads,  was lost on Day One  when the vitamin was referred tro as “Folic Acid”.

This blogger will be the first to admit that  had never heard of “folic acid” or “folate”.

Folic acid… Sounded suspiciously like hydrochloric acid… sulphuric acid… hydroflouric acid…  Nasty chemicals which have no place in the human body.

Except that the unfortunately-sounding apellation – folic acid – had nothing to do with any of the above tissue-damaging chemicals above. Like ascorbic acid – aka, ascorbate or Vitamin C.

Like most  people, the substance was more recognisable with it’s more benign label; Vitamin B9. A quick googling soon informed me that folic acid = Vitamin B9.

*whew*

Panic over.

Visions of a nefarious government secret agency lacing our food with ACID were dispelled.

But… how many other people failed to make the connection? Most folk have only a basic understanding of  Nature and science. Fears arise easily – especially when things have gone terribly wrong in history…

Atomic power… asbestos… pesticides… thalidomide… chloroflurocarbons… human-produced atmospheric CO2… History is littered with triumphs of science and technology – only to learn later that there were unintended consequences.

Heck, the Ancient Romans used to store and  drink wine from urns made from lead. Wine is acidic… and it leeched lead from it’s vessels. The consequential lead poisoning must have been horrific.

The 21st century version of lead-poisoning in antiquity is plastic bottles containing BPA (bisphenol A) – which has been discovered to have nasty effects on the human body.

See: BPA Chemical Leaches From Hard Plastic Drinking Bottles Into The Body, Study

When humans are unfamiliar with something, they are naturally cautious and wary. (A survival trait, no doubt, when our ancestors had to cope with poisonous plants, big nasty  insects, hungry sabre-tooth tigers, and other perils of  Paleolithic Earth.)

The reality  of Vitamin B9 was  simple and straight forward; it was a natural compound that could reduce the incidence of Neural Tube Defects. But even that term – Neural Tube Defects – meant nothing to the average Bloke and Blokette.  It was a vague medical term that  99% of us had never heard before.

Another way to explain Neural Tube Defects is spina bifida (one form of NTD),

The human nervous system develops from a small, specialized plate of cells along the back of an embryo. Early in development, the edges of this plate begin to curl up toward each other, creating the neural tube—a narrow sheath that closes to form the brain and spinal cord of the embryo. As development progresses, the top of the tube becomes the brain and the remainder becomes the spinal cord. This process is usually complete by the 28th day of pregnancy. But if problems occur during this process, the result can be brain disorders called neural tube defects, including spina bifida…

… Spina bifida, which literally means “cleft spine,” is characterized by the incomplete development of the brain, spinal cord, and/or meninges (the protective covering around the brain and spinal cord). It is the most common neural tube defect in the United States – affecting 1,500 to 2,000 of the more than 4 million babies born in the country each year.

See: MedicineNet.com – Spina Bifida (Neural Tube Defect)

Whilst many with spina bifida can walk with assistance-devices, others will be confined to wheelchairs for their entire lives.

Many will have problems with urination, having to use plastic catheters inserted into their urethra/penis to urinate. Some will need hygiene pads to contain uncontrollably excreted faeces in their underwear. Others have other surgically-enhanced techniques for relieving themselves.

A number will require ongoing surgery to address complications caused by their condition,

Some children will need subsequent surgeries to manage problems with the feet, hips, or spine. Individuals with hydrocephalus generally will require additional surgeries to replace the shunt, which can be outgrown or become clogged.

Some individuals with spina bifida require assistive devices such as braces, crutches, or wheelchairs. The location of the malformation on the spine often indicates the type of assistive devices needed. Children with a defect high on the spine and more extensive paralysis will often require a wheelchair, while those with a defect lower on the spine may be able to use crutches, bladder catherizations, leg braces, or walkers.

Treatment for paralysis and bladder and bowel problems typically begins soon after birth, and may include special exercises for the legs and feet to help prepare the child for walking with braces or crutches when he or she is older.

See: How is spina bifida treated?

For people  with spina bifida, in wheelchairs, they will need ongoing assistance until their final day.  The way they overcome they restricted mobility and challenges  is nothing short of heroic.

There are many things they will struggle with, and many that will be beyond their abilities without varying degrees of assistance.

For  many of us, visiting a friend who happens to live a few dozen steps up from the road is something we do without much consideration. Not so for a person with spina bifida.

Imagine the degradation of being lifted up stairs to enter a building, and being carried up by others. (Not all buildings have electors or ramps, contrary to public perception – and 99.99% of private homes certainly do not have elevators.)

If you’re in a wheelchair, you will most likely never journey through New Zealand’s wilderness.

And going to a beach will most likely involve being carried bodily onto the sand. (Unless they can afford an expensive, specialised, wheelchair.)

A home for a person with spina bifida has be be totally adapted to his/her needs; wheelchair ramps (both front and rear door);  bathroom adapted to be a “wet area”; modified cabinets, benches, oven, sink, in kitchens; lowered light switches, etc.

The State has to provide ongoing assistance in many areas of a wheelchair bound person’s life and home.

Relationships can be more difficult to form, as many people do not see past a wheelchair or crutches.

I encourage an able-bodied person to try to spend 24 hours in a wheelchair. You probably wouldn’t  make it past 30  minutes.

I write this not for pity for people with spina bifida – they don’t need our pity – but for understanding that for every decision we make, there are consequences.

Not adding vitamin B9  to bread will have consequences; women giving birth to babies afflicted with spina bifida.

Critics of fortification use the cliche of  “mass medication” and insist that pregnant women take vitamin B9 supplements to assist their unborn child.

“Mass medication” is a mis-nomer. Vitamin B9 is not “medicine”. It is a natural occurring compound like Vitamin C, Vitamin D, Vitamin E, etc, etc, etc.

And if folic acid/vitamin B9/folate/whatever was so harmful – why are bottles of B9 supplements available in every single supermarket, chemists, health-food shop in New Zealand?

No one has ever suggested that adding Vitamin C to our fruit drinks is “mass medication” – it would be ridiculous to suggest so.

And by the time a woman discovers that she is pregnant, it may be too late to take Vitamin B9 supplements,

Folic acid, taken from  one year to one month before conceptionthrough the first four months of pregnancy, can reduce the risk of NTDs by 50-70%…”

Source:  The Free Dictionary

Where did the campaign, along with the “mass medication” meme, originate? Like many of these fear-campaigns, it’s a matter of ‘following the money‘,

The Bakers’ Association has labelled the compulsory introduction “mass medication” of the population, and warned that bread containing folic acid will be less safe than it is now. “

The Bakers’ Association “mass medication” rhetoric was followed by ex-National MP, and neo-liberal,  Katherine Rich, who was now leading the NZ Food and Grocery Council,

Food and Grocery Council chief executive Katherine Rich said there was no good reason to medicate an entire nation without clear benefits and known risks.

“They are embarking on a medical experiment of grand proportions,” she said. “If there are long-term effects and the Government is keen on adding folic acid, they should indemnify”.”

See: Bakers furious at ‘mass medication’ of NZ’s bread

See previous blogpost: Crony Watch!

The same Katherine Rich who opposed liquor controls for supermarkets and has been a staunch defender of  light-handed regulation of the alcohol industry.

See: Big Alcohol‘s Global Playbook: New markets, reduced regulation and lower taxes

Interesting how two separate business organisations were using similar fear-tactics; “mass medication” (Bakers’ Association) and “medical experiment” (NZ Food and Grocery Council ). And note that the NZ Herald in which those comments were reported is dated 17 May 2009 – one of the very first references to “mass medication”.

These fear tactics were unsupported by any hard facts, and relied on dubious “experts” and dodgy “science”. It was all very convenient for commercial interests that were more concerned at cost – than the health of this nation’s children.

Bomber Bradbury, from the ‘Tumeke’ blog summed it up nicely when he said,

” There was also a torrent of anger about ‘putting stuff in my food, personal choice blah blah blah’. I’m all for the heavy hand of Government regulation if it means avoiding 70+ children each year (abortions plus live births) being born with deformities. I don’t buy into the ‘personal choice’ stuff at all, we all concede certain choices to live together and if putting folic acid into bread reduces deformities, what’s the problem? The issue HAS to be based on the science, and right now there is science that suggests a connection with cancer – if that science is as weak as some have posted here, and is as weak as Gluckman thinks it is, then it should be a 6month review tops to explore that and make a call. Kicking for touch with a 3 year moratorium is weak by Key and means 200 kids + will be born with deformities in those 3 years.

The irony that many claimed this was the ‘nanny state putting medicine in my food’ misses the point that it will be the nanny state who will have to provide for the deformed children.”

See: Folic Acid U-turn wrong call

Bomber Bradbury has hit the nail on the head when he says,

The irony that many claimed this was the ‘nanny state putting medicine in my food’ misses the point that it will be the nanny state who will have to provide for the deformed children.

Bingo!

Profits from bread: privatised.

Massive financial costs of 20+ children born with spina bifida: socialised.

How many times have we heard that?!

Concerns over “increased cancer” fears were dispelled in a discussion on 8 July, on TVNZ’s Q+A, with Andrew Marshall from the Paediatric Society of NZ,

GREG BOYED

First and foremost, a couple of hundred more cases of cancer per year – what are your responses to that?

ANDREW MARSHALL

Completely false. If we look at the United States where they introduced mandatory fortification in ’98, there’s been a reduction in all cancers since that time. So it’s not true it will increase cancer. It reduces cancer overall.

GREG What are your thoughts on Dr Smith’s science, because, as he said, he’s done extensive studies on an extensive number of people.

ANDREW I’ve reviewed his studies. He is very selective in the studies he chooses. He talks about a meta-analysis of 38,000. There’s a different meta-analysis using a similar population – some of the studies overlap – of 35,000, which is much stronger. It shows no relationship with cancer, no increased risk, no statistical risk. So he’s selective in the studies he chooses, and he’s chosen a weaker study which showed a borderline. Even the writers of that study said there was no definite increase; it was borderline.

See: Q+A: Transcript of Andrew Marshall interview

On 2 September 2012, “Food Safety” Minister, Kate Wilkinson was interviewed on TVNZ’s Q+A. Greg Boyd asked why National had decided not to opt to add vitamin B9 to nearly all bread.  In a breath-taking example of ignoring real research and common sense, Wilkinson said,

The decision that was made was really based on consumer choice rather than the science, because, as you know with science, you can have scientists arguing black and scientists arguing white. At the end of the day, the consultation went out. The submissions were clearly in favour of voluntary, so people can make up their own mind whether they want folic acid in their bread or not. “

As Q+A producer, Tim Watkin,  said on the ‘Pundit’  blog,

So the baking industry won the day over the medical folk, not by the strength of their arguments or superiority of their science, but by the weight of numbers.

Bizarre.

We’re an anti-intellectual enough country at the best of times, but to be so cavalier about science is a terrible signal to send.

See: Q+A: Interview with Food Safety Minister Kate Wilkinson

For Wilkinson to state,

The decision that was made was really based on consumer choice rather than the science…

The clear message is that people want choice.”

… means we have abandoned common sense and policies made for social good,  and allowed commercial interests and the paranoia of a few individuals, to determine the health and safety of our children?!

One must also ask that if National was swayed by “the submissions were clearly in favour of voluntary” – why have they not taken heed of the vast number of submissions opposing state asset sales.

See: Hundreds beg committee to stop sale of state assets

Selective much?

Executive director, John Forman, from The Organisation for Rare Disorders was also  obviously disappointed by National’s decision,

“Up to 20 babies every year will die or be seriously disabled by neural tube defects (NTD) in New Zealand, thanks to the Government’s decision today to keep the fortification of bread voluntary.”

See: Folic acid to remain voluntary

Indeed, whilst we enjoy our “choice” – unborn children do not. Their future lives will be blighted by the choices that we adults have made for them.

Spooked by back-room dealings and manipulations by vested interests, we have allowed ourselves to be panicked and corralled like a bunch of sheep. The food industry maintains its profits by not having to pay for vitamin B9 to be added to bread, and National maintain’s it’s slavish adhrerence to the mantra of “personal choice”.

Another example of the Cult of the Individual, with it’s nasty, self-centered “Me First” attitude, and all it’s dreadful consequences.

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Additional

Bakers furious at ‘mass medication’ of NZ’s bread (May, 2009)

Q + A: Paul Holmes interviews Sue Kedgley and Kate Wilkinson about folic acid (July, 2009)

Minister sides with bakers on folic acid (July, 2009)

Will bill make food safer or be a form of control? (February, 2012)

Folate fortified bread back on table (May, 2012)

Australians beating us over meat labelling (May, 2012)

Folic acid to remain voluntary (August, 2012)

Q+A: Interview with Food Safety Minister Kate Wilkinson (September, 2012)

Previous blogposts

Crony Watch!

Other blogs

Tumeke: Folic Acid U-turn wrong call (July, 2009)

The Pundit: National’s folic tangle (July, 2009)

Corporations & Health Watch: Big Alcohol‘s Global Playbook: New markets, reduced regulation and lower taxes (December, 2011)

The Pundit: The folate debate – no easy choices (July, 2012)

The Pundit: Get foliced! Now science is just a ‘nice to have‘ (September, 2012)

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  1. Ralph
    3 September 2012 at 4:27 pm

    Take all of the vitamins and minerals out of the food supply. Then charge to engineer them back in. Utterly ridiculous and surely a key factor in many modern food aversions, allergies and illnesses.

  2. Possum
    3 September 2012 at 4:29 pm

    its already in some breads, except ppl have 2 be mind readers 2 know which 1, probably the cheapest bread cus that’s what most ppl buy.

  3. Possum
    3 September 2012 at 4:33 pm

    another point, truely how many pregnancies are planned anyway, ponder

    • 3 September 2012 at 4:36 pm

      It would probably be listed in the ingredients, Possum… but often you need a microscope to find it!!

      And we were just discussing that very point, in our household, Possum; how many prenancies are planned?!

      • Possum
        3 September 2012 at 4:37 pm

        and when you go shopping ur going 2 look at every brand of bread 2 find out which 1, lol. got better things 2 do and btw not planning 2 get pregnant again at my age. hahahahahahaha

  4. Possum
    3 September 2012 at 4:50 pm

    besides is’nt B9 etc in vegemite, that right you dont eat veg…..you better find out which bread then, lol…… being checky

  5. 3 September 2012 at 4:53 pm

    Luv your cheekiness, Possum. Makes me smile after reading endless crap from Dear Leader…

    And no, I don’t like the taste of vegemite or marmite. Yuk. I’m a peanut butter fan. 🙂

    • Possum
      3 September 2012 at 4:54 pm

      like eating nuts so you dont go NUTS. lol

  6. Danielsmum
    6 September 2012 at 11:40 am

    Finally a sensible blog on the folate issue ! For those who want to educate themselves on the wider issue of to folate (or not to folate as the case is – thanks to Kate Wilkinson who quite obviously doesn’t appreciate years of medical research) http://issuu.com/danielsmum/docs/sbnz_submission_on_folate_fortification_to_ministr?mode=window&viewMode=doublePage Are we disappointed ? Yes, but as parents of children with Spina Bifida we also acknowledge that our kids are amazing, they have introduced us to a world and subject we would otherwise never have experienced, they challenge us to be more compassionate to others with conditions that society sees as disabilities. We see endless opportunity and possibility. The biggest issue people with disabilities have is the attitude of others who see the condition first rather than the person. If we could change that around, the world would be a better place.

  7. 6 September 2012 at 1:47 pm

    “Yes, but as parents of children with Spina Bifida we also acknowledge that our kids are amazing, they have introduced us to a world and subject we would otherwise never have experienced, they challenge us to be more compassionate to others with conditions that society sees as disabilities. “

    Indeed, DM, well said. The human indomitable spirit at it’s finest… *thumbs up*

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