I used to see my multivitamin and mineral as good nutritional insurance. It certainly is a form of insurance, but there can be consequences with taking your daily supplement blindly.
The folic acid fortification program in the United States provides us with a very good example of why supplementation willy-nilly can have perverse consequences.
People do not get enough folate in their diets and a low folate status is associated with birth defects like spina bifida. Since many women do not plan their pregnancies and many who do plan them do not consume enough folate in preparation, the USDA decided to fortify grain-based foods with folic acid in the late 1990s.
Nearly a decade later, researchers are trying to determine the effect of this food fortification program. Neural tube defects like spina bifida are on the decline, but cognitive problems are on the rise in the elderly.
It appears that you can get too much of a good thing under certain circumstances.
Added folic acid in your diet should improve your cognition. It is even a depression-fighting nutrient. However, it appears that if you are low in vitamin B-12 (another depression-fighting nutrient), the added folic acid will worsen your cognitive state.
According to Morris et al. in a 2007 paper, the 60-plus year old study participants benefited from folic acid if their B-12 status was sound and actually had worse cognitive function if their B-12 status was low.
One reason the study focused on an older group of people is because as we age, we are more likely to be deficient in vitamin B-12. That leaves the older folks in our population at risk of facing cognitive impairment due to high folic acid intake.
In a review article published in the same issue of the American Journal of Clinical Nutrition, researcher A. David Smith calls for more research on the food fortification program and questions the ethics of saving a small number of babies from neural tube defects while putting at risk a large portion of the population.
What You Can Do
Consume Food Folate
The folic acid fortification example makes a case first for beginning to rely more on our food than on our supplements for the nutrients our bodies need. Food contains folate and very little of that folate is in the form of folic acid. There is no evidence that a lot of dietary folate will adversely affect our moods or cognition. In fact, it is difficult to get enough folate. It would be next to impossible to get too much in the natural form that our food contains.
Know Your Status
Ask your doctor for a plasma homocysteine test. An elevated level (above about 12) is associated with a poor status of B-12, B-6, folate (or some combination). If your levels are elevated, have your levels of each of those B-vitamins tested. If you are low in B-12, begin a supplementation program and add B-12 food sources to your diet. With an improved B-12 status, you will then benefit from folic acid rather than hurt by it.
Consider the Methylfolate Form as a Supplement
Smith offers this as a possible remedy to the problem - use methylfolate instead of folic acid. Folic acid is metabolized into methylfolate. Some researchers speculate that unmetabolized folic acid is part of the problem in this story. (And not everyone effectively metabolizes folic acid in the first place.)
Comments (2)
Although this may not be an example of what's going on here, it is important to mention that a possible factor in this finding is that nutrients are often antagonistic to each other. This is why I recommend people get a supplemental program which includes EFAs, minerals, trace minerals and vitamins instead of one mineral here, one vitamin there, etc. The public's poor comprehension of supplements and the often stifled evidence supporting their usage has lead them to listen to equally uninformed doctors who say supplements are unnecessary and they end up taking supplements that just aren't very good or inclusive. Great multivitamin/multiminerals don't megadose you on five nutrients and allow freakish imbalances to take place by avoiding five or ten other nutrients. IE, don't take a calcium supplement. Calcium needs to be accompanied by magnesium and should have other cofactors involved in its proper absorption such as boron, vitamin D, vitamin K, selenium, etc. 90+ nutrient baselines are going to do more for your body than absurd doses of zinc or iron alone. It is irresponsible to say that folic acid supplementation is a risk to public health instead of a B12 deficit being dangerous alone and potentially more dangerous when you supplement with nutrients while leaving B12 out of the equation. You need both. Taking just one may be unhelpful, taking none will DEFINITELY be unhelpful. It's all in the way you present it to the public and usually it's presented in a way that downplays nutritional supplements or implicates them in something sinister. Then, there is always the bit about consulting your doctor when your average doctors have had a very small slice of the nutritional information out there brought to their attention and that precious little is often contrary to the majority of what's been found to work.
~ J. D. Shafer -Researcher and author of 90+ blog and newsletters
http://journals.aol.com/ninetyplus4life/Capacity/
Posted by J. D. Shafer | November 20, 2007 10:11 AM
Posted on November 20, 2007 10:11
Thanks for posting J.D. I agree with you. In some cases, taking a higher dose of one or two nutrients may be in order but it depends on the person's status. In this case the folic acid fortification is really for women who may become pregnant and yet it has health consequences for everyone who is eating the fortified grain products. In this case then, there is no analysis of any particular person's status, just a shotgun approach.
Amanda
Posted by Amanda Rose | December 23, 2007 7:54 AM
Posted on December 23, 2007 07:54