Some individuals may be wondering if multivitamins are worth the cost and the effort. Not surprising when one considers all the bad press multivitamins are getting lately. For instance, in the Harvard Men’s Health Watch, published March of 2008, readers may have gotten the impression that most of the ingredients in multivitamins were not worth buying or ingesting. In the Nutrition Action Health Letter of June 2008, it was suggested that individuals only take multivitamins every two days and not everyday. What brought about this concerned buzz? Folic acid. Or to be more precise, the concern that people were getting too much folic acid because of the use of multivitamins.
So, what to do? Here is a good suggestion. Take a multivitamin on a daily basis, but cut down, or eliminate, consumption of fortified foods that can deliver a lot of folic acid to the body.
The Difference Between Folic Acid and Folate
Folic acid and folate are both in the family of B vitamins. The names they carry come from the Latin word for leaf—folium. Folate can be found naturally in vegetables, fruits, many types of grains, and several other foods. It is in a natural form at this phase. On the other hand, folic acid is the synthetic form. It is only available when it is added to different types of foods or when added to vitamin supplements. The important thing to remember is that folic acid will absorb more quickly but the body will still need to convert it to folate before it actually does any work.
Folate is essential in healthy cell function. It has the job of moving carbon atoms (along with the attached hydrogen and oxygen atoms) from one chemical compound to the next. This transfer is crucial to cell functions and that is why folate is so important. Folate is also crucial for making and repairing DNA. It also assists in the conversion process of amino acids, which are the foundation for proteins. Some of the best ways to get folate is to eat beans, sunflower seeds, various types of greens, fruits, and vegetables.
Starting the late 1990’s, folic acid was added to just about all enriched breads sold in the US. It was also added to rice, pasta, flour, grain products and cornmeal. It was added to these food products as a means of preventing spina bifida as well as anencephaly. These are birth defects caused (in part) when there is not enough folate in the mother at the time of conception. By adding folic acid to food products, folic acid was increased, on average, by 100 micrograms per day. This helped to reduce the number of US children who were born with a neural tube defect by an estimated 25 to 50 percent. Controlled studies also showed that folic acid helps to protect people from strokes. Some studies have also suggested folic acid may reduce the risk of heart disease as well.
The IMO (Institute of Medicine) has recommended that adults receive 400 micrograms of folate or folic acid per day. They recommend that pregnant women get 600 micrograms per day. The IMO often sets guidelines for both vitamins and other nutrients. It should be noted that the IMO also suggested that individuals NOT take more than 1,000 micrograms of folic acid a day if it comes from vitamin supplements or if it comes from fortified food. This limit does not apply to folate that is eaten via food intake.
While it may sound contrary, it has been shown that taking too much folic acid can actually hide B12 vitamin deficiency signs. Older individuals often suffer from this at the rate of about one in six. This is often because the elderly do not get the level of B12 that they need or it is not absorbed efficiently. It has also been shown that excessive folic acid levels can mask the signs of anemia. This is another of the early warning signals of vitamin B12 deficiency. If not treated in a timely manner, it could lead to health issues such as dementia, confusion, and severe damage to the person’s nervous system; some of which may be irreversible.
The above are just a few of the health issues associated with excessive folic acid levels. It is also known that normal levels will often help prevent early tumors, but too much folic acid can actually help tumors grow faster. Some other studies have reported that too much folic acid may be linked to an increased risk for various types of cancer such as breast, colorectal, and prostate cancer. It should be noted, however, that these reports and studies are somewhat limited and many other studies have not found a link between excessive folic acid and cancer.
It is not surprising that many consumers are confused over folic acid. In one major study, it was reported that fortifying with folic acid may cause a minor increase in colon cancer. Another equally major study, suggested that other causes may be at the root of colon cancer. And others debate that more effective detection methods for finding colon cancer are the reasons more cases were noted. It could be argued that since doctors are now more effective in locating colon cancer earlier, it is their work that has brought about the increase in colon cancer reporting and that folic acid has nothing to do with it. In fact, studies have shown that there is a lowered chance of colon cancer, as well as breast cancer, when folic acid or folate levels are increased.
It is known that with higher intakes of folic acid the body cannot convert it all into folate. How this may or may not affect the person’s overall health is not clear at this time.
When is Enough?
It is important that readers understand that getting too much of the folate form is not a problem. This form is found in foods and it is naturally balanced within that food. The body can easily take care of its absorption. Now, folic acid, on the other hand, can become a problem. Here is how that problem occurs:
Many of the foods that we eat everyday such as nutrition bars, breakfast cereals, and forms of fortified foods, can contain as much as 800 micrograms of folic acid. This is more than double what most people need on a day-to-day basis. Consider this: if a person consumes an average size bowl of the breakfast cereal Special K, they will get about 390 micrograms of folic acid. If that same person ingests a Nitro-Tech nutrition bar later in the day, they have addd another 800 micrograms of folic acid. And if they eat just one half cup of pasta later on, they can add another 85 micrograms to the total. As you can see, it doesn’t take much to get to and exceed the daily recommended upper limit of 1000 micrograms. And this is the upper limit as set by the IMO.
It is important to know when enough is enough when it comes to vitamin intake. And this applies to all vitamins and minerals. For instance, too much vitamin A can lead to a weakening of bones which can lead to bone fractures. Likewise, too much folic acid can lead to health issues as well.
On the other hand, it is also important to remember that we often do not get the needed amount of vitamins and folic acid that we require through food alone. Eating foods that are fortified with folic acid is one way to increase intake, but it must be done with common sense. Nothing is better than healthy food, but multivitamins and supplements can play an important role as well. This can be especially true for certain groups of people such as pregnant women, elderly individuals, those who do not have access to healthy food on a regular basis and others.
A sensible idea is to take a multivitamin every day and make it a habit to limit or eliminate foods that have been fortified above 100 to 200 micrograms of folic acid. This is one of the best ways to get the vitamins you need without going overboard.