FOLIC ACID FOR CANCER PREVENTION

Q. I have a family history of colorectal cancer. Recently a friend told me about a study that showed folic acid may reduce my risk. I know folic acid is important during pregnancy (my wife was told to be on it through both her pregnancies) but can it help me, as well?

A. More than just a prenatal vitamin! Folic acid is probably best known for its importance during pregnancy, as it has been shown to very significantly decrease risk of neural tube defects. Since many pregnancies are unplanned, and given that folic acid can also help to prevent and treat cervical dysplasia, which can be a precursor to cervical cancer,it is now recommended that all women of childbearing age take a multi vitamin containing 400-600 mcg of folic acid/day. That being said, you don't have to pregnant or even female to benefit from folic acid. Here's why:

The many benefits of folic acid:
Folate deficiency is thought to be one of the most common nutritional deficiencies.

Here are just a few of the conditions, effecting both men and women, that have been associated with folic acid deficiency or have been shown to benefit from folic acid supplementation.
Anemia
Dementia
Parkinson's
Autism
Depression
Schizophrenia
Arterial disease
Colon, breast and pancreatic cancers

Deficiencies are most common in the elderly, during pregnancy and in alcoholics.

Folic Acid and Cancer
Seeing as Folate plays a role in healthy cellular growth and the synthesis of DNA, it stands to reason that deficiencies have been associated with damage to DNA and have been implicated in the development of breast, and pancreatic , as well as colorectal cancers. Studies in the past, related specifically to colorectal CA, had suggested that just the opposite was true, that folic acid intake instead increased the risk of colorectal cancer, especially in those individuals with existing adenomatous polyps. More recently studies are disputing this. Findings are now showing that at a dose of approx. 400-500 mcg/day (compared with 200 mcg/day) there is an approximate 30% decrease in risk. Higher dosages were tested, although above a 500 mcg/day dosage, no additional benefits were observed.

Folic Acid and homocysteine – the cardiovascular connection
Elevated homocysteine levels have been associated with impaired endothelial vasomotor function, which determines how easily blood flows through the blood vessels. Homocysteine is an amino acid normally found in the blood . At higher than normal levels, the proposed damage that homocysteine causes have been linked to an increased risk of CHD and stroke. A deficiency of folate and/or B12 and/or B6 can lead to increased levels of homocysteine, with supplementation of folic acid being shown to effectively decrease these high levels. Research is still unclear as to whether increasing folate levels in the body can be directly correlated to decreased risk of CHD and stroke, but it is certainly promising given its effects on homocysteine balance. High homocysteine has also been associated with osteoporosis and macular degeneration,as well, making folic acid a possible consideration in the treatment and/or prevention of these conditions.

Folic acid versus Folate, supplement versus food sources
Folate and folic acid are often used interchangeably, but they do differ. Folate is a B vitamin naturally occurring in the foods we eat. It's highest in leafy greens, such as kale and spinach, as well as broccoli, lentils, oranges, liver and brewer's yeast. Naturally occurring folate is harder to absorb than the synthetic folic acid form, found in supplements and fortified foods, mainly white flour products – pasta, bread, breakfast cereals, etc.

Folic Acid and 5 MTF... which is better?
Folate requires cleavage in order to be absorbed from the small intestine. It needs to be cleaved into the pteroylmonoglutamate form for this to happen. Folic acid, on the other hand is already found in this form, does not require cleavage, and therefore is much more efficiently absorbed. That being said, some believe that there is still room for improvement. Many supplement companies are now talking about the superior bioavailability of 5 methyltetrahydrofolate (5MTF). It has been argued that this form of folic acid goes one step further in terms of folic acid breakdown, which may be particularly beneficial to individuals suffering from either liver or intestinal disorders. The liver and intestine both play a part in the reduction and methylation of folic acid into its metabolically active form (5 MTF) , which can be utilized by the tissues. There is still some debate as to whether serum folate levels vary significantly between folic acid and 5MTF supplementation. There does seem to be some benefit in using 5MTF in order to avoid masking a B12 deficiency, which folic acid supplementation can do.

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