An interesting topic found its way into our inbox today: the issue of increased folic acid in food and the possibility that increased levels can be linked to colorectal cancer.

A concerned citizen and friend of the CCAC  wrote to Health Canada online pharmacy to ask about the practice of “fortifying” (adding nutrients, of which folic acid is an example) to everyday items, using flour as an example. Since the enrichment of flour with nutrients like folic acid is the standard in Canada, she was particularly concerned with the results of some studies, which suggest that higher folic acid levels are partly linked to colorectal cancer.

Health Canada replied that the mandatory enrichment of white flour is a cornerstone of Canada’s fortification program, aimed at helping to prevent nutritional deficiencies and maintain or improve the nutritional quality of the food supply.

So as a person trying to prevent or beat colorectal cancer, where should one stand in the great folate debate?

With so much research going into the fight against colorectal cancer, there are bound to be multiple findings and different interpretations of study data. If you’re confused, the CCAC encourages you to contact us with your questions!  Here is our take on the possible dangers of high levels of folic acid:

While there have been reports of the possible increases in the risk of developing colorectal cancer since the practice of adding folic acid to food, one of the most recent studies out of Harvard hypothesizes that folic acid food fortification for people with low levels of the nutrient may actually decrease their cancer risk. Contrary to other studies, the Harvard researchers found no evidence for an increased risk of advanced or multiple adenomas. It was a great study because it adhered to the gold standard of a double-blind, randomized trial, comparing the placebo to folic acid. The results, if interested, can be found in the American Journal of Clinical Nutrition.

The bottom line: Before abstaining from or increasing fortified-food intake, consider a blood test to determine current blood vitamin levels and whether a switch to non-fortified foods is truly in order.  The best advice regarding the intake of a vitamin should always be that sought from a qualified physician who has some experience in nutritional oncology. Short of that, a family physician is always in a position to provide clarification on the pros and cons of vitamin intake.

Click here to learn about folic acid on Wikipedia.

Click here and here to read articles posted to the CCAC site regarding the possible danger of high folic acid levels.

Click here to access the Canada Food Inspection Agency’s page regarding the prohibition against unenriched flour.

I have a question with regards to nutrition labeling as it pertains to the

addition of folic acid to foods, in particular to flour.  Is all flour
sold in Canada enriched with folic acid?  If a label does not show this
additon, can one assume it is not added?

Folic acid supplementation has been in the news lately as some research
has linked high folate levels with colorectal cancers.  ie:

http://www.colorectal-cancer.ca/en/news-and-resources/studies-find-acid/?var_recherche=folic%20acid

http://www.colorectal-cancer.ca/en/news-and-resources/folic-acid-its-sheen/?var_recherche=folic%20acid