Anyone trying to prevent heart disease and cancer is probably thoroughly confused by competing research and news reports about folic acid. In some studies it reduces the risk of cancer(i) and in others it seems to increase the risk.(ii)
The media grab attention with scary headlines like the recent Prevention article, “Is Your Breakfast Giving You Cancer” and the confused consumer of healthy food and vitamin supplements goes back to burgers and fries and throws their supplements in the trash.
Unfortunately, science is never black and white and confusion is easy to come by — even for trained scientists.(iii) The fortification of our food supply with folic acid in 1998 reduced spina bifida birth defects by 19%. A good thing. But by some estimates it may have caused an additional 15,000 cancers deaths a year. Ooops. Now what?
The answer is elemental. As in chemistry, biochemistry to be exact. It all comes down to this. Man-made molecules do funny unpredictable things because they don’t work with our normal biochemical pathways. Nature made molecules we have consumed for millennia work with our bodies.
And therein lies the big problem with the nutrient known as B9. Folic acid, the molecule that is used to fortify our food supply, and is used in most studies and is in most vitamins is a man-made funny looking molecule, a fully oxidized, synthetic chemical compound It is what seems to cause all the mischief. It costs less and is more stable than the nature made form of this nutrient.
On the other hand, the nature made form or forms called “folates” do not seem to cause problems. This molecule is often found in foliage – dark green leafy vegetables, hence the name folate. This can enter your normal biochemical pathways and gets properly metabolized. The folic acid may not be converted or metabolized by the body increasing cancer and disease risk. The excess folic acid becomes oxidized and promotes free radical production and genetic instability leading to cancer and other disease.
Now it gets a bit more complicated. We are all biochemically individual and genetically unique and about 35% of us have a genetic variation in a gene called MTHFR that helps neutralize the folic acid. If this doesn’t work well, then more of the folic acid accumulates from the fortified food and supplements. Those who have this gene are at increased risk of colon cancer because they produce more pre-cancerous colon polyps. High dose folate supplementation in these people reduced their risk of polyps.(iv)
The good news is that you can take the nature made form of this nutrient – it is called methyl-folate (and there are a few forms of that too). This is what should be in food and vitamin supplements. Many contentious companies are now using only this form of the nutrient, but is more expensive.
Here’s what you should do:
Don’t eat fortified foods!! If it needs to be fortified with folic acid, that is because it has been impoverished and refined in the first place – white flour, white rice, cereals, and processed foods. Just eat real, whole fresh food!
Look at your supplement label! If it says “folic acid” then find another vitamin that has the words ” L 5 methyl-tetrahydrofolate or 5 formyl tetrahydrofolate” on the label.
Now for those who want know a little bit more about the reason why folate and its companions B6 and B12 are the most critical and health promoting hit parades in the nutrient world.
The Secret of Folate: The Magic of Methylation
Taking just a few vitamins CAN optimize the function of ALL your body’s systems. It’s true. But you have to know what to take, what form of the nutrients and you have to know why these supplements work …
In this post, I am going to discuss one of the most important biochemical processes for long-term health and how keep it functioning optimally with supplements and other strategies. This process is called methylation because it involves moving around a chemical group called methyl groups consisting of one carbon and three hydrogen molecules.
Unfortunately, many people suffer from one or more of the 8 factors that negatively impact this biochemical process, so problems in this area are widespread though many don’t realize they are suffering.
However, there are MANY things that you can do to optimize this critical biochemical process that may have a dramatic impact on your health. In today’s post I will review the 8 factors that can lead to problems in this area, and outline 12 tips that will help you optimize this essential part of your biology.
But first, I’d like to tell you about two of my patients with seemingly unrelated health problems that were actually caused by a breakdown in this biochemical process. And I want to share a study done on Chinese babies who had a birth defect known as spina bifida.
All three — my two patients and these Chinese babies — were affected by the exact same thing …
What an Elderly Golfer, a College Professor, and Chinese Babies have in Common
One of my patients, Mr. Roberts, was an 88-year-old businessman who didn’t let his age slow him down. He still golfed three times a week, worked two days a week, flew around the world in his private jet, and was "romantic" once a week with a wife 30 years his junior. He also loved his 6 ounces of Grey Goose vodka every night.
Of course, he did have some health problems. Mr. Roberts had been treated well for mild heart disease. His doctor even recommended 800 mcg of folic acid and 250 mcg of vitamin B12 — megadoses by any standard.
Mr. Roberts also had a check-up at the Mayo Clinic and was told that he was healthy, despite having mild anemia and large red blood cells. Yet he still complained of mild fatigue and trouble with his short-term memory. Plus, I noticed a slightly wide gait common in someone with poor balance.
Then there was Mr. McNally, a Boston college professor who was 50 years old, fit, and lean but wore a worried look as he walked into my office.
He recounted the sad tale of his 7 brothers. Four had died of a heart attack and three others had had bypass operations at a young age. Concerned about his own fate, he ate a low-fat diet, exercised regularly, didn’t smoke, had normal blood pressure and cholesterol levels, and took antioxidants and a multivitamin. Perhaps his only vice was the multiple Starbuck’s grande lattes he downed each day. Living under a constant state of impending doom, Mr. McNally came to me asking for a stress test to see how his heart was doing.
Strange as it may seem, these two men reminded me of my time in China. When I lived in Beijing, a study was done on a group of women in Harbin, the northern most industrial city in the Gobi desert, just north of Beijing. It seemed that there was an unusually high rate of birth defects in the area, specifically spina bifida or neural tube defects.
The Chinese have a tradition of holding weddings during the Chinese New Year in February. In Harbin, many of the babies born 9 months later had birth defects. This study sought to determine what the link was and found that the major factor was the lack of fresh greens or vegetables in the Gobi desert in the middle of winter.
Interestingly, these Chinese babies, Mr. Roberts, and Mr. McNally all have something very important in common. They all have inadequate levels of specific vitamins, either acquired or genetic, and their methylation systems are not working properly as a result. I’ll explain more about what “methylation” is in a second. First let’s analyze the similarities in these cases.
Take Mr. Roberts. Our romantically active 88-year-old took high doses of B vitamins. But he still had very high levels of homocysteine and methylmalonic acid — indicators of folic acid and B12 deficiency.
Mr. McNally had similar problems. Our college professor had a genetically sluggish metabolism of homocysteine, which caused extremely high levels of this toxic amino acid to build up in his blood. This was the likely cause of all the heart disease in his family.
Again we see a similar set of problems in those Chinese babies. Their mothers were conceiving in the middle of winter — when their folate intake was low from the absence of fruits and vegetables. This is what triggered such a high rate of birth defects. This was the reason that food was fortified with the synthetic form of folate called folic acid, which as it turns out is biochemically quite different in its effects.
The common link in all three of these cases is a problem with methylation. Let me tell you more about that that actually means.
Methylation is a key biochemical process that is essential for the proper function of almost all of your body’s systems. It occurs billions of times every second; it helps repair your DNA on a daily basis; it controls which genes are turned on or turned off; it controls homocysteine (an unhealthy compound that can damage blood vessels); it helps recycle molecules needed for detoxification; and it helps maintain mood and keep inflammation in check.
To keep methylation running smoothly you need optimal levels of B vitamins. Without enough B vitamins methylation breaks down, and the results can be catastrophic. In these cases we see more birth defects like spina bifida (as with the Chinese babies), more cas
Mark Hyman, MD, believes that we all deserve a life of vitality—and that we have the potential to create it for ourselves. That’s why he is dedicated to tackling the root causes of chronic disease by harnessing the power of Functional Medicine to transform healthcare. Dr. Hyman and his team work every day to empower people, organizations, and communities to heal their bodies and minds, and improve our social and economic resilience.
Dr. Hyman is a practicing family physician, a nine-time #1 New York Times bestselling author, and an internationally recognized leader, speaker, educator, and advocate in his field.
He is the Director the Cleveland Clinic Center for Functional Medicine. He is also the founder and medical director of The UltraWellness Center, chairman of the board of the Institute for Functional Medicine, a medical editor of The Huffington Post, and was a regular medical contributor on many television shows including CBS This Morning, Today Show, Good Morning America, CNN, and The View, Katie and The Dr. Oz Show.
Dr. Hyman works with individuals and organizations, as well as policy makers and influencers. He has testified before both the White House Commission on Complementary and Alternative Medicine and the Senate Working Group on Health Care Reform on Functional Medicine. He has consulted with the Surgeon General on diabetes prevention, and participated in the 2009 White House Forum on Prevention and Wellness.
Senator Tom Harkin of Iowa nominated Dr. Hyman for the President’s Advisory Group on Prevention, Health Promotion, and Integrative and Public Health. In addition, Dr. Hyman has worked with President Clinton, presenting at the Clinton Foundation’s Health Matters, Achieving Wellness in Every Generation conference and the Clinton Global Initiative, as well as with the World Economic Forum on global health issues.
He is the winner of the Linus Pauling Award, The Nantucket Project Award, and was inducted in the Books for Better Life Hall of Fame, and the Christian Book of the Year Award for The Daniel Plan.
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