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Low Folate Levels Could
Cut Colon Cancer Risk
Conventional wisdom has indicated that high levels
of folate cut risks for colorectal cancer, but a
new study suggests low levels may do the trick,
too.
Folate is a B vitamin found in fruits such as
bananas and oranges, leafy green vegetables, asparagus,
broccoli, liver, and many types of beans and peas.
Outside experts called the findings intriguing
but preliminary, stressing that caution needs
to be exercised when interpreting the conclusions.
"In a lot of ways, it's counterintuitive,
but it may have validity," said Dr. Howard
Manten, an associate professor of medicine and
pediatrics at the University of Miami Miller School
of Medicine. "We need confirmatory studies."
"It's an interesting study, but with relatively
small numbers of patients," added Dr. Jay
Brooks, chairman of hematology/oncology at Ochsner
Health System in Baton Rouge, La.
This advice does not necessarily pertain to pregnant
women, he added, since there is good evidence
that extra folate in the diet greatly cuts the
risk for having children with neural tube defects
such as spina bifida.
Indeed, folic acid has long been known for its
effect on reducing certain birth defects when
taken in sufficient quantities by pregnant women.
That was the rationale behind the U.S.
Food and Drug Administration's 1998 order
for folic-acid fortification of enriched grain
products such as cereals and breads. Canada made
fortification mandatory that same year.
According to the study, which appears in the
April 25 online issue of Gut, there are
also initiatives now in Europe to fortify food
with folate.
Previous research had found that folate might
protect against colorectal cancer. But many of
those studies had looked at dietary intake rather
than how much folate was circulating in the body,
the authors stated.
In the current study, the biggest-ever prospective
look at circulating levels of folate and colorectal
cancer risk, researchers at Umea University, Sweden,
looked at 226 people with colon cancer and 437
controls from the Northern Sweden Health and Disease
Cohort.
Participants completed questionnaires on lifestyle,
including diet, and also submitted blood samples
for analysis.
People with either the lowest or highest levels
of circulating folate were the least likely to
develop bowel cancer, the researchers found. Those
in the middle were almost twice as likely to develop
the disease.
People with a common mutation in the MTHFR gene,
which lowers a person's circulating folate levels,
also had a lower risk of developing the cancer.
There was no apparent link between homocysteine,
an amino acid which may play a role in atherosclerosis,
and folate. B vitamins, including folate, tend
to keep homocysteine levels down.
If nothing else, the findings should make people
think twice before they supplement their diet
with large amounts of any one nutrient.
"The study shows us that before we start
adding extra things into our diet, we may want
to really study them carefully, as we may be doing
more harm than good," Brooks said.