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Folic acid – mandatory fortification may be unnecessary
24 August 2009

Dr Mary Rose Sweeney

Persistently present levels of unmetabolised folic acid found in the population indicate that introducing mandatory food fortification may result in an ‘overdosing’ effect. A study of blood donors, new mothers and babies, published in the open access journal BMC Public Health, has found that most already get enough folic acid from voluntarily fortified foods.

Mary Rose Sweeney, from Dublin City University, Ireland, led a team of researchers who studied 50 blood samples from the Irish Blood Transfusion Service and from 20 mothers and 20 infants’ umbilical–cords, from Coombe Women’s and Infant’s University Hospital, Dublin. She said, “A recent study has suggested excessive folic acid consumption may increase the risk of prostate cancer and more severe adenorectal carcinoma reccurrence. We set out to explore how much unmetabolised folic acid is present in Irish people exposed to the current range of ‘voluntarily’ fortified foodstuffs, and to predict the increase in levels should a policy of mandatory fortification be introduced”.

Folic acid and other micronutrients have been added on a voluntary basis to breakfast cereal, bread and other products in the Republic of Ireland for over 15 years, to remedy perceived inadequate intake. The Food Safety Authority in Ireland is currently discussing whether to make such fortification mandatory. In this study, Sweeney and her colleagues found that circulatory unmetabolised folic acid was present in the majority of their sample. They write, “This implies constant exposure of both normal cells, and potential tumour cells, to this pro-vitamin amongst Irish consumers. In terms of the predicted increase that will arise if mandatory fortification goes ahead, we predict the increase to be in the region of 12%”.

The consequences of increased consumption of folic acid are still unknown, but, according to the researchers, “This should continue to be of concern for those with responsibility for drafting legislation in this area”.

The study is a collaboration between the following institutions

  • School of Nursing, Dublin City University, Glasnevin, Dublin 9, Ireland, 
  • UCD School of Public Health and Population Science, University College Dublin, Dubin 4, Ireland, 
  • Coombe Women’s and Infant’s Hospital, Dublin 8, Ireland, 
  • Department of Pharmacology, University of South Alabama, Mobile, Alabama 36688, USA,
  • Department of Biochemistry, Trinity College, Dublin 2, Ireland.