A generation rich in folic acid

A recent study found more than 90 per cent of an elderly group had unmetabolised folic acid in their blood

EVEN THOUGH Ireland does not have a mandatory programme to fortify foods with folic acid, a new study suggests that older people here could be getting enough in their diet.

Folic acid is an easily absorbed synthetic version of the B vitamin folate. Women at risk of pregnancies affected by neural tube deficit, such as spina bifida, may need additional folic acid, and some countries such as Canada and the United States have mandatory programmes that add the synthetic vitamin to flours.

Ireland has no such mandatory fortification programme, and women who could become pregnant are recommended to take a folic acid supplement.

But many food manufacturers add folic acid to drinks and foodstuffs on sale here in a step called voluntary fortification, and research is ongoing to look at the folic acid and natural folate status in the Irish population, explains Dr Mary Rose Sweeney, a lecturer in health systems research at Dublin City University.

The study, which was carried out by DCU, University College Dublin, St Vincent’s University Hospital, Trinity College Dublin and the University of South Alabama, involved 137 participants in the Lifeways Cross-Generation Cohort Study.

Participants were aged between 60 and 86, and they gave blood samples and dietary information.

“Over 90 per cent of the elderly group had low levels of unmetabolised folic acid in their blood samples, even though they had been fasting overnight,” says Sweeney.

Unmetabolised folic acid has not been converted by the body’s metabolic processes, and its presence in the blood could signal that the body already has enough, she explains.

“Some of remains unchanged by the time it reaches the circulation, suggesting at least enough if not too much exposure. It looks like the Irish elderly are exposed to more folic acid currently than their bodies can metabolise fully into the natural form of folate.”

Sweeney says the findings, which were published recently in the American Journal of Clinical Nutrition, were not surprising because they were in line with what they have seen in other population groups in Ireland.

“We have shown similar prevalence rates in our previous work already published in pregnant women, cord blood and young adults,” she says.

“What’s different in this study is that the subjects were fasting so now we know that these levels are likely to be the persistent levels rather than just a response to recent dietary intake in their last meal.”

The results cannot be linked to any adverse health outcomes, she notes. “We don’t know if unmetabolised folic acid will be shown to cause any either in the short term or long term.”

However, the study, which was funded by the Health Research Board, should be considered by policymakers when looking at folic acid fortification, says Sweeney.

Dr Mary Flynn, chief specialist in public health nutrition with the Food Safety Authority of Ireland, says the authority will be bringing the findings to the attention of the European Commission, and she describes how the general area of folic acid fortification can be tricky.

“You can get too much of a good thing,” she says. “It’s good that elderly people have good folate status, it has been shown to help in terms of cognitive function of elderly people. But we also know that high amounts of folic acid can mask the symptoms of inadequate amounts of another vitamin, B12, and that can be serious. So it’s very hard to be definitive.”

Flynn says would like to see “promised European legislation” setting maximum limits for the addition of nutrients such as folic acid to foods. And while voluntary fortification of foods can boost intake, it can be challenging to regulate, she notes.

“Fortified foods are of benefit, but when we have a lot of them coming onto the market and there are no rules on the amounts of nutrients that can be added or on which categories of foods can be fortified, that’s very tricky,” she says.

“That makes it very difficult to manage when you don’t want people to get too much or too little.”