from the good-for-baby-brain-development dept.
The U.S. Food and Drug Administration will allow the voluntary fortification of corn masa flour with folic acid, which could reduce the occurrence of neural tube birth defects:
Foods made with corn masa flour — like tortillas, tacos and tamales — could soon play a critical role in the health of babies born to Latina mothers in the U.S. That's because, as of today, the U.S. Food and Drug Administration is now allowing manufacturers to fortify their corn masa foods with folic acid. That's a synthetic form of folate, a B vitamin that helps prevent severe defects of the brain and spinal cord when consumed by women early in pregnancy. "I think it will be really monumental for the Latino population," says Michael Dunn, a Brigham Young University food scientist.
Since 1988, the FDA has required that breads, pasta, breakfast cereals and other grains made with enriched flour be fortified with folic acid. In the years since, the number of babies born in the U.S. with neural tube defects has dropped by roughly 35 percent — or about 1,300 babies a year. But these birth defects remain "stubbornly higher" in the Hispanic community, says Dr. Edward McCabe, the chief medical officer at the March of Dimes. Researchers have suspected that the reason why might lie in tortillas and other foods made with corn masa flour – a dietary staple for many Hispanic families.
That's because until now, the FDA had banned fortification of products made with corn masa flour. The agency was concerned that the folic acid might not remain stable. Dunn led a study that helped change the FDA's mind. His research involved lengthy testing in the lab – as well as tests at a local facility making corn masa flour in Utah. He and his team found that the heat and production process doesn't significantly change the quantity of folic acid in a fortified product through its shelf life.
The FDA now says that manufacturers may voluntarily add up to 0.7 milligrams of folic acid per pound of corn masa.
Related Stories
Women who plan to become pregnant are told they need enough folate to prevent birth defects, but new research suggests there could be serious risks in having far too much of the nutrient.
The researchers found that if a new mother has a very high level of folate right after giving birth—more than four times what is considered adequate—the risk that her child will develop an autism spectrum disorder doubles.
Further, very high levels of another vitamin, B12, are also potentially harmful, tripling the risk that a new mom's offspring will develop an autism spectrum disorder. If both levels are extremely high, the risk that a child develops the disorder increases 17.6 times.
There is no such thing as a home testing meter to monitor the levels of folates and B12 in your blood, the way there is for glucose. How would a mother know without running to the doctor every day?
takyon: Also at Johns Hopkins University, The Atlantic, CBS News, and the Baltimore Sun. There is no DOI, because these are preliminary findings that will be presented on May 13th at the International Meeting for Autism Research in Baltimore.
Related: Scotland to Debate Fortification of Flour With Folic Acid as UK Govt Delays
FDA Allows Fortification of Corn Masa Flour With Folic Acid
Researchers have disputed the need for multivitamin supplements for pregnant women, recommending only folic acid and vitamin D supplementation:
In Drug and Therapeutics Bulletin, researchers say they looked at all evidence and found supplements did not boost the health of mothers and babies. But pregnant women should make sure they take folic acid and vitamin D, as well as eating a well-balanced diet, as per NHS guidelines, they add. Supplements-makers said some women were not getting enough nutrients. The researchers said folic acid had the strongest evidence to support its use - taking 400ug a day can protect against abnormalities called neural tube defects in the developing baby.
[...] The researchers said pregnant women might feel coerced into buying expensive multivitamins in order to give their baby the best start in life. But they would do well to resist the marketing claims, which did not seem to translate into better outcomes for mother or baby, they said. "The only supplements recommended for all women during pregnancy are folic acid and vitamin D, which are available at relatively low cost," they said.
Janet Fyle, from the Royal College of Midwives, said: "We would encourage women who are pregnant or are thinking of becoming pregnant to have a healthy, varied diet including fresh fruit and vegetables, alongside taking folic acid supplements.
(July issue of DTB not published yet) (DOI: 10.1136/dtb.2016.7.0414)
Related:
Scotland to Debate Fortification of Flour With Folic Acid as UK Govt Delays
FDA Allows Fortification of Corn Masa Flour With Folic Acid
(Score: 2) by bitstream on Saturday April 16 2016, @04:10PM
So how to find corn masa flour products without fortification? In other news laptops will be fortified with Linux, users are to dumb to know their best..
(Score: 2) by takyon on Saturday April 16 2016, @04:15PM
Well it's voluntary and formerly banned. So you could stock up on corn flour now, or check the label in the future.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @05:41PM
Yes, I don't know how anyone takes nutrition research seriously at all anymore. It is clearly just a series of fads, not science. Stop adding junk to the food supply.
(Score: 2) by wonkey_monkey on Saturday April 16 2016, @05:58PM
I know, right? Bring back anaemia!
systemd is Roko's Basilisk
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @06:36PM
Thinking that ending folic acid fortification will "bring back anaemia" is just your religious belief. It isn't even specified well enough to be testable.
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @07:17PM
Apparently it is your religious belief that it was his religious belief.
That you couldn't recognize he was talking about iron fortification is pretty revealing of your ability to understand the topic.
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @08:15PM
It is possible, but I'm not sure why you would assume that since this discussion about about folic acid...
https://en.wikipedia.org/wiki/Folate_deficiency [wikipedia.org]
(Score: 2) by butthurt on Saturday April 16 2016, @08:58PM
"Anaemia" doesn't imply iron.
http://www.nhs.uk/Conditions/Anaemia-vitamin-B12-and-folate-deficiency/Pages/Diagnosis.aspx [www.nhs.uk]
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @10:25PM
When it is written without "folate deficiency" it does indeed imply iron.
(Score: 2) by butthurt on Sunday April 17 2016, @05:15AM
No, When it's written
"iron deficiency anaemia" [wikipedia.org] it implies that a deficiency in iron is known to be the cause.
(Score: 2) by bitstream on Saturday April 16 2016, @07:21PM
There might be benefits. But there may also be health concerns as this vitamin is artificial and the process to get that right may be questioned. Especially in the times of "donations", cronies and slimmed organizations.
(Score: 2) by opinionated_science on Saturday April 16 2016, @08:26PM
citation?
(Score: 2) by bitstream on Saturday April 16 2016, @10:00PM
Benefits: "Periconceptional vitamin use, dietary folate, and the occurrence of neural tube defects" [doi.org]
Health concerns: "Folic acid fortification: the good, the bad, and the puzzle of vitamin B-12" [ajcn.org]
Synthetic bad: "The extremely slow and variable activity of dihydrofolate reductase in human liver and its implications for high folic acid intake" [doi.org]
And that taking some shortcuts in regards to quality and safety is standard practice all too often should be a quite well known fact.
(Score: 2) by bitstream on Saturday April 16 2016, @07:24PM
There has been talks in some countries to add fluorine to the water supply. Which is a really bad idea due to documented bad health effects. Brush teeth = good, drink = bad. In some places fluorine is naturally included, which is how the substance and its effects was discovered.
The road to sickness is paved with addition of all kinds of good additives for your own good.
(Score: 2) by opinionated_science on Saturday April 16 2016, @08:28PM
any supporting citation?
(Score: 2) by bitstream on Saturday April 16 2016, @10:04PM
"Acute Fluoride Poisoning from a Public Water System" [doi.org]
So yes, it is a real danger. Put it in the toothpaste, not drinking water.
(Score: 2) by schad on Sunday April 17 2016, @01:28AM
Your link is a red herring. It describes a water system that had an incorrect (too high) level of fluoride, but you're arguing that the normal level of fluoride has risks. You haven't presented any evidence to support your argument.
A great many things, including things we need in order to live, are toxic in high enough concentrations. That in no way implies that they can't have health benefits at low levels. Nor does it imply that there can't be benefits to higher, though still sub-toxic, concentrations than would normally occur in nature.
(Score: 2) by bitstream on Sunday April 17 2016, @02:24AM
I can probably find articles that proves that sub-acute levels of fluorine in the drinking water is a bad idea if I were willing to invest that time. Point is, fluorine is a poison that the body don't need. So it should not be forcefully ingested. I know A and E vitamin have optimal dosages, but they are also essentials. Unlike fluorine.
(Score: 0) by Anonymous Coward on Sunday April 17 2016, @07:37AM
Likewise, I could probably prove you're wrong about that if I wanted to. So therefore I'm right.
(Score: 2) by schad on Sunday April 17 2016, @06:05PM
I don't think you can, because those articles don't exist. I'm certain you can find article which claim that fluoridation is dangerous. But you won't find any high-quality, peer-reviewed, reproducible-and-reproduced studies. Well, you will, but they will all say that fluoridation is safe.
Because accidents happen sometimes, people get this idea that fluoridation must be hazardous and that there's a big cover-up. Fluoride is used for mind-control, or to make us docile, or sterile, or stupid. Or maybe it's just that scientists are in thrall to the dentists' lobby, who somehow makes a ton of money from fluoridated water. But despite the best efforts of people on the anti-fluoridation side to prove that it's dangerous, none of them have been able to do so.
(Score: 2) by butthurt on Friday May 13 2016, @09:02PM
The authors of one meta-analysis wrote that "the results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491930/?report=classic [nih.gov]
I found pro- and anti-fluoridation sites that discuss it:
http://ilikemyteeth.org/fluoridation/dangers-of-fluoride/fluoride-iqs/ [ilikemyteeth.org]
http://fluoridealert.org/studies/brain01/ [fluoridealert.org]
(Score: 2) by MostCynical on Saturday April 16 2016, @09:46PM
What "effects"?
Please supply sources/peer-reviewed studies/actual evidence.
"I guess once you start doubting, there's no end to it." -Batou, Ghost in the Shell: Stand Alone Complex
(Score: 0) by Anonymous Coward on Sunday April 17 2016, @02:49AM
There is evidence that long-term fluoridation of the water supply is correlated with hip fractures in the elderly.
Fluoride was also given as a treatment for osteoporosis, because early results showed it increased bone density. It is no longer used, because while it increased density it did not increase bone strength.
http://www.fluoridation.com/lee-jr.htm [fluoridation.com]
https://fluorideinformationaustralia.files.wordpress.com/2013/01/fluoridation-hip-fractures.pdf [wordpress.com] [pdf]
Also it is really hard to get any decent information on fluoride. It has become so politicised, and there are so many crackpots, that anything reasonable is shouted down by both sides.
(Score: 1) by mrgren on Sunday April 17 2016, @03:29PM
Commenter is "to" dumb to spell 3-letter words.
(Score: 2) by bitstream on Sunday April 17 2016, @04:20PM
Commenter had the focus on the content, not spelling.
What is important, and what is not.
(Score: 5, Insightful) by Dunbal on Saturday April 16 2016, @04:31PM
None of this would have been necessary if you would just eat your damned veggies. But you don't. So there you go.
As a physician I understand the need for increasing folic acid intake in the general population as a public health policy. We give folic acid to pregnant women and it has been statistically proven beyond doubt to reduce (not eliminate) neural tube defect like spina bifida, which you would not want your dog to have much less your child. The problem is that usually the neural tube is already formed and the defect in pace by the time the average woman finds out she's pregnant - it only takes 5 weeks from conception and the damage is already done. So the aim here is to make sure that women have plenty of folic acid in their system BEFORE they get pregnant.
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @05:28PM
No-one likes to be told they are wrong, especially not when they certainly *are* wrong...
You, however, are right!
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @05:46PM
In general, physicians seem to have a poor grasp of statistics. That is why I just stopped going to them for advice for anything non-obvious.
https://www.sciencenews.org/blog/context/doctors-flunk-quiz-screening-test-math [sciencenews.org]
http://www.bmj.com/content/349/bmj.g5619/rr/764730 [bmj.com]
(Score: 3, Touché) by wonkey_monkey on Saturday April 16 2016, @06:07PM
From the first link:
OK, it’s kind of a trick question.
So the conclusion is based on asking a deliberately confusing question.
Might as well have asked them about the Monty Hall Problem.
I suspect their results were rather better than the general population in any case.
systemd is Roko's Basilisk
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @06:27PM
That was just the first thing to pop up on a search of "doctors understand statistics". All you have to do is read the medical literature to see it is very rare for them to understand what they are calculating, at least when it comes to statistics.
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @07:13PM
> All you have to do is read the medical literature to see it is very rare for them to understand what they are calculating, at least when it comes to statistics.
That sounds like a statistically unsound proof of your premise.
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @08:12PM
You don't have to do statistics to know getting hit by a car leads to higher chances of death. Similarly, you can just read the literature and see how p-values are misinterpreted over and over and over and over and over and over. There is nothing to argue amongst people who 1) Know what a p-value is 2) Are familiar with the medical literature. The only people who argue fail to meet one of those two criteria.
(Score: 2) by Dunbal on Saturday April 16 2016, @09:17PM
Getting hit by a car leads to a higher chance of death. Death from what? Death from multiple myeloma? Death from acute coronary syndrome? Death from dehydration after chronic diarrhea? There are lots of ways to achieve "death". Yes I am being pedantic. Just as pedantic as you are.
There are good people and there are bad people in all fields and all walks of life. Most people are somewhere in the middle - law of averages, normal distribution, etc. I wouldn't say that either myself or other physicians I know are exceptional at math and statistics, although I have met exceptions. But then again, I wouldn't say that statisticians are exceptional at medicine, either. But when we work together, we usually end up with a rudimentary working knowledge. I don't base my decisions on a single statistic in a single study, but rather the consensus of my schooling, my peers, and ongoing literature and research. So really, I don't HAVE to be good at statistics. I just need for our entire medical herd to be stampeding roughly in the right direction, and to follow the herd.
Because if you ever end up treating a patient on the basis of a single study and a single statistical result, I will roast you alive. A statistician should be well aware of things like "sample size" and "sample error"...
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @10:28PM
The idea that something can be statistically proven to reduce the incidence of some disease is very wrong. I understand where your misconception is coming from. You don't understand why there is constant talk of statistical significance (and it is the focus of nearly every study design and results report) if it really has little to nothing to do with figuring out what is going on.
(Score: 2) by Dunbal on Sunday April 17 2016, @12:12AM
You have to go with what you've got. If a decently designed experiment is published in a peer reviewed journal and the consensus of the profession is that doing X is a good thing, then you do X because you're interested in doing good things.
The horrible part about statistics is that even if I tell you you have a 90% chance of dying from your tumor at 5 years, I can't exactly tell you what will happen to you. Statistics don't work backwards. But that's life. We do what we can, not miracles.
(Score: 0) by Anonymous Coward on Sunday April 17 2016, @02:41AM
Sorry but no, you can't get me to dismiss it with "we do the best we can". I experienced medical research. I tried to do an actual good job, even working for free for a few years after my institution stopped supporting me. I did far better than testing a null hypothesis like my peers: actually listing all the assumptions that were being made and checking them, coming up with a real model to explain what was going on. No one cared, they just wanted to know whether the drug "worked" (according to a significance test) because they don't know what a p-value is. At this point, the standard medical researcher is either brainwashed or corrupt. Doing a good job is bad for your career in biomed, because that will mean you reveal a whole sea of anomalies to all your colleagues "theories".
The limiting factor is social, not that the human body is complicated like you imply.
(Score: 2) by Dunbal on Sunday April 17 2016, @01:17PM
So you discredit an entire field because of your own personal experience? OK. It is your right to do so, I guess. The rationale behind your justification however is emotional not logical. Have you ever entertained the possibility that you might have been in the outlying group?
(Score: 0) by Anonymous Coward on Sunday April 17 2016, @05:25PM
Yes, of course that is the first thing I did. I spent a lot of personal time reading the literature on a wide range of biomed topics. They all write with the same confusion about what constitutes convincing evidence until you go back at least pre-1980, often to pre-1950.
Anyway, I gave it my best shot and no longer have the mental/emotional reserve to interact with confused people wasting their lives (and probably being indirectly responsible for mass human suffering) like that. It is up to others now, I can't deal with being so negative all day.
(Score: 3, Touché) by Dunbal on Saturday April 16 2016, @07:08PM
In general, physicians seem to have a poor grasp of statistics.
I agree. And statisticians have a pretty poor grasp of embryology. But health science is a multidisciplinary field. I know enough [nih.gov] about [oxfordjournals.org] statistics [nih.gov] to know [nih.gov] when [nih.gov] I am [nih.gov] being lied [nih.gov] to [nih.gov].
(Score: 2) by art guerrilla on Saturday April 16 2016, @09:10PM
@ dunbal
wow, that was very staccato-like to read with the linkies...
would just say the use of the word 'fortification' is annoyingly propagandistic...
(okay, what isn't in these 1984 days...)
just go with 'additive', and leave it at that; people can decide on their own priorities and seek it out -or avoid it- as they wish...
*ASSUMING* they will be labeled as such, and there won't be any bee ess food disparagement trumping free speech, again...
(AND Again...)
(Score: 0, Troll) by Anonymous Coward on Saturday April 16 2016, @06:39PM
As a physician I understand the need for increasing folic acid intake in the general population as a public health policy.
Why don't we just add it to the chemical spray that we're dropping in the atmosphere to try and stave off "climate change" while we manipulate the weather?
If you're a physician and have opinions about general population's public health then you should be aware of the environment, but you're ignorant because you think planes having nozzles spraying chemicals is a "conspiracy theory". [youtube.com] This raises the question: What else are you willfully ignorant of? And: Why aren't you trying to find out? Could it be that there are other environmental factors causing birth defects that you choose to ignore and refuse to investigate, while claiming a lack of folic acid to be the problem? Wouldn't it be foolish to claim crop dusting isn't real and ignoring the effect of eating pesticide laden foods? Wouldn't it be daft to assume cloud seeding isn't real, even as it's openly used by farmers to cause rain, and in Beijing prior to the Olympics to reduce pollution? Is it insane to consider that our weather manipulation has advanced slightly? Especially when you have everyone demanding something be done about the "changing climate"?
What is your stance on the toxic chemical fluoride? It's waste product of the energy and manufacturing industry, and is very hard to dispose of. So, having been prevented from just dumping it in our lakes and rivers due to ecological concerns, a market was created for human consumption touting it's "cavity fighting" capabilities. Thus, rather than just dump it down the drain, we put it in the water supply, filter some of it through humans, and THEN it gets into the ecosystem through the drains. As a physician you've been inundated by propaganda from academia, it's mixed in with all the other good data, so you can't really avoid it. However, you should therefore at least question everything to some degree (as science doth require).
I have no beef with putting shit I don't need in food (since I do eat my veggies), so long as it's labeled as to what goes into it. This includes GMO foods, but mostly because I hate Monsanto's patent racket and would rather not fund them. If a company is that shady legally, who knows how shady their researchers are. Do you believe that Tobacco is good for us? "Smoking is harmless and helpful medically as an expectorant", this was told to my grandmother by a physician. Do you believe that Lead is fine for use in paint and fuel additives? "Lead is harmless, and poses no risk to humans at the low levels leaded fuels create", said a PHD in defense of the gasoline industry. And now, "Folic Acid in Corn Masa is good for you", says a physician who hasn't done any research outside of the propaganda laden information of his collegiate indoctrination camp... Seems to me that someone might just want to sell more Folic Acid, regardless of whether it's needed or not.
(Score: 5, Insightful) by Dunbal on Saturday April 16 2016, @07:24PM
Someone marked you troll, which is unfortunate. Unpopular opinions or "people I don't agree with" are not trolls. But anyway you asked a few questions, I'll answer first by saying that obviously I can only speak for myself.
One thing is my view of medical practice as a practitioner - how I approach the doctor-patient relationship, how I feel the dynamic should work, what information I feel is necessary to share with my patients, what I consider to be consent, etc. Another thing entirely is public health. In public health the needs and requirements of an individual disappear. I think the best example would be the difference between micro and macro-economics. In micro-economics you learn all about supply and demand and how it affects a given business type. In macro-economics you learn about supply and demand and how it affects aggregates. The rules are basically the same. The forces and mechanics driving them are different. Likewise in individual medical practice I need to strive to keep my patient as healthy as possible, with his/her informed consent. In public health, consent is no longer required, aggregate statistics are what become important. The goal is still health, but not health of an individual - health of the entire population.
Let me use a popular example: vaccines. Vaccines will cause side effects. Usually these are minor. But there is definitely the statistical chance that a vaccine will kill your child. The chance is usually tiny, in the "one in a million" or less category, but it's there. One kid in a million is going to die, no matter what you do. But, you are going to protect 999,999 other kids from a disease that could kill 20% or more of them. Which decision do you make if you are setting policy - do you let 200,000 kids die to avoid risking the life of a single kid? Or do you push forward with mandatory vaccination, accepting that a kid is going to die, that a few thousand will have bad side effects, and that maybe half of them will have a bit of a headache? It's an easy, logical decision. Unless you're the parent of the kid that dies. Then it really sucks. Public health. Aggregates.
These decisions are also taken with iodine in your salt, fluorine in your water, vitamin D in your milk. There are plenty of foods that are enriched - not out of malice, but for public health - because in the BIG picture the statistics say that more people will benefit than those that will be harmed. What do I think of this? I think that the people who make those decisions had better be damned sure not to make mistakes. And we're all human - I'm sure that mistakes have happened, and will continue to happen. But if you have an easy chance to help people, either individually or in the aggregate - you should.
(Score: 0) by Anonymous Coward on Saturday April 16 2016, @08:24PM
You seems to be a good doc !
I wish more doctor regularly read random article on pubmed like you seem to do.
I devote 2 hr a week to this task and I am not a doc ... knowing is half of the battle, the other involve guns and tanks !!!! :P
(Score: 2) by butthurt on Saturday April 16 2016, @06:36PM
There was a story about how folate fortification was considered in Scotland [soylentnews.org]. It was mentioned by pTamok [soylentnews.org] that some of the symptoms of deficiency in vitamin B12 (which has two essential forms [nih.gov]) can be suppressed by the presence of folate, so that cases of B12 deficiency might go unnoticed until irreversible damage occurs.
(Score: 3, Informative) by Dunbal on Saturday April 16 2016, @07:59PM
This is 100% true. Folic acid can mask B12 deficiency for a while. However B12 deficiency is much, much more rare than folic acid deficiency, especially in a population that eats meat and/or eggs.
(Score: 1, Flamebait) by butthurt on Saturday April 16 2016, @08:33PM
It's been said that the elderly tend to absorb vitamin B12 poorly, as compared to younger people.
In a study [nih.gov] of German women aged 60 to 70 years,
Here "tHcy" is short for "total homocysteine" and "MMA" is short for "methylmalonic acid". As I understand it, elevated homocysteine and methylmalonic acid levels indicate deficiency in folate and B12 respectively.
(Score: 2) by Dunbal on Saturday April 16 2016, @08:37PM
Yes I agree with you. For B12 deficiency you're usually looking at someone with an underlying illness - someone with malabsorption syndrome, chronic diarrhea, tumors affecting the terminal ileum (last 10 cm or so of the small intestine, which is the only place B12 can be absorbed), alcoholism, etc. Or a population that is starving and can't get meat. In either case you need to treat the underlying illness, regardless of any public health scheme.
(Score: 4, Insightful) by Dunbal on Saturday April 16 2016, @08:50PM
I should have added - the elderly are full of absorption problems, which is why it's very difficult to judge their medication doses. I've had elderly patients who show signs of overdose on minimal doses, or who require high doses and get the bare minimum effect from their medication. A lot of it has to do with intestinal absorption in this age group. Their intestinal transit time (the time food stays in their intestine being digested) varies a lot depending on what they eat, and they can swing from constipation to diarrhea and back within a week, so their absorbed dose is all over the place. The general rule for them is "start low and go slow". It's also another reason why most prefer to manage elderly diabetic patients on insulin, which is injected, even for type 2 diabetes which can be treated with oral medication. If you can find a care-giver who can handle the dosing and injecting of insulin you get a more stable response than grandma sweating and dying of low blood sugar one day and being in a ketoacidotic coma the next...
Old people are tricky. Crafty, but tricky lol...
Anyway my point is - low B12 is very rare and patients at risk of low B12 should be supervised closely, regardless of any blanket public health policies.