Folate - the "wonder vitamin." (part 1)

Editor's note: The following article is part one of a two-part series on folate to be concluded in the December 1995 issue.

Folic acid - formerly known as folacin, now as folate - is one of I I vitamins in the B complex. In conjunction with cyanocobalamin (vitamin [B.sub.12]), it is responsible for maintaining normal synthesis of DNA in all cells of the body. When DNA synthesis is disturbed by a deficiency of either vitamin, abnormal cells result; depending upon the site and extent of abnormal cell production, the consequences may be severe.

The earliest sign of folic acid or vitamin [B.sub.12] deficiency is a megaloblastic anemia - so-called because of the abnormal production of megaloblasts, the precursors of mature red cells. Doctors recognized this form of anemia more than 150 years ago, calling it "pernicious anemia." Not until 1926, however, did two Harvard physicians, Minot and Murphy, discover that feeding liver to such patients cured their disease (for which the doctors received the Nobel prize).

Twenty years later, another group of researchers isolated vitamin [B.sub.12] from crude liver extracts and produced it in crystalline form. Dr. Christian Jansen, an Indianapolis-based researcher, discovered that a half gram of oral [B.sub.12] daily can successfully prevent pernicious anemia, thus making [B.sub.12] injections unnecessary.

Women are advised to take folic acid during childbearing years to prevent neural tube defects like spina bifida and anencephaly. However, the value of folic acid in preventing orofacial clefts (e.g., cleft palate) was unknown until California researchers studied 731 children born with cleft palates, as reported by the California Birth Defects Monitoring Program.

The British medical journal Lancet (August 12, 1995) reported the results of this study, which compared mothers of these children with a control group of mothers who bore normal children during the same period. They found that mothers who used multivitamins containing folic acid, or ate breakfast cereal fortified with it, had a 25 to 50 percent reduced risk of having offspring with orofacial clefts. The authors wrote, "These data, however, cannot adequately disentangle whether the reduced risk is attributable to folic acid, to another vitamin or mineral constituent in multivitamin supplements, or to healthy behavior correlated with folic acid, multivitamin, or cereal use." Whether a cause-and-effect relationship exists, the use of multivitamins with folic acid and fortified breakfast cereals during pregnancy is highly recommended.

Even more promising are the results of recent studies suggesting that large doses of folic acid may be instrumental in preventing colorectal cancer - the third most common cancer in the United States after breast and prostate cancer.