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Folic Acid supplementation: long term safety is not an excuse for inaction
by: Michal R. Pijak
I share Lucock´s (1) concerns related to the fact that "the form of folate in supplements and in fortified foods is pteroylmonoglutamate (PGA), a form that does not occur in nature". The author is rightly critical of increasing tendency among clinicians to give supraphysiological doses of PGA.

In this regard, Ie would like to note that in Slovakia the single PGA is available only in 10 mg capsules. This dose is more than 20 times that needed to give maximal concentrations of the normal form of vitamin in plasma. Moreover, physicians are regularly prescribing up to 30mg/day of PGA according to the Prescription Drug Information.

The major concern, as Lucock point out, is that "we do not know the long-term biological effects of exposure to unmodified synthetic folate". In fact, there is evidence that neurological complications in patients with vitamin B12 deficiency (2) are not the only possible risk of folate supplementation. For example, animal and some clinical studies have suggested that folate supplementation in higher doses may increase cancer risk and accelerate tumor progression (3).

Because the long-term effects of PGA are not known, the best way of folate supplementation is through natural food. Those who are healthy and live healthy life (including eating natural food rich in folate) do not need to take folate in its synthetic supplement form.

In certain situations, however, as is the case for some aged individuals and alcoholics, supplements containing recommended amounts of PGA may be warranted. (4,5) Nevertheless, the countries that adopted a policy of folate fortification of foods should provide monitoring of the benefits and possible harms of such fortification.


1. Lucock M. Is folic acid the ultimate functional food component for disease prevention? BMJ 2004;328:211-4.

2. Reynolds EH. Benefits and risks of folic acid to the nervous system. J Neurol Neurosurg Psychiatry 2002;72:567-71.

3. Kim YI. Role of folate in colon cancer development and progression. J Nutr. 2003;133:3731S-3739S.

4. Bailey LB. Folate, methyl-related nutrients, alcohol, and the MTHFR 677C-->T polymorphism affect cancer risk: intake recommendations. J Nutr 2003;133:3748S-3753S.

5. Wharton B, Booth I. Fortification of flour with folic acid. BMJ 2001;323:1198-9.

About the author:
Dr. Michal R. Pijak is a consultant in rheumatology, allergy and clinical immunology at the University Hospital in Bratislava, Slovakia


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Cancer Diet - Minerals
 by: Marilyn Bennett

A cancer diet needs a good balance of minerals because minerals are needed by all cells for proper function. Patients are often found to be mineral deficient, so this is an area of the diet that needs particular attention.

There are two classes of minerals. Macrominerals, such as the well known calcium, magnesium, sodium, potassium and phosphorus, and microminerals, such as boron, chromium, copper, iron, iodine, germanium, sulfur, silicon, vanadium, zinc, manganese and molybdenum.

The good news is we will get most of the minerals we need, provided we are eating a diet based on a wide variety of fruits and veggies, with the addition of nuts, seeds and grains.

Where we can get in to trouble is that minerals are washed out of soils with constant rain, and modern fertilizers don't usually contain the wide variety of minerals we need. Organic gardeners usually use rock minerals on their soils and this results in organic produce have a much higher and broader range of minerals.

Germanium is one micromineral that cancer patients are often low on. It is essential for immune function and is critical to tissue oxygenation. Cancer grows rapidly where there is low oxygenation of cells. Germanium is found in broccoli, celery, garlic, onions, rhubarb, sauerkraut and tomato juice as well as aloevera and ginseng.

Iodine deficiency has been linked to breast cancer in more than one study. Seasalt contains iodine and a variety of minerals rather than the isolated highly processed iodine additive in table salt. Asparagus, garlic, lima beans, soybeans, sesame seeds all contain natural iodine along with the nutrients needed for good absorption.

Large amounts of brassicas eg brussels sprouts, cabbage and cauliflower, along with peaches, pears and spinach can block absorption of iodine, so ensure there is a balance of iodine rich foods in your diet.

Selenium has been linked to cancer. Selenium and Vitamin E work together to attack free radicals. Selenium is critical for pancreatic function, and pancreatic enzymes are critical to the bodies ability to fight tumour activity. This mineral is generally found in meat and grains, however countries such as New Zealand and much of America is known to have selenium deficient soils.

As there have been several studies showing that good selenium levels have significantly reduced the risk of cancer, this is one mineral you want to have enough of.

Food sources that should be included frequently in a cancer diet are: brazil nuts, broccoli, brown rice, brewers yeast, chicken, kelp, onions, salmon, seafood, tuna, wheatgerm and whole grains. Garlic, chamomile, ginseng and parsley are all easy to use concentrated forms that can be added to the diet daily.

A couple of warnings:

Be very careful about self-dosing with minerals as several of them will block absorption of others if the dose is too high.

Again, eating a variety of foods, with particular notice taken of those that have high mineral levels is the safest way to go. If you wish to explore mineral supplementation further, talk to your naturopath or nutritionist. But whatever you do, don't ignore the importance of these vital elements to your well being.



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