It is imperative to make women aware that they may be endangering their health and the health of their unborn children by using conventional supplements.

Nearly all multivitamins and prenatal vitamins contain folic acid.  Unlike most physicians, I do not recommend folic acid supplementation for pregnant women.  Folic acid supplementation can damage the health of women and their children.

Folic acid is the synthetic form of folate, a member of the family of B vitamins that is involved in regulating DNA synthesis and gene expression. Because of these crucial functions, folate plays an important role in fetal development - folate is essential during pregnancy, especially early on in pregnancy, for the prevention of neural tube defects. Folate is abundant in green vegetables like spinach, collards, bok choy, artichokes, and broccoli.

The Standard American Diet (SAD) is so nutritionally inadequate that the U.S. government and most physicians encourage women to take folic acid supplements, assuming that they do not eat green vegetables and are folate deficient.

Taking synthetic folic acid is not the same as getting natural folate from vegetables.

Scientific studies have revealed the dangers to women and their children involved in taking folic acid supplements:

• Women who followed the typical recommendations to take folic acid during pregnancy and were followed by researchers for thirty years were twice as likely to die from breast cancer.¹   Another study following women for ten years concluded that those who took multivitamins containing folic acid increased their breast cancer risk by 20-30%.²   Folic acid in supplement form may contribute to producing a cancer-promoting environment in the body - in addition to breast cancer, synthetic folic acid has been linked to dramatic increases in prostate and colorectal cancers, as well as overall cancer incidence.³
• Folic acid supplementation by pregnant women has been associated with incidence of childhood asthma, infant respiratory tract infections, and cardiac birth defects.⁴

However, food folate is associated with benefits for both women and children:

• Women with lower levels of food folate intake are more likely to be diagnosed with breast cancer.⁵
• The children of women who consumed more food folate during pregnancy were less likely to develop ADHD.⁶
• Several studies have made connections between vegetable intake during pregnancy and lower risks of childhood cancers.⁷

Women deserve to know the facts on the subject so they can make an informed decision.  The problem here is that the message that folic acid is an essential prescription to prevent neural tube defects diminishes the good that can come from using the "folate is important" message to encourage the consumption of (high-folate) vegetables.  Green vegetables do more than merely prevent neural tube defects.  If this was accomplished other congenital defects and cancers could have been avoided in both mother and child.

I am not claiming a women who refuses to eat properly should not take folic acid.   However, I offer a safer option for more informed and motivated mothers and mothers-to-be.  So this is not about ignoring the importance of folate and developmental and medical problems that could result from deficiencies, rather this is about the significant importance of getting real folate from greens and  not relying on synthetic folic acid from  supplements. 

Yes, we can win the war on cancer, on heart disease with the advancements that have been made in nutritional science. Let not live with our heads buried in mediocrity. 

This is too important an issue to ignore, and women are simply not told the facts here.  I decided to take action and also developed a prenatal and other supplements that do not contain folic acid as well as other supplemental ingredients with documented risks.⁶ 

Visit Dr. Fuhrman's website for more information. 

Rich sources of food folate

As a reference point, the U.S. RDA for folate is 400μg.  Below is the approximate folate content for a 100-calorie serving.¹⁷

References:

1. Charles D et al. Taking folate in pregnancy and risk of maternal breast cancer. BMJ 2004;329:1375-6

2. Stolzenberg-Solomon RZ et al. Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am J Clin Nutr. 2006 Apr;83(4):895-904.

3. Fife, J et al. Folic Acid Supplementation and Colorectal Cancer Risk; A Meta-analysis. Colorectal Dis. 2009 Oct 27. [Epub ahead of print]

Hirsch S et al. Colon cancer in Chile before and after the start of the flour fortification program with folic acid. Eur J Gastroenterol Hepatol. 2009 Apr;21(4):436-9.

http://www.medscape.com/viewarticle/591111

Figueiredo JC et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst. 2009 Mar 18;101(6):432-5. Epub 2009 Mar 10.

Ebbing M et al. Cancer Incidence and Mortality After Treatment With Folic Acid and Vitamin B12. JAMA. 2009;302(19):2119-2126

4.  Whitrow MJ. Effect of Supplemental Folic Acid in Pregnancy on Childhood Asthma: A Prospective Birth Cohort Study. Am J Epidemiol. 2009 Oct 30. [Epub ahead of print]

Haberg SE, London SJ, Stigum H, Nafstad P, Nystad W. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child. 2009 Mar;94(3):180-4. Epub 2008 Dec 3.

Källén B. Congenital malformations in infants whose mothers reported the use of folic acid in early pregnancy in Sweden. A prospective population study. Congenit Anom (Kyoto). 2007 Dec;47(4):119-24.

5. Sellers TA et al. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology. 2001 Jul;12(4):420-8.

Kim YI. Does a high folate intake increase the risk of breast cancer? Nutr Rev. 2006 Oct;64(10 Pt 1):468-75.

6. Wiley-Blackwell (2009, October 28). Attention-deficit/hyperactivity Problems Associated With Low Folate Levels In Pregnant Women. ScienceDaily. Retrieved February 5, 2010, from http://www.sciencedaily.com /releases/2009/10/091028134631.htm

7. Kwan ML et al. Maternal diet and risk of childhood acute lymphoblastic leukemia. Public Health Rep. 2009 Jul-Aug;124(4):503-14.

Tower RL et al. The epidemiology of childhood leukemia with a focus on birth weight and diet. Crit Rev Clin Lab Sci. 2007;44(3):203-42.

Petridou E et al. Maternal diet and acute lymphoblastic leukemia in young children.Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1935-9.

Jensen CD et al. Maternal dietary risk factors in childhood acute lymphoblastic leukemia (United States).Cancer Causes Control. 2004 Aug;15(6):559-70.

Huncharek M et al. A meta-analysis of maternal cured meat consumption during pregnancy and the risk of childhood brain tumors. Neuroepidemiology. 2004 Jan-Apr;23(1-2):78-84.

8. Bjelakovic G, Nikolova D, Gluud LL, et al. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD007176.

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