The Right to Eat Unfortified Foods and Health Care Reform

Scientists have begun to question the benefits of consuming too much folic acid. Potential risks relate to new estimates on how long it takes the liver to convert folic acid (“56 times slower than previously thought”); its ability to mask particular types of anemia; and an increased risk in “accelerating the growth of existing cancers.” Unlike strained arguments for health care reform, this really is an issue that affects us all: The FDA requires folic acid fortification in staple foods like breads and cereals.

The FDA’s original report on the matter (from 1999) reasons that folic acid fortification prevents neural tube defects among pregnant women. Even if the risks of over-consuming folic acid are all made up, the logic still escapes me for why everyone’s daily bread has to be modified.

The controversy regarding folic acid is just unfolding, and in all fairness it remains on the fringes of mainstream medicine. But you can feel a strong uneasiness on both sides of the issue: The conventional medical opinion says that folic acid fortification is a miracle of public health and you shouldn’t scare the public into believing half-truths. The opposing view, well, implies that poor regulations actively poison us through our food.

It’s too soon to jump to conclusions, but the fear of scaring the public with new info is almost always unfounded. We’re smart enough to figure things out for ourselves. If there is true skepticism about the benefits of folic acid, then we need to hear it. Afterall, we’re the ones who are being forced to consume it.

The debate raises more fundamental questions however about medical regulation, the role of government, medical science, and the rights of food consumers. It is somewhat ironic that we scrutinize new prescription medications given to subsets of the population, and yet gloss over widespread regulations such as this one, which asks the entire population to eat a synthetic diet as if they were all expecting babies.

As the health reform debate rages on, expect similar shortcut solutions, which attempt to lower health care costs through such non-conventional interventions. Already we are seeing calls to increase vitamin D and folic acid in our diet, while decreasing other ingredients that medicine deems harmful, at least at the current moment. Such actions need to be scrutinized carefully and at all levels of action, including the chance that fortification will help those who need it most, and that it'll insure that the vitamins and minerals are actually metabolized. Large-scale epidemiological studies need to make sure that negative health correlates to low levels of vitamins and minerals aren't confounded by low consumption of products like orange juice and enriched flour.

In fixing health care, there's a strong push-and-pull between ensuring that patients have the personalized attention they need, and treating everyone the same. The solution however needs to err on the personalized approach, because treating everyone the same is no way to give people what they need. Indeed, the more we try to treat everyone the same – be it by putting us all on the same medical plan, or force-feeding vitamins and minerals – the more unintentional consequences will result.

-KJ

______________

Media (in order of appearance)

Photo: (1)[Wonder Bread], 02/21/2009, Werklife; (2)Big Brother, 01/03/2008, Ian Geldard; (3)Vitamin water + energy, 05/25/2007, Ryan. Sphere: Related Content