BMJ  2004;329:1376 (11 December), doi:10.1136/bmj.329.7479.1376

Commentary

Folic acid fortification remains an urgent health priority

¹ Department of Epidemiology, Rollins School of Public Health of Emory University, 1518 Clifton Road, Atlanta, GA 3032

The first 150 words of the full text of this article appear below.

Charles and colleagues report a non-statistically significant association between short term prenatal consumption of folic acid and breast cancer.¹ As the authors note, even though these data are from a randomised controlled trial, they had no prespecified hypothesis. The randomised controlled trial sought to evaluate the effect of antenatal folate consumption and pregnancy outcomes, not breast cancer. Only 31 breast cancer deaths were found, and the confidence intervals were wide and include one. We believe that the most likely explanation for the reported association is chance.

In contrast to the results reported by Charles and colleagues, the existing literature indicates that increased chronic consumption of folate and higher blood folate concentrations lower the risk of breast cancer, especially among women who consume one or more drinks of alcohol a day. Shrubsole and colleagues found, in a population based study of 1321 cases and 1382 controls, that dietary folate is inversely . . . [Full text of this article]

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