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Comment by ksenzee | Hacker News Reader

Flour fortification is one of the great public health successes of the 20th century, and I’m not aware of any data showing that folic acid is any more harmful than any of the other synthetic B vitamins added to our food. I’ve actively looked for such data, as someone with the fairly common genetic mutation affecting MTHFR, and frankly all I find is nonsense.

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To expand on "great public health successes": folic acid supplementation is particularly important if you're pregnant, because it significantly reduces the odds of having a baby with neural tube defects like spina bifida (which is one of the milder NTDs, frankly). But it's also important even if you're not pregnant because B vitamin deficiencies will wreck your health.

This also reminded me of a great post from a few years ago about why salt is fortified with iodine: https://news.ycombinator.com/item?id=38782954

Yes, the FDA has been emphatic that the folic acid supplementation program is a success and we would be fools to think anything else. The reality, as best I can tell, is more nuanced and for a minority of people it's possible to have too much of a good thing, particularly where 5-MTHF would be more beneficial.[1]

I don't hope to resolve the debate, only to point out it should be possible to eat bread that is not fortified with folic acid, if for no reason than I'm not in the high risk group targeted by the FDA and there are potential benefits from reducing folic acid intake in the context of robust intake of folate from other sources.

Or, even simpler: why can't I buy bread without folic acid?

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC11930790/

Right, so I looked at that paper and its citations, and I am still not seeing any studies showing that folic acid supplementation causes problems beyond "can mask signs of B12 deficiency," which is not very compelling. I did see one paper saying "we thought excess maternal folic acid consumption might lead to asthma in children, but nope, it doesn't." To be clear, my bias is actually against folic acid supplementation: we should be using bioavailable folate, at the very least in prenatal vitamins. But I just don't see any data showing actual harm from folic acid.

I can buy unfortified bread at each of the grocery stores in my small town. I can also buy it at the local bakery and at the bread stand at our small farmers market.

It would not surprise me that there are some places in the US that only have easy access to packaged industrial sandwich bread. It would surprise me very much if that was the norm for Americans.

This is interesting to me, because I'm not aware of anywhere I can get unfortified flour. Even the artisan bread at the farmer's market is usually made of flour subject to FDA regulations.

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