High doses of folic acid don’t raise cancer risk

Updated 29 January 2013
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High doses of folic acid don’t raise cancer risk

PEOPLE TAKING HIGH doses of the B vitamin folic acid are not at an increased risk of cancer, according to an international analysis — easing some concern about the possible side effects of national programs aimed to raise intake of the vitamin.
The United States and Canada have required flour to be fortified with folic acid since 1998, after deficiencies of it in pregnant women were tied to brain and spinal cord birth defects in their babies.
But fortification isn’t required in Western Europe, for example, partly out of concern that the extra folic acid might slightly increase people’s risk of cancer due to its role in cell growth. Cells, including cancer cells, need folate — the natural form of folic acid — to grow and divide.
“Folic acid supplementation does not substantially increase or decrease incident of site-specific cancer during the first 5 years of treatment,” researchers wrote in The Lancet.
“Fortification of flour and other cereal products involves doses of folic acid that are, on average, an order of magnitude smaller than the doses used in these trials.
For the analysis, the researchers combined data from 13 separate trials that randomly assigned participants to daily folic acid or a vitamin-free placebo and recorded who went on to develop cancer.
The studies included a total of close to 50,000 volunteers who were followed for just over five years, on average.
During that time, 7.7 percent of people in the folic acid groups, and 7.3 percent in the placebo groups, were diagnosed with any kind of cancer, a difference that could have been due to chance, researchers said.
Likewise, there was no increased risk of individual cancers — including colon, prostate, lung or breast cancer — attributed to folic acid.
Most trials used daily doses of folic acid between 0.5 and 5 milligrams. In the one study that used a much larger dose, 40 mg daily, there was still no difference in cancer diagnoses.
The total daily amount of folic acid through flour fortification is less than 0.5 mg a day for most in the United States. Folic acid is also naturally found in spinach, asparagus, lettuce and other greens, with a recommended daily upper limit of 1.0 mg.
“The conclusion you can make from this is that over a relatively short period of time, there was no significant benefit or harm,” said John Baron from the Geisel School of Medicine at Dartmouth in Lebanon, New Hampshire, who worked on the review.
Most cancers take 10 to 20 years to develop, so it’s hard to tell from shorter studies like this one if there really is no link or if the researchers didn’t follow people for long enough to see an association, whether positive or negative, he added.
The researchers agreed that the study shouldn’t be the last work on the potential side effects of folic acid.
For now, said nutrition researcher Joshua Miller of Rutgers University in New Jersey, people might want to avoid piling supplements on top of multivitamins and fortified food.
“People should realize if they’re eating breakfast cereals and bread and pastas, they’re getting a good amount of folic acid in food,” he said. “I think they should try not to exceed the upper limit.”


Ramadan recipes: My Egyptian grandmother’s old school kunafa

Updated 27 May 2018
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Ramadan recipes: My Egyptian grandmother’s old school kunafa

CAIRO: Believed to have originated in the Levant, kunafa is said to have been introduced to what is now known as Egypt during the era of the Fatimids.

However, if you spent any time at all in my grandmother’s household, you would think that she herself invented the deliciously crunchy dessert, she is such an expert.

She often tells me of how, when growing up in Cairo, she would purchase the dough from a street-side man swirling the batter round and round on a drum-like furnace made of clay.

My generation has revamped the age-old favorite and a range of outlandish fillings — from mangoes, to Nutella and avocados — are now available across Egypt and the wider Middle East.

Ramadan is the perfect time to try this popular dessert and while it is easy as pie to pop to your local bakery, there is nothing quite like making it at home.

The original gangster of the kunafa world will always reign supreme, in my humble, well-fed opinion. So read on and give it a go for iftar today.

Ingredients:

• Katafi (shredded phyllo dough).
• One-and-a-half cups of granulated sugar.
• One cup of water.
• One juiced lemon.
• One teaspoon of rose water.
• 1/3 cup of finely chopped pistachios.
• Ghee as needed.

Method:

Grease an oven dish with melted ghee then place the shredded katafi pastry in a bowl and mix it with ghee. You can cut the already shredded pastry further if needed.

Take the mixture and layer it into the greased pan by pressing lightly with your hand.

Bake for 30 minutes at 350F.

On the side, prepare the sugary syrup by adding one cup of water, the granulated sugar and lemon juice to a pan. Stir and bring the mixture to a boil. Let the liquid simmer until it reaches a syrupy consistency. Remove from the heat, let it cool and add the rosewater (or even a few drops of vanilla essence).

Let the shredded pastry cool and drizzle over with the syrup, before you add a sprinkling of the finely chopped pistachios.

If you're looking for something a little different, bear in mind that Ramadan is kunafa season in Egypt and every year, the shredded wheat dessert gets tens of creative makeovers as bakers across the country — and indeed across the Middle East —buck tradition with their innovative fillings.

Why not try one of these delicious variants of the kunafa?

Mango 

When Ramadan began coinciding with the summer season, mango kunafa emerged as a tradition-breaker. The sweet fruit became a popular filling, replacing longtime favorites, such as nuts, cheese and cream. It combines spun-shredded wheat with whipped cream in a dish that is topped with chopped mangoes. 

Chocolate  

This recipe proved irresistible to many when it first caused a storm on social media. The kunafa is filled with hazelnut chocolate filling and is served in various forms, such as chocolate kunafa cones or the molten volcano kunafa. Some bakers even add a layer of peanut butter on top to seal the deal.

Red velvet

This type of kunafa emerged during the recent red velvet craze that swept Egypt.  The creation combines a layer of red velvet cake with shredded wheat and whipped cream.   

Avocado

This one’s sure to please avocado-loving millennials. Last year, a small bakery in Egypt became the talk of the town when it began using avocado as a kunafa filling. It may not be as popular as various other fillings, but it definitely got tongues wagging.

Biscuits 

Oreo cookies are being used to update the humble kunafa this year. Delectably crunchy Lotus biscuits are also being used to create achingly sweet kunafa treats.

Watermelon 

Yes, you read that right! Another seasonal fruit has just joined the club. It remains unclear if the trend will endure, however, as the idea of combining watermelon with shredded wheat is quite unusual. It is ideal for the soaring temperatures this summer, but will it win over dessert lovers? Only time, and empty plates, will tell.