Term of Award
Doctor of Public Health in Epidemiology (Dr.P.H.)
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Dissertation (restricted to Georgia Southern)
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This work is licensed under a Creative Commons Attribution 4.0 License.
Department of Biostatistics, Epidemiology, and Environmental Health Sciences
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The mandatory food fortification with folic acid, a synthetic form of folate (vitamin B9), has led to a marked reduction in neural tube defects in the United States. However, this public health success may have unintended consequences for the general population due to folate overconsumption. Folate is central to carbon metabolism and is needed for DNA synthesis and DNA methylation, providing plausible biological mechanisms through which folate could modulate cancer risk. The optimized folate amount remains to be illustrated. To assess the relationship between folate and risk of colorectal cancer, the second cancer killer in the United States, we analyzed 14,528 adults aged 19 or older who participated in the 3rd National Health and Nutrition Examination Survey (1988-1994, before folic acid fortification) as the baseline examination. After 18 years of following up, we found that the risk of dying from colorectal cancer in adults with upper quarter folate intake was 1/10th (or 90% lower) of that in adults with lower quarter intake. More efforts are needed to delicately control other vitamins with cohorts exclusively recruited after the initiation of mandatory fortification.
Bhattacharya, Anunay, "A Puzzle with Significant Public Health Importance but Never Finished: The Relationship between Colorectal Cancer and Folate" (2021). Electronic Theses and Dissertations. 2354.
Research Data and Supplementary Material
Available for download on Monday, January 04, 2027