Congenital Heart Defects Decline After Food Fortification With Folic Acid

Health In Focus   - G J E 4
  • Folic acid is an essential micronutrient during pregnancy
  • Deficiency of folic acid can cause neural tube defects
  • Folic acid food fortification has reduced the rates of congenital heart defects by 11 percent

Folic acid is one of the B vitamins (B9) also known as folate. Folic acid plays a crucial role in the brain function, mental and emotional health. Folic acid fortified foods can reduce the rates of congenital heart defects, says a new study.
Congenital Heart Defects Decline After Food Fortification With Folic Acid

Folic acid is an essential nutrient for women before and during pregnancy. Women are recommended to take folic acid at least 1 month before becoming pregnant. An adult woman needs 400mcg of folic acid a day. A pregnant woman needs 600mcg of folic acid per day to prevent neural birth defects.

‘Folic acid food fortification in cereals, flours and pasta helped lower the overall rates of congenital heart defects (narrowing of aorta and ventricular septal defects) by 11 percent.’
The study examined the effect of folic acid fortified food on the subtype of congenital heart disease. "Our study was based on the Canadian experience before and after food fortification was made mandatory in 1998," said K.S. Joseph, M.D., Ph.D., the study's senior author and professor in the partment of Obstetrics and Gynecology and the School of Population and Public Health at the University of British Columbia in Vancouver, Canada.

The researchers analyzed the data from nearly 6 million Canadian births from 1990 to 2011. Factors such as maternal age, pregnancy complications, multiple births (twins, triplets), prenatal diagnosis and pregnancy terminations were controlled. The researchers found that folic acid food fortification reduced the overall rates of congenital heart disease by 11 percent.

Beneficial Effects of Folic Acid in Congenital Heart Defects

1. Folic acid reduced the rates of conotruncal defects or severe heart outflow tract abnormalities by 27%

2. Coarctation of the aorta (CoA), also called aortic narrowing was reduced by 23%

3. Atrial and ventricular septal defects (ASD or VSD) - holes in the wall separating heart chambers was reduced by 15%

However, there were no changes in the chromosomally associated defects (abnormality in the number of chromosomes). In 1998, the Canadian government made it mandatory to fortify all types of flours, pasta and cornmeal with folic acid to prevent neural tube defects. The researchers said that the findings of the study apply to the US population as well. "Folic acid food fortification was implemented at the same time in the US as Canada because of the North American Fair Trade Agreement of 1994," said Joseph.

The research is published in the American Heart Association's journal Circulation .

Birth Defects

Pregnant women who do not get adequate folic acid are more likely to have children with birth defects. Women should take folic acid supplements before and during pregnancy to prevent the risk of birth defects. Folic acid promotes rapid growth and cell division during pregnancy. Folic acid deficiency causes neural tube defects such as cleft palate, brain damage and spina bifida (abnormality of the spine and spinal cord). Some of the dietary sources of folic acid are kale, spinach, orange juice, dark green leafy vegetables, avocado, salmon, and milk. But, dietary sources alone do not meet the daily requirement of folic acid.

"Women who are likely to get pregnant should take folic acid supplements before getting pregnant as they may not necessarily receive adequate folate from diet alone," said Joseph.

Congenital heart defects are the most common types of birth defects. About 40,000 babies are born with congenital heart defects per year in the United States. The most common type of congenital heart disease is a ventricular septal defect.

A study published in the Nature Reviews of Neuroscience showed that women who take folic acid supplements before pregnancy and during the first trimester reduced the risk fo neural tube defects in infants by 75 percent. Other studies have shown that folic acid may also prevent miscarriage and lower the risk of autism.

  1. Folic acid fortified food linked to decline in congenital heart defects - (
  2. Neural tube defects and folate: case far from closed - (
Source: Medindia

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