Folate and neural tube defects: The role of supplements and food fortification

Abstract

Periconceptional folic acid significantly reduces the risk of neural tube defects. It is difficult to achieve optimal levels of folate by diet alone, even with fortification of flour, especially because flour consumption in Canada is slightly decreasing. Intermittent concerns have been raised concerning possible deleterious effects of folate supplementation, including the masking of symptoms of vitamin B12 deficiency and an association with cancer, especially colorectal cancer. Both concerns have been disproved. The Canadian Paediatric Society endorses the following steps to enhance folate intake in women of child-bearing age: encouraging the consumption of folate-rich foods such as leafy vegetables, increasing the level of folate food fortification, taking a supplement containing folate and B12, and providing free folate supplementation to disadvantaged women of child-bearing age. These recommendations are consistent with those of the Society of Obstetricians and Gynaecologists of Canada.

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“…Folic acid, also known as vitamin B9 plays an important role in human growth and development. Lack of folic acid in diet can lead to many diseases [77]. Many genes have been found to be involved in the synthesis and metabolism of folic acid in plants such as GTP cyclase gene (GTPCHI), aminodeoxysynthase gene (ADC), hydroxymethyl dihydropurine gene (HMDHP), pyrophosphokinase gene (HPPK) and dihydrocharidase synthase gene (DHP) etc [78]; [79].…”

“…There was no significant change in folic acid content in transgenic plants with the overexpression of GTPCHI gene, but it should increase the folic acid content in transgenic plants to 50-100 times than the original level when GTPCHI gene and ADCS gene were overexpressed at the same time [81]. Using the promoter from maize driven barley gene HPPK/DHPS to express in rice, it was found that the content of folic acid in transgenic rice seeds reached about 1.5 times of the original level [77]. Therefore, through the strategy of metabolic engineering, using the genes related to folic acid biosynthesis pathway in close related species of rice, it can also increase the content of folic acid in rice grains.…”

Women’s Diet During Pregravid Preparation, Pregnancy and Lactation

“…Дополнительный прием фолатов в преконцептуаль ном периоде на 70-92% сокращает риск развития дефектов нервной трубки; до 26-40% снижает уровень врожденных пороков сердца (при этом отмечен дозозависимый эффект: увеличение дозировки до 800 мкг улучшает показатель до 58%) [21,22]; снижает опасность развития преэкламп-сии, ранней отслойки плаценты и преждевременных родов [23], а также предотвращает развитие других нарушений эмбриогенеза, таких как синдром Дауна, аномалии мочевы-делительной системы, верхних и нижних конечностей, ушей, расщелина твердого и мягкого неба, омфалоцеле [24][25][26]. Кроме того, достаточное потребление фолатов в прекон-цептуальный период ассоциируется с высоким индексом психического развития ребенка, отсутствием когнитивных нарушений, снижением риска развития онкологических заболеваний, депрессии, аутизма и шизофрении [27,28].…”

Folic acid, dietary habits, and homocysteine levels in relation to neural tube defects: A case–control study in North India

“…Nutritional factor is the most common environmental factor influencing susceptibility to diseases. A substantial reduction in the occurrence of NTD was observed with the maternal peri‐conceptional folate supplementation (Ami et al, ) on account of the fact that the neural tube closes 23–27 days after conception. But in India, national guidelines on the proper dose of folic acid to pregnant women are not available (Paayal, Ganesh, & Shaantanu, ).…”