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Food and folic acid boost child health

Wed May 13th, 2009

Infant heart defects have decreased since mandatory folic acid fortification of flour and pasta began in Canada, according to a new study.

Folic acid intake around conception is known to reduce the baby's risk of neural tube defects such as spina bifida. Women are advised to take supplements, but many governments also support fortification of products such as flour and pasta.

This has been mandatory in Canada since December 1998. New evidence suggests it has also cut the rate of congenital heart defects, the most common of all birth defects.

Researchers led by Professor Louise Pilote of McGill University, Canada, investigated the link among 1,324,440 (live and stillborn) infants born between 1990 and 2005 in Quebec.

In total there were 2,083 infants born with severe congenital heart defects - approximately 1.57 per 1,000 births. In the seven years after fortification there was a statistically significant 6.2 per cent decrease per year, say the researchers on the website of the British Medical Journal.

They write: "These findings support the hypothesis that folic acid has a preventive effect on heart defects."

The reduction might seem modest, but "even a small reduction will significantly reduce the costs associated with the medical care of these patients and the psychological burden on patients and their families".

In the UK, the Food Standards Agency has recommended fortification and the department of health is due to make a decision this year.

However, in a commentary, Dr Helena Gardiner of Imperial College London, UK, questions whether fortification is really sufficient to reduce the risks of neural tube defects and congenital heart disease.

It may even be harmful to some groups, "so, rather than considering fortification targeted at populations, should we find more effective interventions to target women of child bearing age?" she asks.

Ionescu-Ittu, R. et al. Prevalence of severe congenital heart disease after folic acid fortification of grain products: time trend analysis in Quebec, Canada. The British Medical Journal, 2009;338:b1673.

Gardiner, H. M. and Fouron, J-C. Folic acid fortification and congenital heart disease. The British Medical Journal, 2009;338:b1144.

Tags: UK News | Diet & Food | North America | Child Health | Childbirth and Pregnancy | Heart Health

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