According to a report published Online First by the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals, healthier nutritional choices by pregnant women are connected with lower birth defect risks, such as orofacial clefts and neural tube defects.

The researchers note that although folic acid does not prevent all birth defects, it has been effective in the prevention of neural tube defects. They write:

“Nutrition research on birth defects had tended to focus on one nutrient (or nutritional factor) at a time. However, the reality of nutrition is much more complex.”

Suzan L. Carmichael, Ph.D., from Stanford University, Stanford, Calif., and colleagues used data from the National Birth Defects Prevention investigation in order to “examine whether better maternal diet quality was associated with reduced risk for selected birth defects.” The data was gathered from telephone interviews with pregnant women (72% case and 67% control mothers) who had estimated due dates between October 1997 to December 2005 across ten states. 2,475 cases with orofacial clefts, 936 cases with neural tube defects, as well as 6,147 controls that didn’t have birth defects were included in the examination. In a survey, mothers revealed their food intake. The investigators created two diet quality indices that focused on overall diet quality based on the U.S. Department of Agriculture Food Guide Pyramid (Diet Quality Index or DQI), as well as the Mediterranean Diet (Mediterranean Diet Score or MDS).

They researchers discovered:

“Increasing diet quality base on either index was associated with reduced risks for the birth defects studied. Most mothers of controls (children without birth defects) were non-Hispanic white and had more than a high school education; 19 percent smokes, 38 percent drank alcohol, and 78 percent took folic-acid-containing supplements during early pregnancy; and 16 percent were obese.

Women who were Hispanic had substantially higher values for the DQI and MDS, whereas values were lower among women with less education and women who smoked, did not take supplements, or were obese.”

They conclude:

“based on two diet quality indices, higher maternal diet quality in the year before pregnancy was associated with lower risk for neural tube defects and orofacial clefts. This finding persisted even after adjusting for multiple potential confounders such as maternal intake of vitamin/mineral supplements. These results suggest that dietary approaches could lead to further reduction in risks of major birth defects and complement existing efforts to fortify foods and encourage periconceptional multivitamin use.”

In an associated report, David R. Jacobs, Jr., Ph.D., from the University of Minnesota, Minneapolis, and colleagues highlight that even though it is important for women to take folic acid for fetal development, recent investigations indicate that supplemental folic acid might have health side effects on older individuals:

“The importance of the findings of Carmichael et al lies in showing that women obtain benefit from the consumption of a high-quality diet, beyond the benefits derived through grain fortification. This raises the question of whether a high-quality diet alone may be sufficient to prevent NTDs (neural tube defects) ‚Äì a strategy that would also remove the potential harm from fortification.

The lesson from the article by Carmichael el al is an important one: people, including women of childbearing age, should eat good good.

Reduction of NTDs may be achievable by diet alone, at the same time reducing potential risk for other chronic disease in the rest of the population.”

Written by Grace Rattue