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Folic acid-fortified foods associated with reduced risk for congenital heart defects
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Foods fortified by folic acid are linked to a decline in congenital heart defects, according to a study published in Circulation.
Researchers analyzed a Canadian cohort of 5,901,701 people born between 1990 and 2011, 72,591 of whom had a congenital heart defect diagnosed at birth or infancy.
According to the study background, in 1998, Canada mandated that folic acid be added to all types of flour, enriched pasta and cornmeal to prevent neural tube defects; the United States adopted a similar regulation around the same time.
“Our study examined the effect of folic acid food fortification on each specific subtype of congenital heart disease based on the Canadian experience before and after food fortification was made mandatory in 1998,” K.S. Joseph, MD, PhD, professor in the department of obstetrics and gynecology and the School of Population and Public Health at the University of British Columbia, Vancouver, said in a press release.
The study was controlled for maternal age, pregnancy diabetes, preterm preeclampsia, multiple births, termination of pregnancy and pregnancy complications.
The researchers found folic acid fortification in foods was linked to an 11% reduction of congenital heart defects between 1990 and 2011.
Joseph and colleagues found that folic acid fortification was associated with a 27% reduction in conotruncal defects (adjusted rate ratio [aRR] = 0.73; 95% CI, 0.62-0.85), a 23% reduction in coarctation of the aorta (aRR = 0.77; 95% CI, 0.61-0.96), an 18% reduction in atrial septal defects (aRR = 0.82; 95% CI, 0.69-0.95) and a 15% reduction in ventricular septal defects (aRR = 0.85; 95% CI, 0.75-0.96).
There was no link between folic acid fortification and severe nonconotruncal defects (aRR = 0.81; 95% CI, 0.65-1.03) or other abnormalities of the heart or circulatory system (aRR = 0.98; 95% CI, 0.89-1.11), according to the researchers.
Women likely to get pregnant should take folic acid supplements because intake from diet alone may not be adequate, Joseph said in the release.
“Our ecological study provides modest evidence of a protective effect of folic acid food fortification on [congenital heart defects],” the researchers wrote. – by Dave Quaile
Disclosure: The researchers report no relevant financial disclosures.
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