Congenital Heart Defects Prevention with Folic Acid?

Written by Dr. Steve Chaney on . Posted in folic acid and congenital heart defects

Does Methyl Folate Work As Well?

Author: Dr. Stephen Chaney

 

congenital heart defects preventionCan folic acid aid in congenital heart defects prevention?

Every once in a while, a scientific study revolutionizes the practice of medicine and transforms how we lead our lives. The study showing that folic acid supplementation reduced the risk of neural tube defects in newborns was such a study.

First a little history: Dr. Richard Smithells and his colleague Elizabeth Hibbard first started to suspect that folic acid deficiencies were linked to neural tube defects such as spina bifida in the early 60s. By the early 70’s there was enough circumstantial evidence for this link that most doctors were recommending pregnant women start on a prenatal supplement containing folic acid once their pregnancy was confirmed by the obstetrician.

That was when Dr. Smithells convinced the Medical Research Council (MRC) of England to conduct a major, multi-center trial to definitively test his hypothesis. The MRC study (MRC Vitamin Study Research Group, Lancet 338: 131–137, 1991) was terminated in 1991 when it became clear that it was unethical to continue withholding folic acid from the placebo group. The study clearly showed:

  • Folic acid supplementation reduced the incidence of neural tube defects in newborns by 72%.
  • Supplementation with folic acid must start prior to conception for maximum efficacy. If women waited until their pregnancy was confirmed by their doctor, the benefits of folic acid supplementation were much weaker. By then, as the old saying goes: “The horse was already out of the barn”.
  • Subsequent studies have shown that folic acid supplementation is effective at reducing neural tube defects even when the mother and/or baby have MTHFR deficiencies.

As I mentioned before, this study revolutionized medicine and public health in this country.

  • The U. S. Public Health Service and CDC changed their recommendation to “All women of childbearing age should consume at least 400 micrograms of folic acid daily to prevent neural tube defects.
  • Starting in 1998, the United States and Canada mandated folic acid fortification of all flour, enriched pasta, and cornmeal.

 

What About Congenital Heart Defects Prevention?

 

folic acid congenital heart defectsWith the clear success of folic acid reducing the risk of neural tube defects, it was natural to ask whether folic acid supplementation might also help with congenital heart defects prevention. Heart defects affect 1% of all newborn babies. While they can often be treated with surgery, that is horribly expensive and not always successful.

As with neural tube defects, previous clinical studies have provided clear evidence that supplementation with at least 400 mcg/day of folic acid reduces the risk of heart defects in newborns. A meta-analysis of 18 clinical studies estimates the risk-reduction at 28% (Scientific Reports, 5: 8506, DOI: 10.1038/srep08506 ).

The authors of this study (Liu et al, Circulation 134: 647-655, 2016 ) set out to determine whether folic acid fortification had significantly reduced newborn heart defects in Canada. They utilized a database of the Canadian Institute for Health Information that covered 98% of births and stillbirths between 1990 and 2011.

Did folic acid supplementation aid in congenital heart defects prevention?

Of the 5,901,701 births and stillbirths in this database, 72,591 were diagnosed with some type of heart defect. The investigators then compared the prevalence of heart defects before and after 1998 to determine the effect of folic acid fortification on heart defects.

 

Does Folic Acid Aid in Congenital Heart Defects Prevention?

 

folic acid fortifiedThe results of the study were clear cut. Folic acid fortification of flour:

  • Reduced heart outflow abnormalities by 27%.
  • Reduced narrowing of the aorta by 23%.
  • Reduced holes in the heart wall separating the chambers by 15%.

Some types of heart defects were not significantly affected by folic acid fortification, so the overall reduction in newborns with heart defects was 11%.

The paper concluded “Although food fortification with folic acid was aimed primarily at reducing neural tube defects, this population based intervention may also have had a beneficial effect on specific types of [heart defects], which in aggregate are more common.”

Overall, folic acid fortification (providing an extra 100 mcg/day folic acid) did not appear to be as effective as supplementation with 400 mcg/day folic acid at reducing total heart defects in newborns. Perhaps because of that, the senior investigator in the study was quoted as saying “Women who are likely to get pregnant should start taking folic acid supplements before getting pregnant as they may not necessarily receive adequate folate from diet alone.”

 

Does Methyl Folate Aid in Congenital Heart Defects Prevention as Well?

methyl folate mythMethyl folate is being widely promoted as safer, more natural, better absorbed, and more effective than folic acid. I have thoroughly debunked the first three claims in my video “The Truth About Methyl Folate.

What about the claim that methyl folate is more effective than folic acid?

The fact is we don’t even know whether methyl folate is even as effective as folic acid. The studies on neural tube defects and heart defects were done with folic acid, not methyl folate. There are literally thousands of studies on the health benefits of folic acid. Almost all of them were done with folic acid, not methyl folate. It is reasonable to assume that methyl folate might be as beneficial as folic acid, but without clinical studies we simply don’t know.

The few clinical studies that have used methyl folate have not included patients that were given folic acid instead of methyl folate. Without that kind of direct comparison, it is impossible to know whether methyl folate is less effective, the same, or more effective than folic acid.

Finally, there is the claim that methyl folate is more effective than folic acid in people with MTHFR deficiencies. Until we start seeing clinical studies directly comparing the effect of methyl folate and folic acid supplementation on health outcomes in people with MTHFR deficiencies, it is impossible to verify that claim. Once again, methyl folate might be less effective, the same, or more effective than folic acid. We simply don’t know.

Folic Acid does aid in congenital heart defects prevention and methyl folate may.

 

The Bottom Line

 

  • It has been clearly established that folic acid supplementation reduces the risk of neural tube defects in newborns, and that food fortification with folic acid has also helped reduce the incidence of neural tube defects.
  • Previous studies have also shown that folic acid supplementation reduces the risk of heart defects in newborns.
  • A recent study has shown that food fortification with folic acid also contributes to a reduction in the risk of giving birth to babies with heart defects.
  • The U. S. Public Health Service and CDC recommend “All women of childbearing age should consume at least 400 micrograms of folic acid daily to prevent neural tube defects.” Based on the latest studies, folic acid aids in congenital heart defects prevention as well.
  • The studies on neural tube defects and heart defects were done with folic acid, not methyl folate. It is reasonable to assume that methyl folate might be as beneficial as folic acid, but without clinical studies we simply don’t know whether it is even as effective as folic acid.
  • As for other claims about methyl folate, there are no clinical studies I am aware of directly comparing methyl folate and folic acid. Without that kind of study, it is impossible to know whether methyl folate is less effective, the same, or more effective than folic acid.

 

For details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (4)

  • Robin

    |

    No mention here of the 4 possible MTHFR mutations that I understand is present in 30 – 40% of the population. People with this mutation do not adequately process folic acid into methyl folate. For the most affected taking folic acid can be harmful. This can contribute to heart disease and play a role addiction behaviors and heart disease and bipolar disease.

    Reply

    • Dr. Steve Chaney

      |

      Dear Robin,

      Unfortunately, there is no evidence to back up your statements. I have addressed this in detail in my video “The Truth About Methyl Folate”
      (https://www.youtube.com/watch?v=MzT-iU8UIwo)

      Dr. Chaney

      Reply

  • Jeanne

    |

    Dr. Chaney,
    I like what you have to say. You are very sincere and scientific and do not prey on the ignorance of most people. I like the fact that your articles are short, not too technical, and not full of promises. I also like the summary at the end of each article.
    Can you address the issue of clean water and whether or not to add minerals to distilled or purified water? If you have already addressed this issue please send me a link.
    Thank you and God bless your work,
    Jeanne Dart

    Reply

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Posted April 18, 2017 by Dr. Steve Chaney

Shin Pain or Shin Splints Caused By Driving

 

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

Driving and shin pain happens to many people. Fortunately, relief is easy to get with just a few minutes of focused self-treatment.

If you drive long distances you are repetitively straining the muscle that runs down the outside of your shin bone. The muscle called tibialis anterior spans from below your knee along your shin bone and inserting into your arch.  It can become so tight that the fibers will begin to pull away from the bone, a condition called “shin splints.”  This is a painful condition and is easy to fix.  Continue reading for

Shin Splint Treatment You Can Do Yourself

shin splint treatmentTo find the muscle, press your fingers on the thick muscle that is just to the outside of your shin bone. Pick up the front of your foot, and then press down, like you are applying pressure to your gas pedal.  You’ll feel the muscle contracting under your fingertips.  As you are driving for hours, the muscle can get so strained you’ll have shin pain all the way to the front of your ankle.

There are several things you can do for shin splint treatment and relieving the tightness of this muscle. You can use the Julstro Perfect Ball (don’t leave home without it), or a tennis ball which is less effective but will work. Place the ball at the top of the muscle, just below your knee. Then press down hard and slide all the way to your ankle. Curling your toes as shown will help stop the feeling of a cramp in your arch.

You’ll find a tender point about mid-way down the muscle, it may even feel like a bump.  This is the common site of the spasm that is shortening the muscle fibers and causing them to put pressure onto your shin bone. Keep pressing your lower leg into the ball until it doesn’t hurt any longer.  You’ve gone a long way to releasing the tension in the muscle and eliminating the pain.

pain free living bookMy book, Treat Yourself to Pain Free Living , or the Lower Body DVD, demonstrates how to do the treatments easily. If the muscle is really tight, the treatment will be a bit painful, so only apply enough pressure that it “hurts so good.”  You’ll be so glad you took the time to stop and work out the tension in your leg, it will make the rest of your trip safer and a lot more pleasant!  Once you have experienced the success, you will not forget this shin splint treatment.

Wishing you well,

Julie Donnelly

 

 

About The Author

julie donnellyJulie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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