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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Latest Article

Calf Cramps Remedy

Posted February 20, 2018 by Dr. Steve Chaney

Don’t Let A Leg Cramp Stop You Short

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

calf cramps remedyGetting a leg cramp while you are running can be the “straw that broke the camel’s back.”  If you don’t treat it properly and quickly when it is happening, you may limp to the finish line, and you can suffer from its effects for days afterward.  I will show you the best calf cramps remedy below.  First, let’s go over spasms and muscle cramps.

A spasm and a cramp are similar because it’s a shortening in the muscle fiber, but that’s where the similarity ends. A spasm is a slow-forming shortening of a group of fibers that tie up into a knot in the muscle. You can feel a spasm with your fingertips, it feels like a bump as you slide along the full length of the muscle. With a spasm, as you press down and slide, it doesn’t hurt until you get to the spasm, and then it can really hurt. But then it stops hurting as you slide off the spasm. A spasm refers pain to the insertion points of the muscle and frequently doesn’t hurt where the spasm has formed (that is, until you press on it).

Why Do Your Muscles Cramp?

calf cramps remedy muscle crampsA cramp (Charlie horse) is when all the fibers of the entire muscle suddenly and violently contract. The muscle will quickly shorten and can go into a huge knot, or it will just totally shorten.

Usually a cramp happens in your calf muscle, although it can happen to any muscle in the body.  Your calf is comprised of two major muscles, the gastrocnemius and soleus. The gastrocnemius, which is shown in this graphic, originates behind your knee and inserts into your Achilles tendon.

Visualize the muscle suddenly shortening, pulling up on your Achilles tendon, and becoming a mass of tight knots through the entire muscle.

Muscles have an “all or nothing” response.  This means that when a muscle fiber contracts, it will shorten 100% of its length.  It never starts to shorten and then make a U-turn and lengthen.  A cramp is seriously painful, and if you try to stretch it out as it’s happening, you can tear the muscle fibers. In fact, that’s the reason it hurts for sometimes days after the cramp.

A Calf Cramps Remedy You Can Administer Yourself

calf cramps remedy squeezeThe best thing to do is to squeeze the two ends of your calf muscle together, which will help the cramp complete as quickly as possible. This will hurt, but for less time than the normal cramping process.  Hold your calf tightly, as shown in this picture, and continue to press the two ends toward each other.

Hold it until you can breathe normally (about 30-45 seconds), and then release. Breathe for a minute or so, and then push the two ends together again.  This second time won’t hurt, you are only doing it to make sure that all the fibers have completed the contraction.

calf cramps remedy hold sittingOnce you have stopped the cramp, don’t stretch…yet. You need to flush out the hydrogen ions (AKA lactic acid) that rapidly built-up in the muscle during the cramp.

There are many ways to self-treat your calf. If you are out on the road you can either sit on a bench or lie on the ground and put the sore calf onto your opposite knee.  Press down and hold the pressure for 30 seconds. Then deeply press along the muscle going from the back of your knee toward your ankle.

calf cramps remedy opposite footYou can also use your opposite heel and press deeply, straight into your calf.

Start at the top of the muscle and move down toward your ankle. Stop whenever you come to a point that is especially painful. The point should be close to the area shown in this picture.

Hold the pressure for 30-60 seconds, or until it doesn’t hurt anymore.  Release, and then repeat 2-3 times.

Complete this self-treatment by squeezing your calf muscle, like you are wringing out a wet towel.  This will force blood into your muscle and get your circulation moving again.

Proof That My Treatments Work

I once taught this technique at an Ironman Triathlon during a 15-minute session I was giving to the triathletes.  Several days later a triathlete emailed me and told me that he had a cramp as he was running, and he did the treatment I’d taught him.  It cost him a few minutes (he wasn’t in the top three, so the time loss wasn’t a huge issue) but he was able to get up and get back to running, totally without pain.

About a mile later he got a cramp in the other leg, but he automatically started to just stretch it like he’d always done before.  He ended up limping all the way to the finish line, and days later it was still hurting.  He wanted to let me know that my cramp treatment really worked great.  This was especially helpful because I’d always wondered what body chemistry did to the outcome of treating a cramp, and here I found out that chemistry wasn’t involved in the treatment of the muscle fibers.

What To Do After The Calf Cramps Remedy

If the cramp happens during a race or athletic event, knowing how to stop it, and these quick massage techniques, will get you back into the game. But it hasn’t totally resolved the issue. Finally, when you have the time to be detailed (after the race, in the evening, etc.), it is important to work out all the spasms and then stretch properly.

When you are treating the muscles afterward, I suggest you consider getting an analgesic cream that goes way deep into the muscle fibers. Use it when you are massaging the muscle, but don’t put it on before you play, run, or before/after a shower because it will go too deep into the muscle and burn like crazy. After you do the treatments, use ice &/or arnica gel (get it at a good health food store) to heal the bruised muscle fibers and help with pain and swelling. Arnica is fantastic, it’s an amazing homeopathic remedy that has been around for ages and really works.

Naturally you will also want to make sure you hydrate properly and that your diet, vitamins and minerals are all in balance.

calf cramps remedy bookCramping is a common problem athletes face, but with a little bit of effort you can prevent muscle injury and get back in the race quickly!

You can find the full treatments for your muscle cramps by going to my book, Treat Yourself to Pain-Free Living . This book has treatments for your entire body, from your head to your feet.  YOU are your own Best Therapist!  Stop pain quickly and easily with self-treatments you can do anytime, anyplace.

Wishing you well,

Julie Donnelly

julie donnelly

About The Author

Julie 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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