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

One of the Little known Causes of Headaches

Posted August 15, 2017 by Dr. Steve Chaney

Your Sleeping Position May Be Causing Your Headaches!

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

Can sleeping position be one of the causes of headaches?  

A Sleeping position that has your head tilted puts pressure on your spinal cord and will cause headaches. I’ve seen it happen hundreds of times, and the reasoning is so logical it’s easy to understand.

causes of headachesYour spinal cord runs from your brain, through each of your vertebrae, down your arms and legs. Nerves pass out of the vertebrae and go to every cell in your body, including each of your organs. When you are sleeping it is important to keep your head, neck, and spine in a horizontal plane so you aren’t straining the muscles that insert into your vertebrae.

The graphic above is a close-up of your skull and the cervical (neck) vertebrae. Your nerves are shown in yellow, and your artery is shown in red.  Consider what happens if you hold your head to one side for hours. You can notice that the nerves and artery will likely be press upon. Also, since your spinal cord comes down the inside of the vertebrae, it will also be impinged.

In 2004 the Archives of Internal Medicine published an article stating that 1 out of 13 people have morning headaches. It’s interesting to note that the article never mentions the spinal cord being impinged by the vertebrae. That’s a major oversight!

Muscles merge into tendons, and the tendons insert into the bone.  As you stayed in the tilted position for hours, the muscles actually shortened to the new length.  Then you try to turn over, but the short muscles are holding your cervical vertebrae tightly, and they can’t lengthen.

The weight of your head pulls on the vertebrae, putting even more pressure on your spinal cord and nerves.  Plus, the tight muscles are pulling on the bones, causing pain on the bone.

Your Pillow is Involved in Your Sleeping Position and the Causes of  Headaches

sleep left side

The analogy I always use is; just as pulling your hair hurts your scalp, the muscle pulling on the tendons hurts the bone where it inserts.  In this case it is your neck muscles putting a strain on your cervical bones.  For example, if you sleep on your left side and your pillow is too thick, your head will be tilted up toward the ceiling. This position tightens the muscles on the right side of your neck.

sleeping in car and desk

Dozing off while sitting in a car waiting for someone to arrive, or while working for hours at your desk can also horizontal line sleepcause headaches. The pictures above show a strain on the neck when you fall asleep without any support on your neck. Both of these people will wake up with a headache, and with stiffness in their neck.

The best sleeping position to prevent headaches is to have your pillow adjusted so your head, neck, and spine are in a horizontal line. Play with your pillows, putting two thin pillows into one case if necessary. If your pillow is too thick try to open up a corner and pull out some of the stuffing.

 

sleeping on stomachSleeping on Your Back & Stomach

If you sleep on your back and have your head on the mattress, your spine is straight. All you need is a little neck pillow for support, and a pillow under your knees.

Stomach sleeping is the worst sleeping position for not only headaches, but so many other aches and pains. It’s a tough habit to break, but it can be done. This sleeping position deserves its own blog, which I will do in the future.

 

Treating the Muscles That Cause Headaches

sleeping position causes of headachesAll of the muscles that originate or insert into your cervical vertebrae, and many that insert into your shoulder and upper back, need to be treated.  The treatments are all taught in Treat Yourself to Pain Free Living, in the neck and shoulder chapters.  Here is one treatment that will help you get relief.

Take either a tennis ball or the Perfect Ball (which really is Perfect because it has a solid center and soft outside) and press into your shoulder as shown.  You are treating a muscle called Levator Scapulae which pulls your cervical vertebrae out of alignment when it is tight.

Hold the press for about 30 seconds, release, and then press again.

Your pillow is a key to neck pain and headaches caused by your sleeping position.  It’s worth the time and energy to investigate how you sleep and correct your pillow.  I believe this blog will help you find the solution and will insure you have restful sleep each night.

Wishing you well,

Julie Donnelly

 

About The Author

julie donnelly

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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