—AHA Advice Part of Four Key Recommendations to Potential Mothers—
WASHINGTON, D.C., June 5, 2007 — "Prospective parents can take positive lifestyle steps to increase the chance that their babies will be born with a healthy heart," says the American Heart Association (AHA) in a communiqué reporting on a new scientific statement, "Non-inherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge," published in Circulation: Journal of the American Heart Association, May 22 (published online).
The statement from the AHA Council on Cardiovascular Disease in the Young and endorsed by the American Academy of Pediatrics, summarized the latest knowledge reflected in medical and scientific literature and identified four key recommendations for prospective mothers. Two of the recommendations stressed the importance of communication with a doctor, while another provided advice on what actions a prospective mother should avoid.
The other recommendation noted that women of childbearing age "should take a daily multivitamin containing 400 micrograms (mcg) of folic acid or a folic acid supplement." The AHA noted that "folic acid is critical to the normal growth and development of the fetus and appears to have a protective effect against the development of heart defects. Data suggest intake of folic acid is particularly important prior to conception."
Women of child-bearing age have long been encouraged to get 400 mcg of folic acid daily in order to reduce the risk of neural tube birth defects, especially spina bifida. According to Judy Meehan, Executive Director, National Healthy Mothers, Healthy Babies Coalition, "Since the government began its mandatory food fortification program in 1998, and public/private partnerships have been urging women to take a multivitamin with folic acid, we’ve seen a 27 percent decline in the number of neural tube birth defects in this country. The importance of women getting the right amount of folic acid daily cannot be stressed strongly enough."
According to the Council for Responsible Nutrition (CRN), women who are thinking of becoming pregnant are not the only ones who should be getting folic acid. Andrew Shao, Ph.D., vice president, scientific and regulatory affairs for CRN, says, "The benefits of folic acid for reducing neural tube birth defects are well-established, but we are also encouraged by recent scientific findings that support folic acid’s potential for benefits beyond reducing the risk of birth defects."
Dr. Shao points to two recent articles, one a meta-analysis, the other a new study, published this year in The Lancet. The meta-analysis, published in the June 5 issue of The Lancet, reviewed eight randomized trials to assess the efficacy of folic acid supplementation in stroke prevention. According to the researchers, folic acid supplementation reduced the relative risk of stroke by 18 percent or more. The benefit was even greater in those trials involving a longer treatment duration or in those subjects who had no previous history of stroke. The study also found that in countries and population groups that did not already have access to increased amounts of folic acid through fortified or partly fortified grain, folic acid supplementation decreased the risk of stroke by 25 percent.
"Our meta-analysis provides coherent evidence that folic acid supplementation can significantly reduce the risk of stroke in primary prevention," said the study’s author, Professor Xiaobin Wang, Children’s Memorial Hospital and Children’s Memorial Research Center, Northwestern University Feinberg School of Medicine.
In January, The Lancet published a randomized, double-blind controlled study that found "folic acid supplemented for three years significantly improved domains of cognitive function that tend to decline with age." The study included 818 participants randomly assigned to a group taking a daily supplement of 800 mcg folic acid or placebo. Dr. Shao noted that these benefits occurred at a dose higher than the amount of folic acid included in a typical multivitamin, which most often includes 200-400 mcg per day. "People can obtain extra folate by taking an additional folic acid supplement or through diet. Americans are likely already getting up to 120 mcg of folic acid from fortified food. It is important that people follow supplement label recommendations and not just add another multivitamin as it will contain other nutrients that go beyond folic acid. As with all studies, this one needs to be considered within the overall context of the research, but what is clear is that we are finding potential new benefits for folic acid on an on-going basis."
1 Jenkins KJ, Correa A, Feinstein J, et al. Future parents' lifestyle choices affect babies' risk of heart defects. American Heart Association Scientific Statement, May 22, 2007, available online http://www.americanheart.org/presenter.jhtml?identifier=3047829.
2 Jenkins KJ, Correa A, Feinstein J, Botto L, Britt A, Daniels S, Elixson M, Warnes C. Noninherited risk factors and congenital cardiovascular defects: current knowledge. Circulation: Journal of the American Heart Association. Accessed on June 5, 2007.
3 Wang X, Qin X, Demirtas H. Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. Lancet 2007; 369: 1876–82.
4 Durga J, Van Boxtel M, Schouten E, et al. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomized, double blind, controlled trial. Lancet 2007; 369: 208–16.