Folate Recommendations during Pregnancy Intersect with Personalized Nutrition 13 Feb 2013
Autism is becoming more prevalent in children. In 2000, approximately 1 child out of every 150 was diagnosed with autism-related disorders. The most recent estimate from the CDC (2008) is 1 child in 88. Why is this?
Suren and colleagues studied the association between maternal folic acid supplement use during pregnancy and the risk of autism spectrum disorders in the child. Their sample had 85,176 children from Norway born between 2002 – 2008. Folic acid dietary supplement use was defined as ‘the 4 weeks leading up to pregnancy to 8 weeks after the start of pregnancy’. 270 children were diagnosed with an autistic disorder. Use of a folic acid prenatal supplement was associated with a reduced risk of autism (Odds Ratio of 0.61). Of course, like any nutrition study, other factors may be relevant since the women using prenatal supplements were more likely to have a college or university education, to be non-smokers, to have planned the pregnancy, to have a prepregnancy BMI < 25, and to be first-time mothers.
In an accompanying editorial, Berry and colleagues note that an earlier report from this same cohort found that periconceptual folic acid supplementation was associated with reduced risk of severe language delay in 3y old children.
These results are consistent with other data. The association between folic acid intake and autism seems to be strongest for mothers and children with methylenetetrahydrofolate reductase (MTHFR) MTHFR 677 C>T variant genotypes. The rare T/T genotype results in a reduction of MTHFR activity and folate metabolism. Individuals with this genotype require more dietary folic acid than those with other genotypes.
It is evident that it is beneficial to have an adequate folic acid intake during pregnancy . Not only will it reduce the risk of neural tube defects but the risk of the child having autism and language delays is reduced. In addition, we know that a nutrient-gene interaction exists. Using modern diagnostics, iti s possible to personalize dietary folate recommendations. People with the T/T genotype need more folate/folic acid than those with other MTHFR genotypes. A genetics test can reduce some of the guesswork.-mm-
Citation
Suren P, Roth C, Bresnah M, Jaugen M, Hornig M, Hirtz D, Lie KV, Lipkin I, Magnus P, Reichborn-Kjennerud T, Schjolberg S, Smith GD, Oyen A-S, Susser E, Stoltenberg C. Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children. JAMA. 2013;309(6):570-577. doi:10.1001/jama.2012.155925 .
Berry RJ, Crider KS, Yeargin-Allsop M. Periconceptual folic acid and risk of autism spectrum disorders. JAMA. 2013;309(6):611-613. doi:10.1001/jama.2013.198.
