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(HealthNewsDigest.com) – With the increasing popularity of low carbohydrate eating plans – paleo, keto, eat-nothing-white, gluten free or very low carb diets – there is concern among experts that birth defects may increase.
In the early 1990s, the US Public Health Service recognized that folic acid (a B vitamin) found mainly in green leafy vegetables, orange juice, avocado, wheat germ and peanuts was important to reduce the risk for neural tube defects (NTDs). They recommended that all women get 400 micrograms of folic acid daily before and during pregnancy. Sadly, a great many women in the US had low folic acid intakes and more than half of all pregnancy are unplanned. More importantly, NTDs occur in the first few weeks of pregnancy, often before a woman actually knows she is pregnant. Even before the common symptoms of nausea and vomiting, experienced in the first trimester, that might prompt changes in the usual diet.
Pregnant women with low folic acid levels are at higher risk of babies born with cleft palates, cleft lips, spina bifida (malformations of the spine and spinal cord) or anencephaly (absence of portions of the brain or skull). They also have more miscarriages. To counteract this, in 1998 both the US and Canada mandated the fortification of bread, cereal, pasta, rice and flour with folic acid. Immediately after fortification began NTD cases declined and the decline has remained stable through 2011. The Centers for Disease Control and Prevention (CDC) estimates this has prevented over 1,300 cases of NTDs annually for a health care saving of over $500 million a year, in addition to eliminating suffering and disability for affected infants and their parents.
Women who have adequate folic acid before conception can reduce the possibility of NTDs by as much as 70%. Since almost half of all pregnancies are unplanned, fortified grain foods are a very important source of folic acid before and at the beginning of pregnancy. Popular low-carb diets could put women at increased risk for birth defects because restricting carbohydrate-rich foods means avoiding the very foods that are rich in folic acid – pasta, cereal and bread. Many popular eating plans suggest avoiding all grains or drastically restricting them daily.
Researchers from the University of North Carolina recently looked at the connection between low carb eating and the likelihood of having a child with spina bifida or anencephaly. What they found was alarming. The intake of folic acid among women on a restricted carbohydrate intake was less than half that of women who regularly ate carbs and they were 30% more likely to have a baby with NTDs. The researchers also found that even if women began folic acid supplements later in pregnancy the supplementation did not compensate for the earlier folic acid deficit because NTDs occur so early in pregnancy.
When they looked more closely at the population being studied, there were some other interesting findings. As daily carbohydrate intake went down, the risk for NTDs increased. Compared to women who did not restrict carb before or during pregnancy, those who did were older, white, born in the US, educated and had higher family incomes. And, their pregnancies were more likely to be planned. This shows that carb restriction was a lifestyle choice and not a result of misinformation. If this group of women were informed about the risks to their unborn child when carbs are restricted, they may change their behavior.
An interesting aside to the issue of folic acid and pregnancy is that dads need to consider their folic acid intake, too. Research has shown that men with low sperm counts and more fragile sperm have low folic acid levels.
Bottom line: When it comes to a healthy pregnancy, adequate folic acid levels are important for both parents.
© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of 30 books. Available as eBooks from iTunes and Kindle/Amazon:
Diabetes Counter – the most up-to-date information on managing diabetes
Calorie Counter – a weight loss guide that won’t let you down
Protein Counter – put the latest protein recommendations to work for you
Healthy Wholefoods Counter – planet-friendly eating made easy
Complete Food Counter – food counts and nutrition information at your fingertips
Fat and Cholesterol Counter – newest approach to heart-healthy eating
Available in print from Gallery Books:
Most Complete Food Counter, 3rd Ed.
Your Complete Food Counter App: http://itunes.apple.com/us/app/your-complete-food-counter/id444558777?mt=8
For more information on Jo-Ann and her books, go to: www.TheNutritionExperts.com.
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