Folate or Folic acid, pre-conception to week 5-8 prenatally, may reduce NTDS & autism risk.
Recent review report by the US Preventive Services Task Force. And, lean muscle mass is protective against Alzheimer's risk.
Folic acid is still found to be safe and helpful for reducing risk of Neural Tube Defects which range from severe spina bifida to less severe cleft palate - both needing surgery though. The neural tube of a developing fetus becomes the spine and lack of folate may affect development along the spine to the skull and palate of the mouth.
Prior to conception is the best time to be taking a supplement and 400 to 800 mcg is recommended unless there was already history of a baby with NTDs born to the mother.
The review includes studies that looked at folic acid supplementation prenatally and autism spectrum developing in the children. Many were not clear or found no association, while two found reduced risk for autism and one that specified supplementation during weeks 5-8 of the pregnancy had reduced risk.
“Six fair-quality cohort studies and 1 fair-quality case-control study published since the 2017 USPSTF recommendation examined the potential association between folic acid supplementation and autism spectrum disorder (ASD) (n = 761 125).10,30 No study reported statistically significant associations between supplementation and increased risk of ASD. Two studies reported statistically significant reductions of autism associated with folic acid supplementation. Other studies in similar geographic settings or populations that used different measures of exposure or comparators reported no association between folic acid supplementation and autism. Three studies reported on associations between folic acid supplementation and ASD by dose and found no differences. Two studies reported on associations between folic acid supplementation and ASD by timing. Neither reported harms; however, 1 study reported a statistically significant reduction of ASD associated with folic acid supplementation initiation in weeks 5 to 8 of the pregnancy.10,30
US Preventive Services Task Force. Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA. 2023;330(5):454–459. doi:10.1001/jama.2023.12876, 1 Credit CME available. (JAMA, Guest access?)
The benefits of methyl-folate supplementation pre-conception might be stronger for reducing autism or NTD risks. If genetic susceptibility is involved, then the mother may not be re-methylating well and folic acid would not be helpful for her and the baby’s genetics might match and also not be using folic acid well.
Pre-conception so that whenever that first month is happening, the baby is covered. Women may not learn of a pregnancy until farther along than week 5-8.
Folate rich foods
Other ideas - eating more folate rich foods like green peas, (uhhospitals.org), split peas (USDA), Black-eyed peas (*cook these like dry soup beans), other beans, orange juice with pulp, okra, broccoli, asparagus and other dep green veggies can provide a variety of healthy nutrients. See: Food Sources of Folate, Dietitians of Canada Fact Sheet (pdf) Sunflower seeds are a good source of folate but are high in phosphorus though (USDA). Fresh parsley (USDA) and other deep green veggies have folate.
Black-eyed peas are a low phosphorus choice compared to other legumes. Lima beans are runner up. **A post focused on low phosphorus choices will be next up.
“One half-cup serving of black-eyed peas contains 44 percent of the recommended daily intake of folate, a B Vitamin that helps to lower the chance of brain and spinal cord defects in newborn babies.” (webmd.com) *and it has seven grams of protein too.
Tuna is a good source of methyl B12 but may be a mercury risk and avoidance or limiting it is recommended for the child bearing years. Having adequate vitamin C helps the body remove heavy metal toxins. (Khan, et al., 2019)
I did a nutrient analysis of the foods that I tended to eat while traveling (before learning of Retinoid Toxicity) because I had lost weight and wondered what had changed - it was much lower carbohydrate, about 30% of total calories from carbs. (pdf) It includes folate and/or folic acid content in the foods I included in a approximately one day’s food equivalent to a Nutrient Label’s 2000 calorie day (which is more than I might eat). Nutrient analysis numbers are based on chemical analysis but are still averages rather than an exact representation of intake.
Who is more at risk for having a baby with Neural Tube defects?
“These factors include:
personal, partner, or family history of neural tube defects,
malabsorption caused by bariatric procedures, *this suggests that anyone with severe malabsorption conditions would also have an increased risk for NTDs occuring in their infant.
the use of certain antiseizure medicines,
and genetic mutations in folate-related enzymes.15-19 «and these are the people who would need methyl-folate, not folic acid. It is better to avoid fortified folic acid too as it is not going to work and may interfere with whatever folate is available.
Ethnic groups such as First Nation persons in Canada and Hispanic persons in California are thought to be at higher risk of neural tube defects.22,23 It is unclear, however, whether this is related to a higher risk of genetic variations among these groups or due to differential intake of folic acid–fortified foods.10”
Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement, (JAMA, Guest access?) *Bullet points added by me.
More lean muscle mass in proportion to fat mass showed a reduced risk for Alzheimer’s dementia and better cognitive performance.
At the other end of the age spectrum - Alzheimer’s dementia has some similarities to autism and more lean muscle mass (total mass minus fat mass) was associated with better cognitive performance and less risk of Alzheimer’s. Having more fat mass was associated with worse cognitive performance but was not associated with Alzheimer’s risk too.
Harris E. More Lean Muscle Might Reduce Alzheimer Disease Risk. JAMA. 2023;330(5):402. doi:10.1001/jama.2023.12544 (JAMA)
And Olive Oil is the vegetable oil to choose for brain health.
A Daily Dose of One Vegetable Oil May Lower Risk of Dying from Dementia, Research Finds. CNN. July 27, 2023. New research finds that regular consumption of olive oil may offer several health benefits, including protecting heart and brain health, as adults who consume olive oil daily have a lower risk of dying from dementia. (CNN)
Disclaimer: This information is being provided for educational purposes within the guidelines of Fair Use and is not intended to provide individual health guidance.
(Khan, et al., 2019) Khan, R., Ali, S., Mumtaz, S. et al. Toxicological effects of toxic metals (cadmium and mercury) on blood and the thyroid gland and pharmacological intervention by vitamin C in rabbits. Environ Sci Pollut Res 26, 16727–16741 (2019). https://doi.org/10.1007/s11356-019-04886-9 https://link.springer.com/article/10.1007/s11356-019-04886-9
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