FDA mandate for folic acid fortification may decrease the incidence of Down syndrome

Increasing folate levels in women prior to conception -- which could be achieved either through fortified foods, natural dietary sources, or vitamin supplementation -- may reduce the incidence of Down syndrome, according to a study funded by the United States Food and Drug Administration (US-FDA) Office of Women's Health.

Down syndrome is a genetic condition usually caused by an error in chromosome segregation in the mother's egg. Normal human cells contain 23 pairs of chromosomes, but Down syndrome cells contain three copies of chromosome 21 -- a condition known as trisomy 21. In the United States, trisomy 21 occurs in about 1 out every 150 conceptions; 80% result in miscarriage and 20% result in babies born with Down syndrome.

Folate, also called folic acid, is a B vitamin found naturally in leafy dark green vegetables, beans, peas, liver, and orange juice. Previous studies have proven that inadequate folate status at the time of conception increases the risk of neural tube defects such as spina bifida -- the leading cause of childhood paralysis. In 1998, the US-FDA mandated that 140 micrograms of folic acid be added to every 100 grams of enriched grain products such as pasta, breakfast cereals, and flour. This mandate was intended to increase the amount of folic acid in the typical American diet and ultimately to reduce the incidence of birth defects.

This study, published in the American Journal of Clinical Nutrition, showed that mothers of babies with Down syndrome often have the same genetic abnormality in folate metabolism associated with spina bifida. The study suggests that the FDA's mandate to fortify foods with folic acid may have additional long-term health benefits. Says lead author S. Jill James, PhD, at the FDA-National Center for Toxicological Research, "Our preliminary research is promising, however, a larger clinical study is needed to determine whether folic acid supplementation 2 to 3 months prior to conception will reduce the

Contact: Jill James, PhD
American Society for Clinical Nutrition/American Society for Nutritional Sciences

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