Can a Father's Diet Affect His Newborn's Health?

Can a Father's Diet Affect His Newborn's Health?

Fathers, like mothers, might need to watch their folic acid levels.

Published on December 15, 2013 by Paul Raeburn in About Fathers

 

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We've known for a long time that women who do not get enough folic acid in their diets from the very first weeks of pregnancy are at increased risk of having children with birth defects of the brain and spine, including spina bifida.


Now, however, comes the surprising news that low folic acid levels in fathers can also increase the risk. This isn't actually new; the link has been known for a while. But it's been hard to understand how this could work.
Mothers provide the environment for the developing fetus, including not only the roof over its head, so to speak, but the complex bath of chemicals in which it swims during pregnancy. It makes sense that altering that chemical soup—with a deficiency of folic acid, for example—would have consequences for the fetus. But the father's only direct connection with the fetus is a single tiny sperm cell. How could his diet have anything to do with the fetus?

In a new study in the journal Nature Communications, researchers at McGill University in Montreal say they've found a possible explanation. Diet can't alter the DNA in the sperm, but it can alter something else, leaving a telltale signature that can disrupt proceedings weeks later in the womb.

A man's diet, it turns out, alters the epigenetics of his sperm. The genes in the sperm carry all the hereditary characteristics that we're familiar with—eye color, height, and so forth. But the proper operation of those genes requires that they be turned on or off appropriately. Epigenetic markings are small molecules that can attach to genes and control whether or not they are turned on.

The McGill researchers now suggest that the link between fathers' folic acid levels and their children's risk of birth defects might be a consequence of diet altering these epigenetic markings in his sperm.

Does this mean men contemplating having children should take folic acid supplements? There’s no way yet to know. Researchers must do more work to establish with certainty what is going on, and at this point they have no way of predicting how much folic acid is enough to reduce the risk—if, indeed, further studies prove that the risk is real.

Nevertheless, the study is yet one more examples of how important fathers are in the lives of their children--often in ways, such as this, that no one could have predicted. This one came out too late for inclusion in my book Do Fathers Matter? What Science is Telling Us About the Parent We’ve Overlooked, (due out for Fathers Day, 2014), but you will see many similar studies there, including a more complete explanation of epigenetics and its role in many aspects of children’s health.

This is perhaps one of the most exciting new areas of research regarding fathers, and I’m following it closely and will be blogging on it here in the weeks and months to come.

Lack of Key Enzyme in the Metabolism of Folic Acid Leads to Birth Defects

Jan. 17, 2013 — Researchers at The University of Texas at Austin have discovered that the lack of a critical enzyme in the folic acid metabolic pathway leads to neural tube birth defects in developing embryos.

It has been known for several decades that folic acid supplementation dramatically reduces the incidence of neural tube defects, such as spina bifida and anencephaly, which are among the most common birth defects. In some populations, folic acid supplementation has decreased neural tube defects by as much as 70 percent.
However, scientists still do not fully understand how folic acid decreases neural tube defects, or why folic acid supplementation does not eliminate birth defects in all pregnancies.

"Now, we've found that mutation of a key folic acid enzyme causes neural tube defects in mice," said Dean Appling, professor of biochemistry in the College of Natural Sciences. "This is the clearest mechanistic link yet between folic acid and birth defects."

Appling and his colleagues published their research in the Jan. 8 issue of Proceedings of the National Academy of Sciences (PNAS).

The scientists made the discovery using mice that lack a gene for a folic acid enzyme called Mthfd1l, which is required for cells to produce a metabolite called formate. Embryos need formate to develop normally.
"This work reveals that one of the ways that folic acid prevents birth defects is by ensuring the production of formate in the developing embryo," said Appling, "and it may explain those 30 percent of neural tube defects that cannot be prevented by folic acid supplementation."

Appling said that the mice provide researchers with a strong model system that they can use to further understand folic acid and its role in birth defects in humans. In fact, humans share the same gene for the folic acid enzyme with the mouse and all other mammals. Indeed, it has recently been discovered that point mutations in that human gene increase the risk of birth defects.

Appling said that he and his colleagues would like to use the mouse system to begin looking for nutrients that could be delivered to pregnant mothers to prevent those neural tube defects that cannot be prevented by folic acid.

Ultimately, women could someday be screened for the gene that produces the enzyme. If they are deficient, steps could be taken to improve their chances for developing embryos free of neural tube defects through further nutrient supplementation.

Folic acid was discovered at The University of Texas at Austin in the 1940s by biochemists Esmond Snell and Herschel Mitchell. The U.S. has fortified all enriched cereal grain products with folic acid since 1996 to ensure that women of childbearing age receive adequate quantities of the vitamin.

Postdoctoral researcher Jessica Momb and graduate student Jordan Lewandowski were largely responsible for this research. Co-authors include graduate student Joshua Bryant, researcher Rebecca Fitch, researcher Deborah Surman, and Steven Vokes, assistant professor of biology.

Spina Bifida NZ Disappointed by Folate Decision

Spina Bifida NZ Disappointed by Folate Decision

Spina Bifida New ZealandFriday 31 August 2012, 11:08AM Media release from Spina Bifida New Zealand

The Minister of Food Safety, Kate Wilkinson today announced her decision not to introduce mandatory folate fortification into New Zealand, despite this being international best practice in 75 other developed and developing countries.

Submissions to the Ministry of Primary Industries that favoured mandatory fortification were received from professional medical associations, doctors and families affected by a neural tube defect (NTD) pregnancy. Submissions favouring voluntary fortification were received from individual consumers, industry associations and individual bakery firms.

In the Ministers briefing paper to Cabinet1 New Zealand had an average rate for Neural Tube Defect (NTD) affected pregnancies of 12.9 per 10,000 births from 2005-2009. This equates to 80 NTD affected pregnancies per year based on 19 live births, 14 stillbirths and an estimated 47 pregnancy terminations.

  http://www.foodsafety.govt.nz/elibrary/industry/fortification-bread-folic-acid/2012-cabinet-paper-folic-acid.pdf

The decision taken today must mean that the Minister and the New Zealand Association of Bakers place no value on the lives of 61 babies lost and the impact that this has on their immediate and extended families. If two buses crashed and 61 children's lives were tragically cut short, as a country we would honour their lives with a national day of mourning. The real tragedy is that these little lives are being lost quietly, out of public (but not private) view, and are seen as disposable.

As a society, we are unable to demean disabled people by parading physically deformed babies before the public or film the pain the parents feel as they watch their baby being terminated to demonstrate the trauma and conflict that a NTD diagnosis causes. It is the unborn babies and those yet to be conceived who will pay the price for this decision when their lives are cut short and terminated because they are diagnosed with having a Neural Tube Defect (including Spina Bifida).

The New Zealand Government needs to acknowledge that the termination of an NTD affected pregnancy following prenatal diagnosis is not part of their preventative strategy. Folate plays a key role in preventing NTDs for women planning a pregnancy, but in New Zealand 50% of pregnancies are unplanned. Folate also plays a key role in other key areas of health, improving cognitive function in the elderly, development of speech language and prevention of cleft lip and palate and is required for cell division and repair. Folate fortification has health benefits for all of society. These benefits not only have an impact on the health budget but on the lives of everyday New Zealanders.

An eminent Canadian doctor, Dr AGW Hunter said that "we need to feel a sense of responsibility and failure every time a baby is aborted because of an NTD, or a child is born with this preventable disability". The decision announced today contravenes the United Nations Convention on the Rights of the Child (UNCRC Discussion 6 October 1997). The NZ Government has a legal responsibility to protect children from disability before birth and all circumstances which might result in disability at the time of birth.

SBNZ only hopes that the Minister and the New Zealand Association of Bakers will now bear that responsibility on their shoulders and that parents of babies diagnosed with Spina Bifida are given access to the MOH High Cost Treatment Pool to access prenatal surgery internationally.

FDA Approves Oral Contraceptive Containing Folate

Robert Lowes
Medscape Medical News

September 24, 2010 — The US Food and Drug Administration (FDA) today approved an oral contraceptive — the first of its kind — that is intended both to prevent pregnancy and reduce the risk for neural tube defects in newborns if and when users of the pill give birth.

Link to article

Folic acid may raise cancer risk in offspring

Folic acid may raise cancer risk in offspring
CARLY WEEKS
From Monday's Globe and Mail
April 20, 2009 at 9:09 AM EDT

Canadian researchers have discovered that folic acid consumed during pregnancy can alter the gene function of offspring, potentially affecting their susceptibility to disease.

The finding is part of a growing - and controversial - body of research that raises serious questions about whether long-term consumption of folate and folic acid may increase the risk of developing certain cancers in some people.

The debate is far from benign. Food manufacturers are required to add folic acid to enriched flour and grain products under federal regulations that came into force in 1998. The premise behind fortification, which was also mandated in the United States, is to ensure that women receive adequate levels of folate in order to reduce the risk of birth defects in their offspring.

A decade later, however, new research and scientific studies have found evidence that increased consumption of folic acid may help trigger the onset of colon and other types of cancer.

Folic acid is the synthetic form of folate, which is a B vitamin that occurs naturally in leafy greens and other fruits and vegetables. It has been shown to significantly reduce the chance of neural tube defects, such as spina bifida, and helps produce and maintain healthy cells and is involved in numerous biological functions.

The new Canadian research, presented yesterday at the annual meeting of the American Association for Cancer Research in Denver, found that folic acid consumption by the mother has effects on her offspring.

The research is part of a burgeoning field of science known as epigenetics, which studies how gene activities are changed or influenced by diet, lifestyle and other environmental factors. Certain genes can become activated or rendered dormant depending on these factors.

In some cases, genes that protect the body against certain types of cancer can be shut off, while genes that promote tumour formation can be turned on. Changes to genes can also trigger mutations, which explains why epigenetics has been gaining so much attention in the scientific community for its potential ability to help explain the mystery of disease risk.

In the new study, led by Karen Sie, a research scientist in the University of Toronto's faculty of medicine, researchers gave two groups of laboratory rats folic acid supplementation. One group received the equivalent of the daily recommended intake for humans, 0.4 milligrams, and the other group received a higher dose, equal to 1 milligram in humans, which is the maximum recommended daily intake for women during pregnancy.

They found that offspring of rats that received the higher dose experienced a much higher degree of changes to genes in the colon and liver shortly after birth. But as the rats aged, there was a significant drop in the changes to genes.

The researchers don't yet know which specific gene functions were changed. It could be that the high degree of changes noted shortly after birth could silence genes designed to suppress tumours. But the changes could also activate genes that help protect against cancer.

Regardless, the discovery that folic acid can turn genes on or off could help in the quest to determine whether the supplement does contribute to increased risk of cancer in some people.

"The concern is with the high dose that people are getting nowadays," Ms. Sie said.

Despite the new findings, there are still strong defenders of folic acid fortification.

"We know ... folic acid is needed to prevent neural tube defects," said Gideon Koren, director of the Motherisk program at Toronto's Hospital for Sick Children. "As we talk now, 40 per cent of women in Canada do not have enough folic acid to protect the baby from spina bifida and other malformations."

Dr. Koren said Canada's fortification program is one of the key elements needed to reduce the incidence of neural tube defects, and that considering changes because of results from studies that primarily involve rats could be dangerous.

However, others say it's becoming harder to ignore the growing debate about folic acid. Despite its clear benefits when taken by pregnant women, the move to fortify food with folic acid means a major portion of the population is consuming a higher level of the supplement than they would otherwise.

Now, concern is growing that parts of the population that may be susceptible to colon cancer and other diseases could be put at greater risk due to their inadvertent exposure to folic acid.

"It's a real dilemma," said Joel Mason, associate professor of medicine and nutrition and director of the Vitamins and Carcinogenesis laboratory at Tufts University in Boston, who specializes in folic acid and folate.

And there are no simple solutions. Putting an end to fortification could put more women at risk of having babies with neural tube defects. But keeping folic acid supplements in the food supply could put certain people at a higher risk of disease.

A significant amount of research is currently being conducted to answer these questions, including studies looking at whether North American folic acid fortification led to changes in the population rates of certain types of cancer.

Dr. Mason said that despite any fears over safety, the research is too preliminary to warrant changes to fortification programs. But government regulators should be paying close attention as new research emerges, he said.

Canadian study finds immigrant women may be at greater risk of having a baby with a birth defect

Canadian study finds immigrant women may be at greater risk of having a baby with a birth defect

Published: Sunday, 19-Apr-2009

Immigrant women are less likely to use folic acid supplements before pregnancy to prevent spina bifida, particularly those who recently immigrated to the country, according to a new study led by a St. Michael's Hospital physician in collaboration with Statistics Canada, Health Canada and the University of Toronto.

The study is the first to provide national estimates of pre-pregnancy folic acid use in Canada.

"Our study's findings report that while about six in 10 Canadian-born mothers take folic-acid supplements in the three-month period before conception, mothers from non-western countries - China, Northern African, Middle Eastern, Caribbean, Latin American or South Pacific countries - are less likely to use the supplements," St. Michael's Hospital's Dr. Joel Ray said. "This information is important for policy makers and health practitioners as we aim to better educate new mothers and prevent neural tube defects in their babies."

Neural tube defects are birth defects of the spinal cord and brain, otherwise known as spina bifida and anencephaly. Research has shown the risk of neural tube defects can be reduced by nearly 50 per cent with folic acid supplements taken just before and soon after conception, or through consumption of food fortified with folic acid. However, an estimated six to 12 in every 10,000 fetuses in Canada still develop neural tube defects.

The study, an analysis of 6,349 new mothers aged 18 to 45 years, examined the relationship between folic acid supplement use in the three months before conception and the mother's maternal country of birth and years of residence in Canada.

Sixty one per cent of Canadian-born women in the study reported using folic acid supplements in the three month period before conception. However, these rates were much lower among women born in the Caribbean or Latin America (41%), Sub-Sahara Africa (44%), Northern Africa or the Middle East (31%), or South Asia (46%). What's more, only 39% of foreign-born women living in Canada less than four years reported using supplements compared to 64% of foreign-born women living in Canada at least 17 years.

"The disparity in pre-conceptual folic acid supplement use may be due to unplanned/unintended pregnancies or lack of awareness of the benefits of folic acid supplements," Ray said. "Immigrant women, especially those from non-Western countries, are least likely to have this information, which can otherwise be easily provided to these women through various communication mediums."

The study's authors suggest immigrant women be provided with a language-specific pamphlet on the benefits of folic acid, or even with free supplements.

http://www.stmichaelshospital.com/

Birth brain defect could be treated with vitamin supplement

Birth brain defect could be treated with vitamin supplement
March 17th, 2009

(PhysOrg.com) -- Pioneering research published today suggests that a vitamin supplement taken during pregnancy could prevent hydrocephalus - one of the common forms of birth brain defect.

Scientists at The University of Manchester and Lancaster University say laboratory tests have shown that administering a combination of vitamins (tetrahydrofolate and folinic acid), dramatically reduces the risk of hydrocephalus.

Dr Jaleel Miyan, who led the research in Manchester’s Faculty of Life Sciences, said: “Hydrocephalus is a condition arising from an abnormal build-up of fluid within the chambers of the brain.

“This fluid build-up - usually caused by a blockage in the fluid’s pathway due to trauma, infection or abnormal development - is associated with an increase in the pressure on the brain resulting in brain damage. When this happens, doctors can relieve this pressure only by performing surgery.

“Our studies have revealed that hydrocephalus is associated with a change in the composition of the cerebrospinal fluid and it is this chemical change that prevents normal growth of the brain cells resulting in arrested brain development. This occurs prior to any brain damage due to raised pressure.”

The findings of the study, funded by Association for Spina Bifida & Hydrocephalus (ASBAH) and published in the Journal of Neuropathology and Experimental Neurology, led the team to examine ways of stimulating cell division to encourage normal brain development.

Dr Miyan explained: “A combination of tetrahydrofolate and folinic acid - both naturally occurring substances - stimulated brain cell growth and had a significant positive effect on brain development in laboratory experiments on rats and reduced the incidence of hydrocephalus.

“In laboratory experiments, the combined folate supplement works at any stage during pregnancy which means that it may be effective even if it is commenced after the diagnosis of hydrocephalus is made at an 18 to 20 week pregnancy scan.

Serious Birth Defects are Declining in North Carolina

Babies have a healthier start in life thanks to efforts led by the NC Folic Acid Council and the March of Dimes



RALEIGH, N.C. – Over the past ten years there has been a significant decline in the rate of spina bifida in North Carolina. In observance of National Folic Acid Awareness Week, January 7-13, the North Carolina Folic Acid Council (NCFAC) and the March of Dimes would like to recognize the work North Carolina has done to reduce the number of babies born with this serious birth defect.

“We’re seeing progress in the fight to eliminate neural tube defects like spina bifida thanks to folic acid fortification and an intense public health campaign to increase folic acid consumption through multivitamins,” said Amy Mullenix, MSW, MSPH, Statewide Campaign Coordinator. “Yet, there are still too many babies born with spina bifida and we want to make sure every woman of childbearing age gets the message that she should be taking a multivitamin every day, just in case.”

More...

Birth defects down after low-carb craze

Saturday, January 5, 2008
Birth defects down after low-carb craze
Rates have dropped 30 percent in state since peak of the diet trend in 2003

By Richard Craver
JOURNAL REPORTER

The passing of the low-carb craze and an increase in fortified, high-grain foods appears to have helped reduce the rate of birth defects in North Carolina, two nonprofit agencies said yesterday.

The N.C. Folic Acid Council and the March of Dimes reported that the rate of defects affecting the central nervous system has dropped 30 percent in the state since the low-carb fad peaked in 2003.

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Folic acid's trade-offs of concern

Folic acid's trade-offs of concern
By Stephanie Desmon | Sun reporter
January 27, 2008

It was all about the babies. A decade ago, when the U.S. required flour, bread and pasta to be fortified with folic acid, health experts believed it would help prevent devastating birth defects such as spina bifida.

There's no question that it worked. As many as 1,000 newborns a year in the United States - and many more elsewhere - have been spared so-called neural tube defects because their mothers got a crucial infusion of folic acid before they even knew they were pregnant.

But now some scientists are asking whether there have been unforeseen trade-offs for the population as a whole - including thousands of additional colon cancer cases each year, a somewhat smaller bump-up in prostate cancer, and an increase in cognitive impairment among the elderly.

More...