Could folic acid help prevent Down’s syndrome?

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Folic acid enjoys a reputation as the pre-eminent pregnancy nutrient, one that is based on its ability to help ward against what are known as neural tube defects (NTDs) such as spina bifida. However, recent evidence suggests that folic acid may have broader benefits for babies: a study has suggested that adequate levels of folate (the form of folic acid found naturally in food) are important for ensuring healthy growth of the foetus and reducing the risk of undersized babies. It appears that folic acid may have a weightier role in pregnancy than was previously thought.

The research in question was conducted at the University of Newcastle upon Tyne and involved the assessment of the diets of nearly 1000 women in the early stages of their pregnancy. This study, published in the British Journal of Nutrition, found that women with low intakes of folate were more likely to have lighter babies. The suggestion here is that folate is an important ingredient in the nutritional mix that ensures a baby attains a healthy birth weight. The implications of this are considerable, as low birth weight is associated with a significantly increased risk of health issues, not just in infancy, but in later life as well.

The importance of folate in pregnancy is believed to be related to its ability to support the functioning of DNA – the material in the body’s cells which is integral to their healthy replication. Proper working of DNA has the potential to affect overall growth and development, and will also reduce the risk of birth defects relating to faulty DNA functioning such as NTDs. The role folic acid plays in assisting DNA function could, in theory, also give it some potential in preventing other conditions related to DNA malfunction such as Down’s syndrome.

Interestingly, research shows that parents of children born with an NTD are at significantly increased risk of having a child affected by Down’s syndrome, and vice versa. Also, previous research has linked evidence of low folate levels in the body with increased risk of Down’s syndrome. While studies assessing the effects of nutritional supplementation on Down’s syndrome risk have yet to be performed, the evidence currently suggests that folic acid may well offer some element of protection in this regard.

Difficulties with DNA functioning and the development of related abnormalities are most likely to occur in the early stages of pregnancy. This means that, for maximum protection, adequate intakes of folate and/or folic acid should be ensured before pregnancy starts. If pregnancy is being planned, I generally recommend that nutritional preparations start two or three months prior to any active attempts at conception. Foods rich in folate to emphasise in the diet include beans, lentils and green leafy vegetables such as spinach, kale and cabbage. In addition, it is recommended that women supplement with 400 µg (micrograms) of folic acid per day prior to conception, and for the at least the first three months of pregnancy. Science shows that this nutrient has considerable potential to bring good things to life.

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