Taking Folic Acid During Pregnancy May Reduce Childhood Obesity Risk

Adequate intake of folic acid during pregnancy is likely to protect children from a future risk of obesity, especially those born to mothers who were obese, finds a new study by Johns Hopkins University in the US.


A National Institutes of Health (NIH)-funded study is reporting that proper maternal folate levels during fetal development may protect children from obesity, particularly those born to overweight women. The study, “Association Between Maternal Prepregnancy Body Mass Index and Plasma Folate Concentrations With Child Metabolic Health,” was published in the journal JAMA Pediatrics.

Maternal nutrition during pregnancy can have long-lasting effects on child health, as well as the health of a mother after pregnancy,”the study’s principal investigator, Xiaobin Wang, MD, MPH, ScD, from Johns Hopkins University, said in a news release. “Our results suggest that adequate maternal folate may mitigate the effect of a mother’s obesity on her child’s health.

Obesity in children and adults is a serious health issue in the United States, contributing to such conditions as heart disease, stroke, and type 2 diabetes. During pregnancy, maternal obesity also increases the risk for a range of pregnancy complications, such as stillbirth, birth defects, and preterm birth. Furthermore, babies born to obese mothers have long-term health risks, including a higher risk of obesity in childhood.

Folate, an essential B vitamin, reduces the fetus’ risk of neural tube defects, which are malformations affecting the brain, spine, and spinal cord. The U.S. Centers for Disease Control and Prevention recommends that women of childbearing age take 400 micrograms of folic acid daily to reduce their children’s risk of neural tube defects. However, the role of maternal folate levels on a child’s future obesity risk was not known, especially among those born to mothers who are obese during pregnancy.

In their study, the researchers investigated the health outcomes of mothers and children (ranging from 2- to 9-years-old) in the Boston Birth Cohort, a predominately low-income, minority population with a high prevalence of maternal and child obesity. The study team analyzed health records from more than 1,500 mother-child pairs, including information that was collected before, during and after pregnancy. To gauge a mother’s folate level during pregnancy, the researchers measured folate from stored plasma samples that were collected two to three days after delivery.

The study team found a wide range of maternal folate levels but observed an “L-shaped” relationship between maternal folate levels and child obesity. In other words, the lowest levels of folate correlated with the highest risk of child obesity. When folate levels reached approximately 20 nanomoles per liter (nm/L), which is within the normal range for adults, further increases in folate levels did not confer additional benefits, indicating a threshold or ceiling effect.

According to the researchers, this threshold is higher than the standard cutoff for diagnosing folate deficiency (less than 10 nm/L).

Obese mothers in the study tended to have lower folate levels than normal weight mothers. However, when the researchers examined obese mothers only, they found that children of obese mothers with adequate folate levels (at least 20 nm/L) had a 43 percent lower risk of obesity compared to children of obese mothers with lower folate (less than 20 nm/L). The children in the latter group had higher body mass index-for-age z-scores (BMI-z) — a measure of body fat in children.

According to the authors, establishing an “optimal” rather than “minimal” folate concentration may be beneficial for women planning a pregnancy, especially obese women.

“Folate is well-known for preventing brain and spinal cord defects in a developing fetus, but its effects on metabolic disorders, such as diabetes and obesity, is less understood,” said Cuilin Zhang, M.D., Ph.D., NICHD senior investigator and a study co-author. “This study uncovers what may be an additional benefit of folate and identifies a possible strategy for reducing childhood obesity.”

The Boston Birth Cohort has been funded continuously by NICHD since 2002 (R01 HD041702, R01 HD086013). The cohort also received support from NIH’s National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases, as well as the Health Resources and Services Administration’s Maternal and Child Health Bureau and the March of Dimes.

The Infographic below shows other benefits of folic acid for children and its importance 

Folic Acid and Childhood health Infographic

Reference:
Wang G, Hu FB, Mistry KB, Zhang C, Ren F, Huo Y, Paige D, Bartell T, Hong X, Caruso D, Ji Z, Chen Z, Ji Y, Pearson C, Ji H, Zuckerman B, Cheng TL, and Wang X. Associations of maternal prepregnancy BMI and plasma folate concentrations with child metabolic health. JAMA Pediatrics DOI: 10.1001/jamapediatrics.2016.0845 (2016).

For more latest obesity, nutrition, and weight loss research visit this page: Latest Studies and Research

Related Tags: Folic Acid Intake during pregnancy, Low Folate During Pregnancy Linked to Childhood Obesity, Folic Acid During Pregnancy May Lower Risk of Childhood Obesity, Enough Folic Acid While Pregnant May Help Prevent Childhood Obesity, New Study on Folic Acid and Childhood Obesity

Do Weight Loss Pills Work? 5 Drugs Compared By Fda

In an analysis that included nearly 30,000 overweight or obese adults, compared with placebo, orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide were each associated with achieving at least 5 percent weight loss at 52 weeks, and phentermine-topiramate and liraglutide were associated with the highest odds of achieving at least 5 percent weight loss, according to a study appearing in the June 14 issue of JAMA.


Approximately 1.9 billion adults are overweight and 600 million are obese worldwide. Identifying effective long-term treatment strategies for overweight and obesity is of paramount importance. The U.S. Food and Drug Administration (FDA) has approved 5 weight loss drugs (orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide) for long-term use in obese (body mass index [BMI] ? 30) or overweight (BMI ? 27) individuals with at least 1 weight-associated condition (type 2 diabetes, hypertension, hyperlipidemia). Data on the comparative effectiveness of these drugs are limited.

Siddharth Singh, M.D., M.S., of the University of California, San Diego, La Jolla, and colleagues conducted a systematic review and meta-analysis of randomized clinical trials that included overweight and obese adults treated with FDA-approved long-term weight loss agents for at least 1 year compared with another active agent or placebo. Twenty-eight randomized clinical trials with 29,018 patients (median age, 46 years; 74 percent women; median baseline body weight, 222 lbs.; median baseline BMI, 36.1) were included.

Also read: Taking Folic Acid During Pregnancy May Reduce Childhood Obesity Risk

The researchers found that a median 23 percent of placebo participants had at least 5 percent weight loss vs 75 percent of participants taking phentermine-topiramate, 63 percent of participants taking liraglutide, 55 percent taking naltrexone-bupropion, 49 percent taking lorcaserin, and 44 percent taking orlistat. All active agents were associated with significant excess weight loss compared with placebo at 1 year: phentermine-topiramate, 19.4 lbs.; liraglutide, 11.7 lbs.; naltrexone-bupropion, 11 lbs.; lorcaserin, 7.1 lbs.; and orlistat, 5.7 lbs. Compared with placebo, liraglutide and naltrexone-bupropion were associated with the highest odds of adverse event-related treatment discontinuation.

"Ultimately, given the differences in safety, efficacy, and response to therapy, the ideal approach to weight loss should be highly individualized, identifying appropriate candidates for pharmacotherapy, behavioral interventions, and surgical interventions. Historically, concerns regarding the long-term safety profile of pharmacotherapy for weight loss have limited their clinical use, particularly among medications with significant adrenergic actions or central appetite-suppressing actions. Short-term clinical trials may not provide comprehensive information on the long-term safety of these agents, and prospective postmarketing surveillance studies are warranted," the authors write.

Ressource: Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis, Rohan Khera, MD; Mohammad Hassan Murad, MD, MPH; Apoorva K. Chandar, MBBS, MPH; Parambir S. Dulai, MD; Zhen Wang, PhD; Larry J. Prokop, MLS; Rohit Loomba, MD, MHSc; Michael Camilleri, MD; Siddharth Singh, MD, MS, JAMA, doi:10.1001/jama.2016.7602, published 14 June 2016.

For more latest obesity, nutrition, and weight loss research visit this page: Latest Studies and Research

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