Birth Defects, Heart Disease May Have Common Cause

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: Birth Defects, Heart Disease May Have Common Cause : Nov. 19, 1999 : Russ Colchamiro : Medical Tribune News Service : There may be a biological connection between certain types of birth defects and coronary heart disease, according to a study published in the latest issue of the Journal of Epidemiology and Community Health. : Researchers led by Dr. David Stone, director of the Pediatric Epidemiology and Community Health Unit at the University of Glasgow in Scotland, analyzed the results of two separate studies. The first showed that there is a high risk in the United Kingdom of neural tube defects birth defects in which the neural tube doesn't form, thus preventing a baby's brain and spinal cord from developing properly. The second study showed that there is a high risk in the United Kingdom of coronary heart disease. : Excess levels of homocysteine a chemical in the body important for cell growth was determined to be a significant factor in causing both health conditions. The researchers concluded that there may be a link between neural tube defects and coronary heart disease. : Stone was quick to caution, however, that this theory derives from two independent observations, and that no new biological research was conducted to prove his contention. : "We found a common thread among existing studies," Stone said. "Because the fields are different, a connection hasn't been made until now. Still, we are predicting a number of phenomena that need to be proven with larger research." : In the original separate studies, researchers found a rising incidence in neural tube defects and coronary heart disease as they moved from studying the southeastern regions of England and Ireland to the northwestern regions. England and Ireland are thought to have the highest risk of neural tube defects in the world. Neural tube defects occur in approximately one to two per 1,000 live births in the United States. : It is known that excess homocysteine levels, which are toxic to the body, can disrupt the development of the fetal nervous system, resulting in neural tube defects, and also damage the cardiovascular system later in life, causing coronary heart disease. : Past research has shown that folic acid, vitamin B6 and vitamin B12 all necessary for cell replication can help counteract the damaging effects of excess homocysteine levels. : These factors led Stone to develop a three-tiered hypothesis: First, mothers of children with neural tube disease may be at an increased risk of developing coronary heart disease. Second, although increased homocysteine levels do not always result in a damaging health condition, there are consistencies of increased rates of neural tube disease and coronary heart disease throughout certain populations. This explains an ecological correlation between neural tube disease and coronary heart disease. And third, proper prenatal care that includes adequate levels of folic acid and vitamins B6 and B12 should reduce the risk of neural tube disease and coronary heart disease and partially or totally reverse damage associated with those conditions. : Several governments, including those of the United Kingdom and the United States, have issued official recommendations that all women planning a pregnancy should receive extra folic acid before conception and during the first three months of pregnancy. However, the researchers consider the impact "disappointing," suggesting that the recommended doses may be too small. : Ross Pelton, director of education at Natural Health Resources in San Diego, and a pharmacist and clinical nutritionist, recommends that women of child-bearing age should undergo a lab test to check folic acid levels before becoming pregnant. "Folic acid is depleted by many prescription drugs, including birth-control pills," he explained. "However, the level of folic acid necessary for repletion is way beyond what you can get over the counter (OTC)." : In the United States, folic acid is available as an OTC supplement in amounts of up to 800 micrograms, Pelton explained, whereas physicians may inject patients with five or 10 milligrams of folic acid approximately 1,000 times higher than the OTC doses levels available only with a prescription. : Pelton said that folic acid sold OTC is limited to 800 micrograms because high levels of the nutrient may mask a B12 deficiency, that, if undetected, can lead to long-term nerve damage. : "I don't recommend any particular level for all women because it's individualized," Pelton said, although he added that folic acid is one of the most commonly deficient nutrients in the diet. He recommended leafy vegetables as a good source of folic acid. : SOURCE: Journal of Epidemiology and Community Health (1999;53:789-793) :

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