Birth Defects Down After Low-Carb Craze

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, 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.

According to a study commissioned by the Aramark food-service company, 18 percent of Americans were on a low-carb diet in 2003.

During that year, the rate of neural-tube defects jumped to 8.4 for every 10,000 live births from 6.6 in 2002, the N.C. State Center for Health Statistics said.

The rate of spina-bifida cases, the most common type of neural-tube defect, rose to 5.1 for every 10,000 births in 2003 from 4.3 in 2002. There was a similar increase in spina-bifida cases nationally in 2004, the Centers for Disease Control and Prevention said.

In 2005, the rate of neural-tube defects in North Carolina had dropped to 5.9 for every 10,000 births — a 10-year low — as women began to lose their appetite for the low-carb diet.

The preliminary 2005 prevalence of neural-tube defects is the lowest that the state has recorded, said Amy Mullenix, the statewide campaign coordinator for the two agencies. "Yet, there are still too many babies born with spina bifida," she said.

The rates since 2003 are considered preliminary by the N.C. State Center for Health Statistics.

The neural tube is an embryonic structure that grows into the brain and spine. Defects occur when the neural tube fails to close properly, around or before the 28th day of pregnancy — which is before most women know that they are pregnant.

In 1998, the U.S. Food and Drug Administration began fortifying grain and cereal products with folic acid to help reduce neural-tube defects.

Folic acid is used for cell growth and reproduction, fundamental building-block processing and genetic-material production. Because folic acid is water soluble, it passes through the body very quickly.

"Some women cut down dramatically on their bread intake and didn’t supplement their folic-acid needs in other means, such as a daily multivitamin," Mullenix said.

Even though it would take eating an entire loaf of bread fortified with folic acid to provide the required daily dosage, most grain products help provide folic acid, said Megan Whelen, the March of Dimes coordinator for a 12-county region that includes most of the Triad.

The rate of neural-tube defects has dropped about 40 percent from 1995, when it was 10 for every 10,000 births. The rate for spina-bifida cases increased to 3.4 for every 10,000 births in 2005 compared with 3.0 in 2004, but that is down 45 percent from 6.2 for every 10,000 births in 1995.

In Western North Carolina, which includes Alleghany, Ashe, Avery and Watauga counties, the folic-acid campaign has helped reduce neural-tube defects by 80 percent from 1995 to 2005. Mullenix said that women in Western North Carolina may have been more prone to neural-tube defects because of genetic factors linked to their ancestries.

Mullenix said that getting a daily dosage of folic acid is critical considering that about half of all pregnancies in North Carolina are unplanned.

"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," she said.

The agencies will observe National Folic Acid Awareness Week beginning Monday.

A key part is raising more awareness of the need for folic acid among Hispanic women. According to the N.C. State Center for Health Statistics, the rate of neural-tube defects was 14.2 for every 10,000 births from 1999 to 2003 — the latest data available by ethnicity — compared with 6.7 for black women and 6.3 for white women.

"There is a lot of work being done in the Triad to gain more awareness of folic acid’s contributions to prevent birth defects," Whelen said. "We’re very active in the high schools and college campuses, and the students are very understanding and receptive to our message.

"The goal is to get them into a daily habit of taking folic acid for their health, particularly in their child-bearing years."

– Richard Craver can be reached at 727-7376 or at rcraver@wsjournal.com.