Low-carb diet could hurt fetuses


By ANDRÉ PICARD, PUBLIC HEALTH REPORTER
From Friday's Globe and Mail


The popularity of low-carbohydrate regimes like the Atkins diet could trigger a sharp resurgence in devastating birth defects and childhood cancers, scientists warn.

Bread, pasta, breakfast cereals and orange juice ? which are largely shunned in low-carb regimes ? are key sources of folic acid, a micronutrient essential to the neurological development of fetuses.

Since 1998, all white flour, white pasta and cornmeal in Canada have been fortified with folic acid.

As a result, the number of children born with neural tube defects has fallen by half. The incidence of neuroblastoma, a common childhood cancer, is down 60 per cent.

"Fortification is one of the greatest success stories in the history of medicine but, with so many people on low-carb diets, there is a real danger that those gains will be lost," said Gideon Koren, director of the Motherisk program at the Toronto Hospital for Sick Children.

Folate, or vitamin B-9, is found in leafy green vegetables like spinach, fruits like oranges, and in legumes like lentils and kidney beans.

The synthetic version, folic acid, is found in commercially prepared baked goods and pasta and can be purchased in supplements.

The recommended daily dose is four micrograms. A woman would have to eat about eight slices of white bread daily to reach that minimal level. Because almost half of all pregnancies are unplanned, supplements are recommended for all women of childbearing age.

Dr. Koren said in an interview that while he applauds efforts by people to maintain a healthy weight, women should avoid fad diets during their reproductive years because they will miss out on essential micronutrients, including folic acid, vitamin D and vitamin A.

"Low-carb diets are a striking example of how you can do something really bad for your child's health while trying to do good for your own health," he said.

Dr. Koren and a number of other scientists are planning to ask Health Canada to issue a formal warning to women about the risks of low-carb diets.

A recent survey revealed that one in every nine adults in North America is currently on a low-carbohydrate regime like the Atkins or South Beach diets and that twice as many again are planning to go that route in the next two years.

If they follow through with the diet plans, that would mean that as many as 75 million adults could be on low-carb diets in the United States and Canada by 2006.

The survey revealed that almost 40 per cent of people on low-carb diets had stopped drinking orange juice. An even larger number are likely to have abandoned bread. Canadian flour sales dropped almost 10 per cent in the last year.

The numbers have caught the eye of health groups and scientists.

"We're really beginning to worry about the popularity of low-carb diets but, at this point, we just don't know what the impact is going to be," said Nancy Green, medical director at the March of Dimes, a charitable group that works to prevent birth defects.

She said folic acid fortification has had such a dramatic impact that it follows that if people shun foods that are fortified, rates of birth defects could jump again.

The problem could largely be avoided if all women of childbearing age took a daily multivitamin that contains folic acid, she added.

Fewer than 300 children with neural tube defects are now born annually in Canada, down from more than 800 a year 15 years ago.

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Good grief. I'm not even sure what to say about this article. Are they going to try to blame low-carb diets for global warming and the AIDS epidemic next? It's a little eerie to see so much shrill negative press about something that hasn't actually hurt anybody yet.

Good lord. If Coke decides to put a multivitamin in their cola, will it become unhealthy and dangerous to not drink coke ? Maybe Proctor and Gambles could find some way of making NOT smoking unhealthy. I could see their point if folic acid was naturally present in white bread. But it's a supplement for god's sake.



Instead, why not just tell people to take a supplement if you are that freaking worried about people missing out on the vitamins and minerals found in white bread, pasta, and sugar. Yeah right, what a nutritional loss that is. Wonder who is paying her to say that.
Gimme a break.

I get plenty of Folate from Greeen Vegetables...Plus, unlike the Folic Acid in Wonder Bread, its NATURAL FOLATE. I get my Vitamin A from Spinach also. Vitamin D, I get from Shrimp and Low-Carb milk. Vitamin C, I get from Broccoli, Spinach, and Strawberries. So, Nutritional Deficiencies are no problem for me. But, then again I'm not a woman. So, the Folate/Fetus Issue is irrelevant to me.

Hello
Why arent they concerned that the average diet is so nutrient deficient that fortification becomes necessary?
I have taken vitamin supplements for over 20 years, and I havent found 1 doctor supportive of that. But fortification is accepted as a requirement.
Steve

My folate profile on Fitday is great, between 90-100% from spinach and such, I gather.
So what is the big deal?
Gee, how did we survive on the savannah for so long...?

I get folate from greens and much more than I ever got before, vitamin D from eggs, butter and LC milk

I also take a multivitamin with folate as folic acid 150%

There are 2 things really wrong with lc diets

1 you are not suffering, we really should suffer for the sin of being overweight.
2 you are in control there is nothing worse to the control freaks we call gps, patronising gits most of them (well mine have been). what they really want is an excuse to control our lives.

All I can say is tough I am eating a much better and healthy diet than ever before and am loosing weight,thats all that counts.

Personally I come up short on folate most days, which I why I bought a supplement. I suspect if it hadn't been for fortification I would've come up short before. Maybe I was short anyway.

I eat lots of veggies, but I don't eat the 6 cups of brocolli or 4 or so cups of spinach you need to eat to get enough folate.

And my stupid multivitamins don't have it! Next time I buy them, I'll make sure it does. In the meantime, I take a special folic acid supplement.

I get a kick out of this folate deal. I'm currently taking a MVI and have an average of 330% RDA. Before i took the vits I averaged around 150%. and this is on induction!

Another schizoprenic article...pains me for that guy to write such nonsense.
How did he graduate from his journalism school?
He says that LC causes folate deficiencies, but goes on to say that «the average woman would need to eat 8 slices of white bread» to get enough, and that «that whole problem could be avoided with a vitamin supplement»...
What to conclude from that eludes me...

Unbelievable. I took folic acid tablets daily during my last pregnancy - I didn't have to rely on veggies or bread to get it.

Oh what ridiculous rubbish. Refined grains are high in folic acid only because they are fortified with it. You would be better off avoiding the grains and popping a complete multivitamin.
In fact, since macronutrients are so readily available in fortified products and vitamins, the only reason we even need to eat even fruit and veggies are for the antioxidant properties of the micronutrients.

As for drinking JUICES to get folic acid; juices may be high in natural sources of folic acid, however are absolutely LOADED with sugar and too much sugar causes metabolic/hormonal diseases. THere are so many wholesome, superior sources of folic acid WITHOUT drinking liquid sugar like that. Lack of folic acid may cause devastating neural tube defects, but perhaps they should examine the effects of even mild uncontrolled insulin resistance/diabetes type 2 in the mother on the fetus. Their assumption is that lc = low folic acid = neural tube defects and it is just not true. It is quite possible to get more than adequate folic acid on a LC diet while also avoiding the physiological pitfalls of excessive sugar. However, sad to say, you CANNOT do this on a high carb diet! On a high carb diet you are always exposing your body and your child to excessive amounts of sugar and doing irreversible damage to the baby.

Studies have shown having an IR/diabetic mother is an independent risk factor (independent in that all other variables have been isolated/controlled for) for future weight problems and IR/diabetes in the child. Yes, insulin resistance may very well begin even before birth if mommy is a big fan of krispy kreams. The children of uncontrolled diabetics are also often abnormally large, due to the excessive blood sugar levels and hormonal levels the fetus is exposed to.

We all know that a carb rich diet tends to also exacerbate insulin-related hormonal disorders like pcos. This is a danger to the child, particular the female child. There was a popular study which showed that high levels of testosterone in pregnant mothers positively correlates with their future daughters preference for male polarized activities and behaviors post-natal. This alone sounds harmless enough, but what it implies is slightly more serious. It implies that mommy's hormones, and therefore mommy's hormonal disorders in the mother do affect the child, and high testosterone in the mother virulizes the fetus just as it virulizes the mother (say, hirutism, male pattern hair loss, cessation of menstruation, etc). At this stage of life, even slight sex hormone imbalances can have devastating effects on the developing fetus... far more serious than tomboyish behavior. There are a plethora of disorders and birth defects related to too high or too low sex hormones, and they run the gamut from retardation (autism) to a child being born "intersexed" (meaning the genitalia is neither clearly female or male). While I may be prematurely linking a too high carbohydrate diet as a risk factor for these unfortunate birth defects, tell me, would you want to take such a risk? We know carbs spike insulin. We know insulin causes fat storage. We know both high insulin and high adipose levels = abnormally high and unbalanced sex hormone levels. Finally, we also know that unbalanced sex hormone levels in mom = risk factor for many birth defects. No positive concrete link may have been found yet, but tell me, why take the risk when a healthy, well planned controlled carbohydrate diet (like atkins maintenance) gives you all the benefits of high carb with none of the risks?

I vote that WooWoo sends her reply to that twit who wrote the original article.

Another thing they are failing to consider is the fact that birth defects from lack of folic acid is a problem primarily among those living in poverty. Fresh veggies and fruits are expensive, and the poor tend to live on refined carbs which are cheap. The poor had diets which were low in folic acid not because they were eating bacon and eggs instead of greens, but because they were eating pasta instead of greens.

The answer to this problem was to fortify grains with some nutrients, so this way the poor would be a little healthier. This obviously worked in preventing some defects, and will continue to work as the poor can't afford to stop eating grains. It is the middle classes who can afford the fatty bacon and cream, however these middle classes are not in any danger from losing the nutrients from fortified foods, as they can also afford expensive multivitamins and veggies (which are encouraged on LC plans).

The poor, on the other hand, will still continue to buy what they can afford and it is unlikely that LC diets will make much of a dent in their eating habits.