Maternal Folate May Reduce Childhood Obesity Risk

Adequate maternal folate levels during pregnancy may protect children from a future risk of obesity, especially those born to obese mothers, according to a study published in JAMA Pediatrics and conducted by researchers funded by the National Institutes of Health, USA.

"Maternal nutrition during pregnancy can have lasting effects on child health, as well as a mother's health after pregnancy," said the study's principal investigator, Xiaobin Wang, of Johns Hopkins University, Baltimore. "Our results suggest that an adequate maternal folate level may mitigate the effect of a mother's obesity on child health."

Obesity in children and adults is a serious health problem in the United States, contributing to conditions such as heart disease, strokes, and type 2 diabetes. During pregnancy, maternal obesity also increases the risk of a number of complications, such as stillbirth, birth defects, and premature birth. In addition, babies born to obese mothers have long-term health risks, including an increased risk of childhood obesity.

Folate, an essential B vitamin, reduces the fetus's 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 (a synthetic form of folate) daily to reduce their children's risk of neural tube defects. However, the role of maternal folate levels on the child's future obesity risk was not known, especially among those born to obese mothers during pregnancy.

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

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

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

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

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

"Folate is well known to prevent brain and spinal cord defects in a developing fetus, but its effects on metabolic disorders such as diabetes and obesity are less understood. This study uncovers what may be an additional benefit of folate and identifies a possible strategy to reduce childhood obesity." – Cuilin Zhang, senior investigator and co-author of the study.

Source: https://www.nichd.nih.gov/news/releases/Pages/061316-child-obesity.aspx

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