The Folate and Autism Debate – Research Dives In

Autism is a popular topic of interest, especially as cases are on the rise and the media is focusing in on new and upcoming research. Then, in 2016 researchers at Johns Hopkins stated that too much folate is associated with autism. A publishing on John Hopkins Hub states, “Women who plan on becoming pregnant are told they need enough of the nutrient folate to ensure proper neurodevelopment of their babies, but new research from Johns Hopkins suggests there could be serious risks in having far too much of the same nutrient.”¹ Their findings showed that mothers who have very high levels of folate right after giving birth (more than four times the adequate amount), may have twice the chance of birthing a child who develops autism. The same goes for vitamin B12; very high levels may triple the risk of autism development. If both levels are high, the risk can increase by 17.6 times, scary statistics for any mother now questioning the use of prenatal supplements.

A publishing from Oregon State University shot back at John Hopkins stating, “…researchers at Johns Hopkins Bloomberg School of Public Health shared some interesting, yet unpublished and non peer-reviewed research at the International Meeting for Autism Research.”² Linus Pauling Institute Principal Investigator Emily Ho, Ph.D. states, “…when headlines such as ‘Folic Acid May Increase Autism Risk’ splashed across newspapers and television screens, it was a blow to the progress that has been made in this area, and if not addressed quickly, could lead to hundreds if not thousands of babies born with serious, preventable birth defects…The data does not say that folic acid supplements cause, or even may cause, autism.” She then states that data currently available actually shows the opposite is true, and folate supplementation is associated with a decreased risk of autism.

Now, this past week a study was released in JAMA Psychiatry that aimed to explore associations between folic acid and multivitamin supplementation before and during pregnancy and its risks of autism spectrum disorder in children. The study involved 45,300 Israeli children and after years of follow-up, 572 (1.3%) were diagnosed with autism spectrum disorder. The results were interesting to say the least. Exposure to folic acid and/or multivitamin use before pregnancy was statistically significantly associated with a lower risk of autism spectrum disorder compared to those who were not exposed. The same results were found for those using folic acid and/or multivitamin during pregnancy as well.³ The authors conclude that more research needs to be conducted before a firm association can be drawn. There are always risks associated with too little or too much of one good thing. The National Institutes of Health Office of Dietary Supplements recommends 400 mcg per day pre-pregnancy, 600 mcg per day during pregnancy, and 500 mcg per day during lactation.⁴ It is important to remember that optimal nutrition is found in a balance, and not in extremes.

Sources:

1. Desmon S. Too much folate in pregnant women increases autism risk, study suggests. Johns Hopkins University. https://hub.jhu.edu/2016/05/12/too-much-folate-pregnant-autism/. Published May 12, 2016. Accessed January 5, 2018.
2. Glausser A. Why Headlines Linking Folic Acid to Autism Are Misleading. Oregon State University. http://blogs.oregonstate.edu/linuspaulinginstitute/2016/05/17/folic-acid-folate-autism-pregnancy/. Published May 17, 2016. Accessed January 5, 2018.
3. Levine SZ, Kodesh A, Viktorin A, et al. Association of Maternal Use of Folic Acid and Multivitamin Supplements in the Periods Before and During Pregnancy With the Risk of Autism Spectrum Disorder in Offspring. JAMA Psychiatry. 2018;
4. National Institutes of Health Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/. Updated April 20, 2016. Accessed December 8, 2017.

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