By TAP Integrative

In 1998, the government of Canada mandated that flour, enriched pasta and cornmeal be fortified with folic acid in order to prevent neural tube defects in newborns. The changes have been successful in substantially reducing the prevalence of neural tube defects, but they may be having an unexpected benefit as well: decreasing rates of congenital heart defects (CHDs).

The research on the effects of folic acid supplementation on heart defects has been mixed, with good evidence supporting a reduction in prevalence of one specific subtype: severe conotruncal CHDs. The evidence for other less-severe types of CHD has been less conclusive. However, previous research did not adequately account for other known risk factors for CHD, and that led researchers to design a study that would.

The population study, published in 2016 in the journal Circulation, looked at nearly 6 million births in Canada between 1990 and 2011. The goal was to evaluate the effects of folic acid food fortification on the prevalence of specific nonchromosomal CHD subtypes. The researchers controlled for maternal age, pre-pregnancy diabetes mellitus, preterm preeclampsia, multiple births, and pregnancy termination for lethal congenital abnormalities.

The study found an overall 11% reduction in nonchromosomal CHDs after the institution of folic acid fortification regulations. Below are reductions for specific CHD subtypes:

  • Conotruncal defects: 27%
  • Coarctation of the aorta: 23%
  • Ventricular septal defects: 15%
  • Atrial septal defects: 18%

In addition, the study found that older maternal age, pre-pregnancy diabetes mellitus, and preterm preeclampsia were associated with increased rates of CHD.

This study finds evidence that, in addition to reducing rates of neural tube defects, folic acid fortification also provides modest protection against CHD.


Liu S, Joseph KS, Luo W, et al. Effect of folic acid food fortification in Canada on congenital heart disease subtypes. Circulation. 2016 Aug 30;134(9):647-655.


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*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease