Folic acid in flour prevents cardiac defects

(© Jana Beuthner)

Since 1998 it has been mandatory in Canada to add folic acid to flour and pasta. In May 2009 scientists from Montreal’s McGill Adult Unit for Congenital Heart Disease Exellence published a study in the British Medical Journal, which showed that since beginning this practice there had been a significant reduction in the occurrence of certain cardiac defects; the actual annual reduction was 6.2 percent. In the nine years before folic acid was introduced into flour (1990 – 1998), and for seven years following its introduction (1999 – 2005) the study examined five pre-defined cardiac defects: tetralogy of Fallot, complete AV canal, univentricular cardiac defect, truncus arteriosus communis and TGA. Due to the symptoms, the severe cardiac defects considered in the study had generally been accurately diagnosed shortly after birth.

The results of the study allow the assumption that an increase in folic acid intake can prevent severe cardiac defects in newborns. This applies particularly if the mother-to-be consumes a sufficient amount of folic acid at the time of conception, and not just once the pregnancy has been established. Enhancing basis foodstuffs with folic acid means that it is possible to reach those women that become pregnant unexpectedly and/or do not take health supplements. A Hungarian study published in 2004 shows an even greater reduction in the occurrence of heart defects. This can be explained by the fact that the study examined pregnant women who had taken multivitamin preparations containing a significantly higher amount of folic acid than the target dose intended with dietary enhancement.

It could also be observed that there was a particular reduction in cardiac defects of the vessels leaving the heart. This suggests that folic acid affects the migration of the cell groups responsible for forming these structures during the development of the heart.


Folic acid (vitamin B9 resp. B11, folate) is a vitamin found in wholegrain products, greens, tomatoes, egg yolk, nuts as well as in the livers of veal and poultry. Folic acid plays a significant role in copying the cells’ genetic information and is therefore particularly important during pregnancy. It has been known for some time now that folic acid deficiency in pregnant women can lead to neural tube defects in the foetus. The recommended daily intake is 600µg for adults (800µg for pregnant women and nursing mothers) – actual intake usually only averages around 300 micrograms per day.

Author(s): Hermine Nock, Dr Stefanie Weismann-Günzler
Last updated: 2009-07-20