Carbohydrate metabolism has role in spina bifida?

Low concentrations of myo-inositol, a nutrient involved in carbohydrate metabolism, or slightly elevated glucose levels in the blood increase the risk of having a child with spina bifida, say Dutch researchers.

Their findings point to a possible link between problematic glucose metabolism and the birth defect.

Women are currently recommended to consume certain amounts of folic acid to reduce the risk of spina bifida and other birth defects, and in countries that have mandated folic acid fortification of flour, prevalence of neural-tube defects has been halved.

But most countries have not introduced such a policy and each year about 3 per cent of all new births around the world are affected with major structural birth defects, or more than 4 million each year.

To investigate the role of nutrition, lifestyle and genetic factors in the development of spina bifida, Radboud University Nijmegen Medical Centre has recruited 132 families with a child with spina bifida and 236 control families for a major study.

In the latest findings, the team reports that myo-inositol levels were slightly lower in mothers with a spina bifida child and that lower levels appeared to double the risk of the disease in offspring.

Myo-inositol (hexahydroxycyclohexane) plays an important role in many biological processes in humans, including cell communication and carbohydrate metabolism. Around 30 per cent of the nutrient is synthesized by the human body but the rest is absorbed from food.

The findings appear to support previous results from a British group showing that myo-inositol prevented 70 per cent of the cases of spina bifida in mice.

Dutch project leader Dr Steegers-Theunissen said the new study, thought to be the first human trial to investigate myo-inositol in spina bifida risk, could be a result of a combination of genetic factors impacting the metabolism of myo-inositol and diet.

The study did not rule out the role played by folic acid in prevention of birth defects, she told NutraIngredients.com, "but myo-inositol levels could have an additional effect".

The researcher added that findings on glucose levels indicated that "there is something wrong in metabolism of glucose". The levels were not as significant as in cases of diabetes for example, but were slightly higher in spina bifida mothers, raising the risk of the disease in their offspring by 4 to 6 per cent.

"We have previously found the intake of mono- and disaccharides to be significantly higher in mothers of children with spina bifida, which could be the cause of higher glucose levels," said Dr Steegers-Theunissen.

"It means that nutritional factors are important," she said, but cautioned that connecting the findings to metabolic syndrome remained a big step.