The Journal of the American Medical Association has a paper thus far only published online – Association of Prenatal Exposure to Population-Wide Folic Acid Fortification With Altered Cerebral Cortex Maturation in Youths – that is both interesting and a big stretch. Government mandated folic acid fortification of enriched grain products has been in force for 20 years. This fortification doubled blood folate levels in women of childbearing age and was followed by a sharp decrease in neural tube disorders such as spina bifida. The study’s key points are below:

Question Is increased fetal exposure to folic acid, implemented through population-wide fortification of grain products, associated with clinically meaningful changes in postnatal brain development?

Findings In a cohort of 292 youths 8 to 18 years of age with normative results of clinical magnetic resonance imaging, delayed age-associated thinning of the cerebral cortex, a pattern suggesting reduced risk for severe mental illness, emerged among individuals who gestated during and after the fortification rollout in the United States (1996-1997). Studies of 2 additional independent US cohorts (N = 1078) confirmed the reliability and temporal specificity of fortification-associated delays of cortical thinning and demonstrated an associated reduction in psychosis risk.

Meaning Beyond its known association with the prevention of neural tube defects, increased gestational exposure to folic acid through food fortification may protect against psychosis through altered postnatal cortical development.

What was found was that there was less cortical thinning in the brains of children whose mothers ingested a diet contains more folic acid than was the norm before the government required fortification with the vitamin. The authors observe that cortical thinning is associated with a greater risk for mental disease and that folic acid may protect against psychosis as well as preventing neural tube disorders. An interesting speculation that until more data are accumulated will remain just that – speculation.

The entire paper is available at the JAMA website linked above. It’s not behind a paywall so you can download it and read it at your leisure. It’s also linked below in pdf format.

Association of Prenatal Exposure to Population-Wide Folic Acid Fortification JAMA July 3, 2018