Folic acid supplements and risk of facial clefts: national population based case-control study.

OBJECTIVE: To explore the role of folic acid supplements, dietary folates, and multivitamins in the prevention of facial clefts. DESIGN: National population based case-control study. SETTING: Infants born 1996-2001 in Norway. PARTICIPANTS: 377 infants with cleft lip with or without cleft palate; 196 infants with cleft palate alone; 763 controls. MAIN OUTCOME MEASURES: Association of facial clefts with maternal intake of folic acid supplements, multivitamins, and folates in diet. RESULTS: Folic acid supplementation during early pregnancy (> or =400 microg/day) was associated with a reduced risk of isolated cleft lip with or without cleft palate after adjustment for multivitamins, smoking, and other potential confounding factors (adjusted odds ratio 0.61, 95% confidence interval 0.39 to 0.96). Independent of supplements, diets rich in fruits, vegetables, and other high folate containing foods reduced the risk somewhat (adjusted odds ratio 0.75, 0.50 to 1.11). The lowest risk of cleft lip was among women with folate rich diets who also took folic acid supplements and multivitamins (0.36, 0.17 to 0.77). Folic acid provided no protection against cleft palate alone (1.07, 0.56 to 2.03). CONCLUSIONS: Folic acid supplements during early pregnancy seem to reduce the risk of isolated cleft lip (with or without cleft palate) by about a third. Other vitamins and dietary factors may provide additional benefit.

[Consumption of whole grain foods and chronic disease]. / Inntak av fullkorn og kronisk sykdom.

BACKGROUND: We summarise evidence concerning the health effects of whole grain intake, as well as implications for Norway. All forms of whole grain products contain both the bran and the germ, which are rich in nutrients, in addition to the starch-rich endosperm. However, refined grain consists only of the endosperm, which contains far fewer nutrients. MATERIAL AND METHODS: Review of published epidemiologic and food consumption data concerning grain intake. RESULTS: Recent epidemiologic investigations have found that whole grain intake is associated with reduced risk of several chronic diseases, especially cardiovascular diseases and diabetes. For example, the follow-up data of the cardiovascular disease study in Norwegian counties carried out during 1977-83 showed an inverse relationship between total mortality rates and eating whole grain bread. The United States Department of Agriculture and the Food and Drug Administration have endorsed statements that whole grain products can have positive health effects. About four times as much whole grain food is eaten in Norway as in the United States. However, many refined grain breads have recently been introduced in Norway. INTERPRETATION: Norwegians should be encouraged to maintain or even increase their consumption of whole grain foods.