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Nutrition, One-Carbon Metabolism and Neural Tube Defects: A Review

1, 2,3 and 1,3,*
Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China
Fuli Institute, Zhejiang University, Hangzhou 310058, China
Monash Asia Institute and Departments of Medicine and of Nutrition and Dietetics, Monash University, Melbourne 3006, Australia
Author to whom correspondence should be addressed.
Nutrients 2016, 8(11), 741;
Received: 18 August 2016 / Revised: 6 November 2016 / Accepted: 16 November 2016 / Published: 23 November 2016
(This article belongs to the Special Issue B-Vitamins and One-Carbon Metabolism)
PDF [674 KB, uploaded 23 November 2016]


Neural tube defects (NTDs) are a group of severe congenital malformations, induced by the combined effects of genes and the environment. The most valuable finding so far has been the protective effect of folic acid supplementation against NTDs. However, many women do not take folic acid supplements until they are pregnant, which is too late to prevent NTDs effectively. Long-term intake of folic acid–fortified food is a good choice to solve this problem, and mandatory folic acid fortification should be further promoted, especially in Europe, Asia and Africa. Vitamin B2, vitamin B-6, vitamin B-12, choline, betaine and n-3 polyunsaturated fatty acids (PUFAs) can also reduce the NTD risk by interacting with the one-carbon metabolism pathway. This suggest that multivitamin B combined with choline, betaine and n-3 PUFAs supplementation may have a better protective effect against NTDs than folic acid alone. Genetic polymorphisms involved in one-carbon metabolism are associated with NTD risk, and gene screening for women of childbearing age prior to pregnancy may help prevent NTDs induced by the risk allele. In addition, the consumption of alcohol, tea and coffee, and low intakes of fruit and vegetable are also associated with the increased risk of NTDs, and should be avoided by women of childbearing age. View Full-Text
Keywords: folate; neural tube defects; vitamin B; choline; betaine; one-carbon metabolism; tea; alcohol; coffee folate; neural tube defects; vitamin B; choline; betaine; one-carbon metabolism; tea; alcohol; coffee

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Li, K.; Wahlqvist, M.L.; Li, D. Nutrition, One-Carbon Metabolism and Neural Tube Defects: A Review. Nutrients 2016, 8, 741.

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