May 12, 2016
Study Asks, Is Too Much Folic
Acid The Cause Of Autism?
By Mike Stobbe
AP Medical Writer
New York (AP) For decades, pregnant women and women who may become pregnant have been advised to take folic acid to help prevent certain birth defects.
But a new study suggests it may be possible to get too much of a good thing - very high levels of the vitamin in mothers' blood at the time of childbirth was linked to higher risk of their children developing autism years later.
Other research points to an opposite relationship between folic acid and autism, showing that adequate amounts of the vitamin at the time of conception can significantly reduce the risk.
Indeed, some experts raised questions about the new research. They note the findings are preliminary numbers, and based on a small number of families seen at only one hospital.
Also, the analysis is based on measures of the vitamin in mothers' blood at the time of delivery, which may not reveal much about what was going on in the women's body at the time of early fetal brain development.
Even the researchers themselves said there's no cause to change current public health recommendations. "We are not suggesting anyone stop supplementation," said one of the researchers, M. Daniele Fallin of Johns Hopkins University's school of public health.
But it raises an intriguing question that should be explored in other research, Fallin said. Two outside experts agreed.
"It's a finding that has plausibility," said Dr. Ezra Susser, a Columbia University professor of epidemiology and psychiatry. He said other researchers have wondered whether too much folic acid can cause problems.
The findings were presented Wednesday at an autism research conference in Baltimore.
Folate is a vitamin found in foods that is important in cell growth and development of the nervous system. A synthetic version, folic acid, is used in supplements and is used to fortify flour and cereals.
Decades ago, researchers found certain levels of folic acid could prevent major birth defects of the baby's brain and spine. In the early 1990s, U.S. health officials began recommending that all women who might become pregnant should take 400 micrograms of folic acid daily. And in the late 1990s, federal regulations began mandating that folic acid be added to flour, bread and other grain products.
Those steps are considered one of the great public health success stories of the last half-century. Officials estimate that 1,000 birth defects are prevented each year because of it.
The new researchers followed 1,391 children who were born at Boston University Medical Center in 1998 through 2013. About 100 of them were later diagnosed with an autism spectrum disorder.
The researchers went back and looked at levels of folate and vitamin B12 in the blood of the children's mothers at the time of childbirth. They found that 16 of them had very high levels of folate, and 15 had extremely high levels of vitamin B12.
Those are very small numbers of cases. But they represent significantly higher proportions than were seen in moms whose children who didn't develop autism.
If both levels are extremely high, there is more than a 17-fold greater risk that a child will develop autism, the researchers said.
Most of the moms in the study said they took multivitamins - which would include folic acid and vitamin B12 - throughout their pregnancy. But the researchers say they don't know why some women had such high levels in their blood.
It may be related to taking too many supplements and eating too many fortified foods. Or there could be a genetic reason that caused some women to absorb more folate than others. Or there could be a combination, they said.
Many studies of autism focus largely on white children in middle- and upper-income families. This one drew mainly from low-income and minority families, the researchers noted.
Bullying Is Not 'Kids Being Kids,' 'Zero Tolerance' Doesn't Work
Jennifer C. Kerr
Washington (AP) -- Zero-tolerance policies are ineffective in combating bullying, an independent government advisory group says in urging schools to take a more preventative approach that includes teaching tolerance to address this "serious public health problem."
In a report released Tuesday, the National Academies of Sciences, Engineering, and Medicine said bullying should no longer be dismissed as merely a matter of kids being kids. "Its prevalence perpetuates its normalization. But bullying is not a normal part of childhood," the report said.
Schools, the researchers concluded, should end zero-tolerance policies that automatically suspend students for bullying.
"There's no evidence that they are impactful in a positive way," said Catherine Bradshaw, a professor and associate dean at the University of Virginia, and part of the committee that wrote the report. "They can actually do more harm than good and in fact don't provide the skill training or replacement behaviors for youth that are suspended or expelled."
The report also said zero-tolerance policies may lead to an underreporting of bullying because suspensions are perceived as too punitive.
Frederick Rivara, chairman of the committee and a professor of pediatrics and epidemiology at the University of Washington, cautioned that bullying has lasting negative consequences and cannot be ignored. "While there is not a quick fix or one-size-fits-all solution, the evidence clearly supports preventive and interventional policy and practice," he said.
Programs that teach children how to get along with one another and what to do if they see kids who are being bullied, are more effective, Rivara said. Parents, too, can do their part, he said, by encouraging children to tell them if they're being bullied, reporting it to the school or teacher and making sure their schools have effective anti-bullying programs in place.
Another committee member, Sandra Graham, a professor at UCLA, said schools need to be more proactive in teaching tolerance. "We need to be able to learn to live and accept and get along with people who are different from us," she said.
"Bullies are often very popular ... there are a lot of kids who bully to maintain their popularity and social status, so schools need to be addressing that," Graham added.
Bullying behavior is seen as early as preschool and peaks during the middle school years, the researchers said. The problem has morphed from the traditional bully-in-the-schoolyard scenario to newer forms of electronic aggression, such as cyberbullying on social media sites.
The report said both bullies and their victims can suffer short and long-term consequences, including poor grades, anxiety and depression.
A government report this month on school crime from the National Center for Education Statistics and the Justice Department suggested bullying is down sharply from more than a decade ago. It found the percentage of public schools reporting bullying at least once a week decreased from 29 percent in 1999-2000, to 16 percent in 2013-14.
The National Academies was more cautious about trying to gauge the extent to which bullying is a problem across the country. In its report, it said bullying likely affects between 18 percent and 31 percent of young people. It had lower estimates for cyberbullying victims, saying it ranged from about seven to 15 percent of youngsters.
The committee also looked at the relationship between bullying and school shootings, but concluded that the data are unclear on the role of bullying as a factor or cause in the shootings. It also found no causal link between being bullied and suicide.