Researchers studied over 2,500 children in Greece to understand how folic acid supplements taken by mothers during pregnancy might affect their children’s health years later. They found that while folic acid didn’t directly change children’s metabolism, it appeared to work indirectly by helping keep children’s waistlines smaller. Children whose mothers took folic acid had better blood pressure, better insulin control, and healthier body fat patterns. This suggests that what mothers eat before and during pregnancy could have lasting effects on their children’s metabolic health, even into the teenage years.

The Quick Take

  • What they studied: Whether folic acid supplements taken by mothers during pregnancy affect their children’s blood pressure, blood sugar control, and body composition years later
  • Who participated: 2,577 children ages 9-13 from Greece whose parents answered questions about the mother’s folic acid use during pregnancy. The study used data collected between 2007-2009.
  • Key finding: Maternal folic acid supplementation didn’t directly change children’s metabolism, but it appeared to work indirectly by keeping waist circumference smaller, which led to lower blood pressure and better insulin sensitivity in children
  • What it means for you: If you’re planning pregnancy or currently pregnant, taking folic acid supplements may help your future child maintain a healthier body composition and better metabolic health during childhood. However, this is one study showing a connection, not proof of cause-and-effect, so talk with your doctor about your specific situation.

The Research Details

This was a cross-sectional study, which means researchers looked at information collected at one point in time rather than following people over years. They gathered data from children ages 9-13 and asked their parents about whether the mother took folic acid supplements during pregnancy. The researchers then measured the children’s height, weight, waist size, and body fat using standard methods. They also took blood samples to measure blood pressure, blood sugar, and insulin levels.

The researchers used a special statistical method called structural equation modeling to understand how folic acid might affect children’s health. This method helps identify both direct effects (folic acid directly changing something) and indirect effects (folic acid changing one thing, which then changes another thing). They adjusted their analysis to account for other factors that could influence the results, like the mother’s age, education, and the child’s physical activity level.

Understanding how maternal nutrition affects long-term child health is important because it could help doctors give better advice to pregnant women. If folic acid truly helps children develop healthier body composition, this could prevent obesity and related diseases later in life. The indirect pathway they found (through waist circumference) is particularly interesting because it suggests the mechanism by which folic acid might work.

This study has several strengths: it included a large number of children (2,577), used standardized measurement methods, and adjusted for many confounding factors. However, it’s a cross-sectional study, which means it shows associations but cannot prove that folic acid caused the health benefits. The study relied on parents’ memories of whether the mother took supplements, which may not be completely accurate. Additionally, the study was conducted in Greece, so results may not apply equally to all populations.

What the Results Show

The study found that maternal folic acid supplementation had no direct effect on children’s metabolic health markers. However, when the researchers looked at indirect pathways, they discovered important connections. When mothers took folic acid, their children tended to have smaller waist circumferences, and this smaller waist size was associated with lower blood pressure (both systolic and diastolic), better insulin sensitivity, and lower insulin resistance.

Specifically, the indirect effect through waist circumference showed that children had lower systolic blood pressure (the top number) and diastolic blood pressure (the bottom number). The children also showed improved insulin sensitivity, meaning their bodies were better at using insulin to control blood sugar. Additionally, they had reduced insulin resistance, which means their bodies didn’t have to work as hard to maintain normal blood sugar levels.

Body fat thickness (measured with skinfold calipers) also showed similar protective effects on blood pressure. However, overall body mass index (BMI) did not appear to be the mechanism through which folic acid worked, suggesting that the distribution of body fat (particularly around the waist) matters more than total weight.

The study found that body fat distribution was more important than overall weight in explaining the relationship between maternal folic acid and children’s metabolic health. The fact that waist circumference and skinfold thickness mediated the effects but BMI did not suggests that where fat is stored on the body is crucial for metabolic health. This aligns with other research showing that abdominal fat is more metabolically harmful than fat distributed elsewhere.

This research builds on existing knowledge that maternal nutrition during pregnancy affects child development and health. Previous studies have shown that folic acid is essential for fetal development and may influence long-term health outcomes. This study adds to that body of knowledge by identifying a specific pathway: maternal folic acid may work by helping children maintain healthier body composition, particularly smaller waist circumferences. The findings align with broader research showing that prenatal nutrition has lasting effects on childhood metabolism.

This study has important limitations to consider. First, it’s cross-sectional, meaning it captured information at one point in time and cannot prove that folic acid caused the health benefits. Second, mothers’ folic acid use was reported from memory through questionnaires, which may not be completely accurate. Third, the study was conducted in Greece, so the results may not apply equally to other populations with different genetics, diets, or healthcare practices. Fourth, the researchers couldn’t account for all possible factors that might influence the results, such as the child’s diet or physical activity level during the study period. Finally, the effect sizes, while statistically significant, were relatively small, so the practical importance remains unclear.

The Bottom Line

Based on this research, pregnant women and those planning pregnancy should discuss folic acid supplementation with their healthcare provider. Folic acid is already recommended for all women of childbearing age due to its role in preventing birth defects. This study suggests an additional potential benefit for children’s long-term metabolic health, though more research is needed to confirm this. Women should aim for the recommended daily intake of folic acid (400 micrograms per day for non-pregnant women, 600 micrograms during pregnancy). Confidence level: Moderate - this is one study showing an association, not definitive proof.

This research is most relevant to women planning pregnancy or currently pregnant, as well as new mothers interested in their child’s long-term health. Healthcare providers caring for pregnant women should be aware of these findings. Parents of children ages 9-13 may find this information interesting for understanding their child’s current health. This research is less relevant to women who are not planning pregnancy or to men, though it highlights the importance of maternal health for all family members.

The effects observed in this study were measured when children were 9-13 years old, meaning the benefits of maternal folic acid supplementation may take years to become apparent. Parents shouldn’t expect to see immediate changes in their child’s health, but rather should view folic acid supplementation as a long-term investment in their child’s metabolic health throughout childhood and potentially into adulthood.

Want to Apply This Research?

  • If you’re pregnant or planning pregnancy, track your daily folic acid intake (target: 400-600 micrograms per day) and log it in your app. After your child is born, you could track their waist circumference measurements at annual check-ups to monitor body composition changes over time.
  • Start taking a prenatal vitamin containing folic acid if you’re planning pregnancy or currently pregnant. Set a daily reminder to take your supplement at the same time each day. If you’re a parent, encourage your child to maintain healthy eating and physical activity habits, as these work together with maternal nutrition to support good metabolic health.
  • For pregnant women: maintain consistent folic acid supplementation throughout pregnancy and track adherence in your app. For parents: monitor your child’s growth metrics (height, weight, waist circumference) at annual pediatric visits and discuss results with your healthcare provider. Track any changes in your child’s energy levels, physical activity, and eating habits over time.

This research suggests an association between maternal folic acid supplementation and improved childhood metabolic health, but it does not prove cause-and-effect. This study was observational and cannot account for all factors affecting health outcomes. Folic acid supplementation is already recommended for pregnant women and women of childbearing age to prevent birth defects; this research suggests additional potential benefits. Always consult with your healthcare provider before starting, stopping, or changing any supplementation regimen, especially during pregnancy. This information is for educational purposes and should not replace professional medical advice. Individual results may vary based on genetics, overall diet, physical activity, and other health factors.