Evidence supporting the use of: Vitamin B9 (calcium methylfolate)
For the health condition: Birth Defects (prevention)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 5

Vitamin B9 (calcium methylfolate), commonly referred to as folate or folic acid (when in synthetic form), is strongly supported by scientific evidence for the prevention of certain birth defects, particularly neural tube defects (NTDs) such as spina bifida and anencephaly. Multiple large-scale epidemiological studies and randomized controlled trials have demonstrated that adequate folate intake before conception and during early pregnancy significantly reduces the risk of NTDs. The Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and numerous health agencies worldwide recommend that women of childbearing age consume sufficient folate, either through diet or supplementation, to prevent these serious birth defects.

Calcium methylfolate is a bioactive, stable form of folate that is directly usable by the body, unlike synthetic folic acid, which requires conversion via the MTHFR enzyme. Some individuals have genetic variants (e.g., MTHFR polymorphisms) that reduce their ability to convert folic acid to the active form, making methylfolate a preferred choice in certain cases. Scientific guidelines recognize both folic acid and methylfolate as effective in preventing folate-deficiency-related birth defects, with methylfolate being particularly useful for individuals with reduced conversion capacity.

Given the substantial body of evidence, supplementation with folate (including methylfolate forms) is a key public health measure to reduce the incidence of birth defects. The evidence base supporting this use is robust, with decades of research, public health campaigns, and observed reductions in NTD rates following folic acid fortification of foods in multiple countries.

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