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Down syndrome
neural tube defects
Hirschsprung disease

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diet and nutrition


Methioninean essential amino acid found in meat and dairy products, such as liver, eggs, cheese and milkplays a role in normal embryo development in animals. Methionine is used in the same metabolic pathway as folic acid; when the body lacks folic acid, methionine intake becomes a limiting factor.

Examining mothers' dietary habits around conception and in early pregnancy, we found:

bullet Women who consumed more methionine had 30%-40% lower risk for neural tube defects; this was true regardless of folic acid intake.
bullet It's not certain if methionine or another correlated nutrient is associated with the risk reduction.

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The younger the mother, the higher the risk for having a baby with gastroschisis, a serious abdominal wall defect. We theorized that teen mothers themselves may still be growing, thus competing with their pregnancy for nutrients. Indeed, nutritional deficiencies may play a role.

bullet Low vegetable and fruit consumption increased risk 3-fold.
bullet A 3-4 times greater risk was noted with low intake of carotenoids (found in fruits and vegetables) and glutathione (from animal protein or fruits/vegetables). Both nutrients are antioxidants and may protect the fetus from oxygen stress, a factor theorized to contribute to gastroschisis.
bullet High dietary levels of nitrosamines (found in preserved meats and beer) more than doubled risk.

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Nitratesa commonly occurring group of substances found in foods, medications, drinking water, and cigarette smokehave been implicated in cancer and other health outcomes. More than 85% of women's dietary nitrates came from fruits and vegetables. Nitrates in food did not increase risk for neural tube defects.

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bullet Women with high coffee consumption (4 or more cups daily) were less likely to have recognized Down syndrome pregnancies. These pregnancies are prone to miscarriage; drinking coffee may increase this susceptibility, reducing the chance of having a recognized Down syndrome pregnancy. (Mothers who were high coffee consumers were about 50% more likely to have had a previous miscarriage.) reference information
bullet Environmental factorsinteracting with the developmental instability caused by an extra chromosomemay influence which babies with Down syndrome have associated abnormalities. 4.2% of mothers drank 4 or more cups of coffee daily; they had a 6 times higher chance of having a baby with Hirschsprung disease. reference information

table- average daily intake


Program studies often include a detailed dietary questionnaire, providing a fascinating look at women's diet and nutrition around the time of conception.

bullet Despite adequate caloric intake, diets were frequently less than optimal. Fewer than half ate the recommended 5 servings/day of fruits/vegetables;
less than 10% consumed 6 servings/day of grains. Total fat intake exceeded the recommended 30% of daily calories.
bullet About 20% reported using food supplements. This was more common among Whites (34%) and rare in foreign-born Latinas (5%).
bullet More than 3/4 of women reported eating cereal at least weekly, making fortified cereal a good route for food supplementation.
bullet 10% of women fell below the Recommended Dietary Allowance (RDA) for vitamin E, 25% were below RDAs for calcium, magnesium and zinc, and 50% were below RDA for iron, despite vitamin/mineral supplements. Most women got enough folic acid and vitamin C.
bullet 13% had dieted to lose weight.
bullet 4% were vegetarian.

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