{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:15:38Z","timestamp":1787062538624,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T00:00:00Z","timestamp":1516838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"CDC","doi-asserted-by":"publisher","award":["PA 96043"],"award-info":[{"award-number":["PA 96043"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"CDC","doi-asserted-by":"publisher","award":["PA 02081"],"award-info":[{"award-number":["PA 02081"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"CDC","doi-asserted-by":"publisher","award":["FOA DD09\u2010001"],"award-info":[{"award-number":["FOA DD09\u2010001"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006087","name":"National Center on Birth Defects and Developmental Disabilities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006087","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2018,7,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Folic acid fortification significantly reduced the prevalence of neural tube defects (NTDs) in the United States. The popularity of \u201clow carb\u201d diets raises concern that women who intentionally avoid carbohydrates, thereby consuming fewer fortified foods, may not have adequate dietary intake of folic acid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To assess the association between carbohydrate intake and NTDs, we analyzed data from the National Birth Defects Prevention Study from 1,740 mothers of infants, stillbirths, and terminations with anencephaly or spina bifida (cases), and 9,545 mothers of live born infants without a birth defect (controls) conceived between 1998 and 2011. Carbohydrate and folic acid intake before conception were estimated from food frequency questionnaire responses. Restricted carbohydrate intake was defined as \u22645th percentile among controls. Odds ratios were estimated with logistic regression and adjusted for maternal race\/ethnicity, education, alcohol use, folic acid supplement use, study center, and caloric intake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean dietary intake of folic acid among women with restricted carbohydrate intake was less than half that of other women (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01), and women with restricted carbohydrate intake were slightly more likely to have an infant with an NTD (AOR\u2009=\u20091.30, 95% CI: 1.02, 1.67).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first study to examine the association between carbohydrate intake and NTDs among pregnancies conceived postfortification. We found that women with restricted carbohydrate intake were 30% more likely to have an infant with anencephaly or spina bifida. However, more research is needed to understand the pathways by which restricted carbohydrate intake might increase the risk of NTDs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bdr2.1198","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T01:06:43Z","timestamp":1516842403000},"page":"901-909","source":"Crossref","is-referenced-by-count":45,"title":["Low carbohydrate diets may increase risk of neural tube defects"],"prefix":"10.1002","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1600-3700","authenticated-orcid":false,"given":"Tania A.","family":"Desrosiers","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Siega\u2010Riz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina Chapel Hill North Carolina"},{"name":"Department of Nutrition, Gillings School of Global Public Health University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget S.","family":"Mosley","sequence":"additional","affiliation":[{"name":"Adult and Child Consortium for Health Outcomes Research and Delivery Science University of Colorado Anschutz Medical Campus Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Meyer","sequence":"additional","affiliation":[{"name":"North Carolina Birth Defects Monitoring Program, State Center for Health Statistics, North Carolina Division of Public Health Raleigh North Carolina"},{"name":"Department of Maternal and Child Health, Gillings School of Global Public Health University of North Carolina Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"National Birth Defects Prevention Study","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,25]]},"reference":[{"issue":"2","key":"e_1_2_8_2_1","first-page":"5","article-title":"Use of low\u2010carbohydrate, high\u2010protein diets among Americans: Correlates, duration, and weight loss","volume":"8","author":"Blanck H. M.","year":"2006","journal-title":"MedGenMed: Medscape general Medicine"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20679"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg286"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.185"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-009-0458-1"},{"key":"e_1_2_8_7_1","unstructured":"Dugan A.(2014 July 29). Americans still avoid fat more than carbs.Gallup News. Retrieved fromhttp:\/\/news.gallup.com\/poll\/174176\/americans-avoid-fat-carbs.aspx."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2014.06.011"},{"key":"e_1_2_8_9_1","first-page":"8781","article-title":"Food standards: Amendment of standards of identity for enriched grain products to require addition of folic acid","volume":"61","author":"Food and Drug Administration","year":"1996","journal-title":"Federal Register"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2001.113"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.12325"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn331"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdrc.21090"},{"issue":"1","key":"e_1_2_8_14_1","article-title":"Total carbohydrate determinations in USDA's National Nutrient Database for Standard Reference","volume":"29","author":"Pehrsson P.","year":"2015","journal-title":"The FASEB Journal"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/86.5.1773"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.10012"},{"key":"e_1_2_8_17_1","unstructured":"Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. (1992).MMWR Recommendations and Reports 41(RR\u201014) 1\u20137."},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23384"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws349"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-011-0806-9"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23378"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.099994"},{"key":"e_1_2_8_23_1","volume-title":"USDA National Nutrient Database for Standard Reference, Release 20","author":"USDA Agricultural Research Service","year":"2007"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(21)03057-1"},{"issue":"1","key":"e_1_2_8_25_1","first-page":"1","article-title":"Updated estimates of neural tube defects prevented by mandatory folic Acid fortification \u2010 United States, 1995\u20132011","volume":"64","author":"Williams J.","year":"2015","journal-title":"MMWR Morbidity and Mortality Weekly Report"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbdr2.1198","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.1198","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T09:33:25Z","timestamp":1695029605000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.1198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,25]]},"references-count":24,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,7,3]]}},"alternative-id":["10.1002\/bdr2.1198"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.1198","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,25]]}}}