Getting a Healthy Start - Think about Folate Now!

By Lee Philips M.D.
PersonalMD.com Advisory Board

Did you know the most crucial stages in a babys development occur before a woman may realize she is pregnant? Both you and your baby need adequate folic acid to prevent neural tube defects. The critical time for the development of the brain and spinal column is in the first four weeks of pregnancy. The tricky part is that over half of all pregnancies are unplanned and these defects occur in the developing fetus before most women know they are pregnant. That's why it is important that all women of child-bearing age (15-45) to get 400 micrograms (.4 mg) of folic acid daily. Many women consume much less than 400 micrograms of folate a day. Even if you' re not planning to get pregnant right now, taking folic acid reduces the chance of the baby having a birth defect of the brain or spinal cord, if you have an unplanned pregnancy. Some women don't realize they are expecting until it is too late for supplements to do much good.

What is folate?

Folate is a B vitamin found in a variety of foods and the synthetic form known as folic acid is found in vitamin and mineral supplements. Folic acid is needed to synthesize DNA which is the building block for for all new cells of the body, and thedaily requirement increasesduring pregnancy. Folate is especially critical in the first weeks of pregnancy, when the neural tube is developing, which later forms the spinal cord and brain. With inadequate amounts of folate birth defects such as spina bifida and anencephaly may occur.

There are about 2,500 with spina bifida and anencephaly are born each year in the United States. The recommended daily dosage of folic acid can reduce a baby's risk of some types of birth defects by 50 percent.Some women are at a higher risk for having babies with these birth defects. If you have diabetes, take anti-seizure drugs, have a family history of neural tube defects, or have already had a pregnancy affected by neural tube defects, talk to your doctor before you become pregnant. Women who may need more folic acid include drug or alcohol users, smokers, women on birth control pills, and women who diet and don't eat well-balanced meals.

Neural Tube Birth Defects

There are two main kinds of neural tube defects reduced by adequate folate intake, anencephaly and spina bifida. The most serious neural tube defect is anencephaly. The baby is born without part of its skull and brain, and dies soon after birth. The most common neural tube defect is spina bifida.

The bones of the spinal column that surround the spinal cord do not close properly during the first 28 days of pregnancy. A portion part of the baby's spinal cord remains outside the body and forms a sac protruding on the infant's back. Doctors must repair the opening of the spine shortly after birth or the child will die. Depending on the severity of spinal cord damage there will be varying degrees of paralysis and incontinence. Many children require a series of operations and other treatments throughout childhood. To help prevent this type of birth defect, it is very important for women who are or may possibly become pregnant, take adequate ammounts of folate.

Some Good Sources of Folate

Women have options for getting the needed folate. Leafy green vegetables and lettuce; citrus fruits and juices: beans and peas; broccoli and asparagus; and liver are great natural folate sources. Folate's potential to reduce the risk of neural tube defects is so important that the FDA requires food manufacturers to add folic acid to enriched grain products such as flour, bread, cereal, pasta, rice and waffles. Some of the natural folate in non-whole-grain products is lost in the process of refining whole grains. Whole-grain products do not have to be enriched because they contain natural folate. By following the USDA Food Pyramid Guide, which suggests 3 to 5 servings of vegetables, 2 to 4 of fruits and 6 to 11 servings of grains daily, women can easily get 400 of folate in their diet. Taking a multivitamin that has 0.4 mg of folic acid is another way of getting the recommended amount.

FOLATE FACTS:
Folic acid come from the word foliage because it is found in high concentrations in green leafy vegetables.
Folate also known as folic acid is a water soluble B vitamin.
Americans get plenty of the B vitamins, with the exception of folate.
Nutrition information on food and vitamin labels can help women get enough folate, which is 400 micrograms a day before pregnancy. For pregnant women, the daily requirement jumps to 800 micrograms.
Because folate is a water soluble vitamin, it is lost in cooking water.
Eat more raw vegetables, salads, spinach, broccoli.
To prevent folate loss cook vegetables in a small amount of water for the shortest amount of time, or steam, microwave or stir-fry.
Store your fresh fruits and vegetables in the refrigerator.
The longer they are fruit and vegetables are stored the more folate that is lost.
Babies conceived in the winter are more likely to be born with spina bifida, perhaps because of the lack of fresh fruits and vegetables available in the winter months.

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