Putting Folic Acid in the Limelight

By: Mary Walker, RD, LDN

Instructor of Nutrition – Penn State DuBois

January is a month with extra special appeal because it is the first month of the year and a time for new beginnings. Did you know that Jan. 5-11 is Folic Acid Awareness Week? You may be asking why this vitamin is being placed in the limelight.

Perhaps the best place to start is:

What is folic acid? Folic acid is a water-soluble B vitamin. It helps the body make healthy new cells. “Folic acid” and “folate” mean the same thing. Folic acid is a manmade form of folate. Folate is found naturally in some foods. Most women do not get all the folic acid they need through food alone.

Who needs folic acid? All people need folic acid. However, folic acid is especially important for women who are able to get pregnant. When a woman has enough folic acid in her body before and during pregnancy, it can prevent major birth defects by 50 to 70 percent.

Birth defects that folic acid is instrumental in preventing involve the neural tube (the brain and spinal cord develop from the neural tube) and they include:

Spina bifida (SPEYE-nuh BIF-ih-duh) occurs when an unborn baby’s spinal column does not close to protect the spinal cord. As a result, the nerves that control leg movements and other functions do not work. Children with spina bifida often have lifelong disabilities. They may also need many surgeries. According to the Center for Disease Control (CDC) Web site, the most recent estimates indicate 1,500 babies (1 out of every 2,800) are born with spinal bifida each year in the United States.  The total lifetime cost of care for a child born with spina bifida is estimated to be $560,000.

Anencephaly (an-en-SEF-uh-lee) is when most or all of the brain does not develop. Babies with this problem die before or shortly after birth.

Did you notice that folic acid is important before becoming pregnant? The nutritional status before pregnancy is just as important as during the pregnancy. Other important roles that folic acid has include helping to keep your blood healthy. Not getting enough can cause anemia. Experts think that folic acid might also play a role in heart health and preventing cell changes that may lead to cancer. More research is needed to know this for certain.

How much folic acid do women need? Women able to get pregnant need 400 to 800 mcg or micrograms of folic acid every day, even if they are not planning to get pregnant. (This is the same as 0.4 to 0.8 mg or milligrams.) That way, if they do become pregnant, their babies will be less likely to have birth defects. Did you know that half of the pregnancies in the United States are not planned?

By now, you may be wondering how can I be sure I get enough folic acid each day? One way is to take a multivitamin that has 400 micrograms (mcg) of folic acid. When choosing a brand of vitamins, look for “USP” or “NSF” on the label. These “seals of approval” mean the pills have been made properly and contain the amounts of vitamins listed on the label. Also, look for the date of expiration. It the bottle does not have an expiration date, do not buy it. Furthermore, do not overlook store brands. They can be just as good and cost less. In case you are taking a prenatal vitamin, you are probably getting all the folic acid you need.

The foods you eat are another source of folate which is found naturally in leafy green vegetables (a way to remember this is think of folate and foliage), citrus fruits (the Florida orange growers often promote through commercials), beans (such as kidney, pinto, black bean, just to name a few), and whole grains. Folic acid is added to foods that are labeled “enriched”. These foods would include: breakfast cereals, breads, flours, pastas, cornmeal, and white rice. Some breakfast cereals have 100 percent of the Daily Value of folic acid in each serving. Check the label to see how much your cereal contains. If the percent listed is less than 100 percent, multiply the percentage by 400. For example, a cereal has 50 percent of the Daily Value of folic acid; you would multiply 400 times .50 and know that you are receiving 200mcg of folic acid in a serving.

According to the Center for Disease Control Web site, fortification of cereal grain products was mandated by the Food and Drug Administration in January of 1998. Before this fortification, about 4,130 babies in the United States had neural tube defects and nearly 1,200 died. After folic acid fortification, the number of pregnancies affected by neural tube defects each year dropped to about 3,000 and the related deaths declined to 840. Due to this significant reduction in the rates of neural tube defects by 2006, folic acid fortification was recently named one of the Ten Great Public Health Achievements in the United States. Taking this expertise globally, the Center for Disease Control’s National Center on Birth Defects and Developmental Disabilities has a global initiative to significantly reduce infant mortality and childhood morbidity resulting from more than 300,000 neural tube defect-affected births worldwide each year. One of the objectives is to expand the reach of global folic acid fortification to low and middle income countries which could lead to the prevention of 150,000-210,000 neural tube defects worldwide each year.

Can I get enough folic acid through food alone? The body does not use the natural form of folic acid (folate) as easily as the manmade form. We cannot be sure that eating foods that contain folate would have the same benefits as consuming folic acid. Also, even if you eat a healthy, well-balanced diet, you might not get all the nutrients you need every day from food alone. In the United States, most women who eat foods enriched with folic acid are still not getting all that they need. That’s why it is important to take a vitamin with folic acid every day.

While you can’t get too much folate from foods that naturally contain it, you can get too much folic acid from supplements. So, unless your doctor tells you otherwise, do not consume more than 1,000 mcg of folic acid a day. Consuming too much folic acid can hide signs that a person is lacking vitamin B12, which can cause nerve damage. Lacking vitamin B 12 is rare among women of childbearing age. Plus, most prenatal vitamins also contain

B 12 to help women get all that they need. People at risk of not having enough vitamin B 12 are mainly people 50 years and older and people who eat no animal products.

Older adults need 400 mcg of folic acid every day for good health. But older adults need to be sure they also are getting enough vitamin B 12. Too much folic acid can hide signs that a person is lacking vitamin B 12. People older than 50 are at increased risk of not having enough vitamin B 12. If you are 50 or older, you may wish to ask your doctor what vitamins and supplements you might need.

Want to learn more about folic acid, I would encourage you to visit the folicacidinfo.org Web site. The Web site has a folic acid quiz, which is fun and very educational. Also the Center for Disease Control Web site has additional information.

The Women’s Health Task Force is a small group volunteering their time to educate women and families on important health issues. If you have an interest in health, work in a caring profession, or just want to volunteer with other sincere women, consider attending our monthly planning meetings. These meetings are held the first Thursday of each month beginning at 12 p.m. The next meetings will be held Feb. 6 at Penn State Extension in Clearfield County located at 511 Spruce St., Suite 4, Clearfield.  All interested persons are encouraged to attend. Additional information is available by calling Jana Davidson, Penn State Extension, at 814-765-7878.

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