Family Planning Or Not, Folic Acid Is Key

Folic acid is something most women hear about when they’re pregnant, but you may be surprised to learn that it’s recommended for all women.

Folic acid, the synthetic form of vitamin B9, is also known as folate. It plays a starring role during pregnancy because it helps prevent neural tube defects, birth defects of the brain, spine or spinal cord.

Neural tube defects can happen in the initial weeks of pregnancy, making folic acid an important supplement to take before conception. The Centers for Disease Control and Prevention (CDC) report that women who take the recommended daily dose of folic acid at least one month before conception, as well as during the first trimester of pregnancy, reduce a baby’s risk of neural tube defects — things like spina bifida and anencephaly, a condition that can cause miscarriage or stillbirths — by up to 70 percent.

“Ideally, women need to start folic acid supplementation before they even try to conceive,” explains Dr. Jami Barnard, an obstetrician-gynecologist at the Institute for Women’s Health in San Antonio. “A baby’s neural tube is developing and closing three to four weeks after sperm meets the egg, so it’s important to have that supplementation.” Dr. Barnard points out that the three- to four-week time frame is often before women are even aware that they are pregnant, so beginning folic acid supplements after you discover you are pregnant may be too late. “Women don’t usually realize they need to start supplementation so early,” she explains. “It’s not something I knew about before medical school.”

If you’re not actively trying to get pregnant, you’re probably not thinking about embryonic development. However, the CDC reports that 50 percent of pregnancies in the US are unplanned, making folic acid important even if you’re not planning your family.

Dr. Kristin Brozena Shah agrees. “Any woman of child-bearing age, which is 18-40, who is considering pregnancy — or not using contraception — needs folic acid to ensure good brain and spinal cord development,” explains Brozena Shah, Fellow of the American College of Obstetricians and Gynecologists, with San Antonio’s Women Partners in OB/GYN.

“A multivitamin with 400-800 micrograms of folic acid daily reduces the risk of neural tube defects or seizure conditions,” notes Dr. Barnard. Though that may not be enough for everyone: If you have certain conditions, such as Crohn’s disease or a family history of neural tube defects, “work with your doctor to determine how much you should be taking,” says Dr. Barnard.

Your body also needs folic acid to make normal red blood cells and prevent a type of anemia. It is essential for the production, repair and functioning of DNA as well.

Since folate occurs naturally in food, women often wonder if they can get enough folic acid through their diet rather than relying on supplements. “Some patients want to be healthy, be organic and trust that their bodies will do what they need to do,” explains Dr. Barnard, whose patients will often point out that they eat a healthy diet. Unfortunately, that may not be enough: Some healthy, low-carbohydrate diets avoid the very foods that are enriched with folic acid.

In an effort to ensure that people are getting enough folic acid, per federal law it has been added to cold cereals, flour, breads, pasta, bakery items, cookies and crackers, since 1998. If you’re skipping those fortified foods thanks to a low-carbohydrate diet, you may not be getting enough folic acid.

Foods that are naturally high in folate include leafy vegetables like spinach, broccoli and lettuce, and some fruits, including bananas, melons and lemons. Other natural sources of folate include beans, yeast, mushrooms, orange juice and tomato juice. A large glass of orange juice and a bowl of fortified cereal can provide 50 to 100 percent of the recommended daily amount of folic acid.

But that’s not enough insurance for Dr. Barnard. “The recommended dosage is safe for the general population. Neural tube defects are the second most common congenital defect. We know that 70 percent of neural tube defects can be prevented with folic acid supplementation,” she notes. “So why not [take a supplement]?”

Thanks to folic acid’s effectiveness in preventing some birth defects, research is being done to determine if there are other benefits. There is some evidence that folic acid may help prevent premature births and preeclampsia. There’s no known link between folic acid and autism spectrum disorders, but researchers are looking into it. And for women who are not pregnant, there’s some evidence that suggests that folic acid may help prevent high blood pressure.

So enjoy your fortified carbohydrates and take those supplements with a smile — you’re helping ensure that you, and perhaps your future baby, are in good health.

By Dawn Robinette

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