Preventing Birth Defects With Folic Acid

Asparagus is full of folic acid and antioxidants.
Asparagus is full of folic acid and antioxidants.
©iStockphoto.com/crolique

The old saying goes that a pregnant woman is eating for two. The new twist on that old wisdom (this time backed by solid research) is that a woman should be eating for two before she becomes pregnant -- certainly in terms of the quality of her diet if not truly in terms of quantity.

It's only been fairly recently that science has shown us just how much is at stake if a woman's nutritional status is not up to snuff when she conceives. Certain aspects of the fetus's normal development depend greatly on the mother's nutrition before she becomes pregnant. One of the most crucial links is that between the mother-to-be's intake of folic acid and neural-tube birth defects in her child. If the woman is at a healthy, appropriate weight for her size when she conceives, this also appears to have a beneficial effect on pregnancy outcome.

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In this article, we will review how women can decrease the risk of neural-tube birth defects by eating a healthier diet and increasing their intake of folic acid. This alternative treatment can be followed before and during pregnancy.

Of course, a woman's nutrition and lifestyle during pregnancy can greatly affect her chances of delivering a healthy baby, too. Adequate weight gain during pregnancy is important for reducing the chance of having a low-birth-weight infant, who has a higher risk of health problems as a result. Avoiding toxic substances -- such as alcohol, tobacco, marijuana, and other illegal drugs, and even many legal medications -- during pregnancy also increases the likelihood of having a healthy baby.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Folic Acid and Neural-tube Defects

By getting enough of the B vitamin folic acid in the month before she conceives and during the first several weeks of her pregnancy, a woman can help prevent a group of birth defects in her child known collectively as neural-tube defects (or NTDs). In NTDs, the central nervous system (the brain and spinal cord) and/or its coverings do not finish developing properly. Often, a portion of the brain or spinal cord is left undeveloped or dangerously exposed.

In the NTD anencephaly, the brain is severely underdeveloped. In spina bifida, part of the spinal cord is exposed or defective. Spina bifida is currently the number one disabling birth defect. The hope is that with the knowledge of the folic-acid connection, many future tragedies of this type can be prevented.

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NTDs are the only birth defects to be so directly linked to the mother's nutritional status. But, in an ironic twist, traditional prenatal care may not prevent NTDs; often, by the time a pregnant woman visits her physician and begins taking prenatal supplements that provide folic acid, it is already too late to prevent an NTD. That's because all NTDs occur in the first four weeks after conception. After that, spinal-cord development is complete.

Most women, however, don't even know they're pregnant until at least three weeks after conception, and many don't seek medical care for days or weeks after that. So, it's clear: Any woman who might become pregnant (close to half of all pregnancies are unplanned) should get plenty of folic acid through her diet and/or supplementation. Indeed, the U.S. Public Health Service now recommends that any woman capable of becoming pregnant consume 0.4 milligram (400 micrograms) of folic acid a day.

Besides multivitamins or prenatal vitamins, food sources of folic acid include fortified breads, cereals, rice, pasta, and other grain foods. The Food and Drug Administration (FDA) now mandates that manufacturers add folic acid to enriched grain products (breads, flour, cereals, crackers, cornmeal, rice, pasta), just as they add other B vitamins and iron. Some breakfast cereals are fortified with the full 400 micrograms of folic acid per serving. (Check the labels on grain products to ensure the products you choose are providing you with enough folic acid every day.)

One important point to note: Folate is actually the naturally occurring form of this B vitamin; folic acid is the synthetic form found in supplements and fortified foods. Folic acid is more easily absorbed by the body. Folic acid is also the form of the vitamin that studies have linked to decreased risk of NTDs.

On the other hand, since your body requires this B vitamin (in either form) for proper protein metabolism, for cell division, and to make the red blood cells that carry life-giving oxygen throughout your body, it's still important for men, women, and children who do not take vitamin supplements to get plenty of naturally occurring folate from their diet. Good food sources of folate include leafy green vegetables (such as romaine and endive lettuce and mustard greens), broccoli, legumes (dried beans and peas and lentils), and orange juice.

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