Folic
Acid: For Expectant Mothers
Folic Acid: What Every Expectant Mother Should
Take
By: Dr. George Obikoya
Folic acid, also called Pteroylglutamic Acid, Folate,
or Folacin, is one of the vitamins of the B complex that is essential
for a variety of metabolic processes in our body. In humans, folic
acid is necessary for the synthesis of nucleic acids and the formation
of heme, the pigmented, iron-carrying component of the hemoglobin
in red blood cells.
A diet deficient in folic acid can impair the maturation of young
red blood cells, resulting in folic-acid-deficiency anemia. Pregnant
women with an insufficient intake of folic acid are more likely
to give birth prematurely or to deliver babies with low birth weight
or with neural tube defects. Recent research has shown that adequate
amounts of folic acid can prevent up to half, or more of these birth
defects, if women start taking folic acid supplements shortly before
conception.
Folic acid is necessary for growth and cellular repair, since it
is a critical component of DNA and RNA as well as essential for
the formation and maturation of red blood cells. Folic acid deficiency
is one of the most common of all vitamin deficiencies. Although
it occurs in both males and females, folic acid deficiency anemia
most often affects women over 30. It becomes increasingly common
as age impedes the body's ability to absorb folic acid, a water-soluble
vitamin that is manufactured by intestinal bacteria and stored for
a short time in the liver.
A healthy adult needs at least 400 mcg of folic acid every day.
Requirements at least double during pregnancy, and increase by 50%
when a woman is breastfeeding. The average American diet, high in
fats, sugar, and white flour, provides about 200 mcg of folic acid,
approximately the amount needed to maintain tissue stores of the
substance for six to nine months before a deficiency develops.
Most of the folic acid in foods (with the exception of the folic
acid added to enriched flour and breakfast cereals) occurs as folate.
Folate is only about half as available for the body to use as is
the folic acid in less ezpensive pills and supplements. Folate also
is easily destroyed by sunlight, overcooking, or the storing of
foods at room temperature for an extended period of time.
Folic acid deficiency usually results from a diet lacking in foods
with high folic acid content, or from the body's inability to digest
foods or absorb foods having high folic acid content. Other factors
that increase the risk of developing folic acid deficiency anemia
are: age, alcoholism, birth-control pills, anticonvulsant therapy,
sulfa antibiotics, and certain other medications, illness, smoking,
and stress.
Fatigue is often the first sign of folic acid deficiency anemia.
Other symptoms include: anorexia nervosa, pale skin, rapid heart
beat, sore and inflamed tongue, weakness, and weight loss.
Although adequate folic acid intake usually cures this condition
in about three weeks, folic acid deficiency anemia can make patients
infertile or more susceptible to infection. Severe deficiencies
can result in congestive heart failure. In addition to eating raw
or lightly cooked vegetables every day to help maintain normal folic
acid levels, it is also necessary to take a folic acid supplement
containing at least 400 mcg of this vitamin. Because folic acid
deficiency can cause birth defects, all women of childbearing age
who can become pregnant should consume at least 400 mcg of folic
acid daily. In fact, women who take folic acid when trying to conceive
have been shown to have a lower risk of a pregnancy affected by
neural tube defects.1 The UK Department of Health has recommended
that folic acid is taken by all women planning a pregnancy.2, 3
A good rule of thumb if you are pregnant is: Get your folic acid
by eating foods high in folate, such as broccoli and dark leafy
greens, and taking a daily supplement that contains at least 400
micrograms of folic acid before you become pregnant, you can help
protect your baby against neural-tube defects such as spina bifida.
During pregnancy, increase your daily intake to 600 micrograms.
For years, young women have been advised to take folic acid supplements
before they become pregnant and to continue taking them in the early
stage of pregnancy. The practice is known to reduce the odds of
having a baby with a neural-tube defect. The persistent concern
that folic acid supplements during the pregnancy might increase
the risk of miscarriage has been dismissed by a study published
in New England Journal of Medicine.
A team of researchers from the U.S. and China collaborated on this
study of more than 23,000 Chinese women who did and did not take
folic acid supplements before and during the first trimester of
pregnancy. The miscarriage rate was the same (9%) for both groups.
Folic acid does not increase the rate of miscarriages.
Another study of nearly 250,000 Chinese women has found that taking
folic acid to reduce risk of neural tube birth defects does not
increase a woman's chance of giving birth to twins, according to
a Jan 27, 2003, news release from the Centers for Disease Control
and Prevention. Many studies have shown that folic acid reduces
the incidence of spina bifida and other neural tube defects; however,
some researchers have questioned whether multiple births could be
associated with folic acid consumption during pregnancy.
According to the release, the new study found no link between folic
acid intake and multiple births. There was no difference in twin
birth rates for women in the study who took 400 mcg of folic acid
daily before conception and during early pregnancy compared to those
who took no folic acid.
This study focused on women who had participated in a previous study
of neural tube birth and defects and who took one 400 mcg folic
acid pill per day. The study found no link between taking folic
acid and having twins.
A woman who is pregnant should have regular medical checkups, and
take a good prenatal vitamin that contains folic acid.
A good multivitamin is the foundation of health
and nutrition. Take a look at our scientific reviews of many of
the popular brands for factors such as ingredients, areas of improvement,
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quality liquid multivitamin, we suggest that you take a look at
the Multivitamin
Product Comparisons.
References
1. MRC Vitamin Study Research Group. Prevention of neural tube defects:
results of the MRC vitamin study. Lancet 1991; 338: 132-7
2. Expert Advisory Group. Folic acid and the prevention of neural
tube defects London: Department of Health, 1992.
3. Sutcliffe M, Schorah CJ, Perry A, Wild J. Prevention of neural
tube defects. Lancet 1993; 342:1174.
4. New England Journal of Medicine (9/8/01).
5. Gastrointestinal Disorders: Malabsorption Syndromes." The
Meck Page. 13 Apr. 1998 http://www.merck.com
6. News release, Atlanta: Centers for Disease Control and Prevention,
Jan 27, 2003) http:/www.cdc.gov/od/oc /media/pressrel/r030127.htm
(accessed 10 Feb 2003).
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