We can all recount our mothers’ admonition to eat our fruits and vegetables. Truth is, mom was certainly on to something. A diet laden with fruits and vegetables can ensure that we get the proper nutrients to keep our bodies strong and prevent disease. Unfortunately, the typical American diet of highly processed foods does not always include the proper amounts of key vitamins and minerals needed to sustain good health. As an obstetrician, I am particularly concerned about the diets and nutritional health of young women in their childbearing years. Eating foods rich in iron, calcium, and folic acid can help a woman maintain optimum health now and help secure good health in the future. In the case of folic acid or folate, that future might be that of her unborn child.
Folate is found naturally in foods such as liver, beans and legumes, leafy green vegetables, and citrus fruits. A diet which includes healthy portions of romaine lettuce, spinach, asparagus, broccoli, cauliflower, beets, and lentils will give you a good amount of folate, which is a water-soluble B vitamin. Folate is instrumental in helping the body synthesize and repair DNA. It is also used by the body to produce red blood cells, aid with rapid cell division and growth, and help prevent anemia. All of these are especially important during pregnancy, particularly during the first 28 days when the fetus is developing key neurological structures. Folic acid is a synthetic compound that is used in vitamin supplements and fortified foods. Since its discovery in 1931, folate has long been recognized as an important component to diets, and most developed countries have instituted fortifying foods with folic acid to help improve the nutritional needs of their citizens. It is easy to find many products that will include folic acid as an added ingredient including cereals, breads, and juices among others.
Numerous studies have shown that proper amounts of folate help minimize several complications of pregnancy including miscarriages and neural tube birth defects, such as spina bifida and anencephaly. Anencephaly is a defect where a child is born without parts of the brain and skull, and infant death usually occurs shortly after birth. Spina bifida is a defect in the formation of the spinal column and can affect the spinal cord and nerves. Babies born with this defect can have a wide range of symptoms including physical and mental disabilities. Some born with spina bifida will only have mild symptoms while others may have more severe symptoms like paralysis and neurological deficiency. Clinical trials have also concluded that folic acid intake may also decrease the incidence of other birth defects related to heart, urinary tract, orofacial (cleft lip and palate), and limbs. Further studies are necessary to replicate and substantiate these findings.
In an effort to reduce the risks of these birth defects, all women in their child-bearing years are highly encouraged to increase their folate levels through diet and supplements. While some women will meet or exceed the Recommended Dietary Allowance (RDA) of 400 mcg per day with foods in their diets, many will not. The U.S. Food and Drug Administration mandated in 1996 that folic acid be introduced to grains and cereal products, and food labeling will show folate as a percentage of daily value or DV. So for instance, some healthy cereals actually provide 400 mcg of folic acid per serving, and the label will indicate that the DV value for folic acid is 100%.
If label reading and keeping track of all your nutritional DVs is not for you, taking a multi-vitamin that includes a minimum of 400 mcg or 0.4 milligrams (mg) is a great way to ensure that you are getting the essential folic acid your body needs. Vitamin makers have become very proficient at marketing vitamins to particular consumers based on gender, age, and health needs. Choosing a multi-vitamin formulated specifically for women will most likely include the recommended minimum. The important message is for all girls and women to have 400 mcg of folate daily through diet or supplements to minimize the risks of having a pregnancy that could result in a birth defect. It is estimated that around 50 percent of pregnancies are unplanned so even women who are not actively trying to become pregnant should be getting folate.
Some women may need to have additional amounts of folate in their diet depending on their health and pregnancy history. Consulting with your healthcare provider is the best way to find out if your personal needs may be different from the average recommendation. For instance, women on certain medications like certain antibiotics should not take folic acid as it may interfere with the absorption and efficacy of the medication. Similarly, some medications may interfere with the proper absorption of folic acid, and dosage may need to be adjusted. Women who have medical conditions that may compromise their ability to absorb nutrients will also require different recommendations.
The exciting news about folate is that it is now being studied to see if it can help with a myriad of medical conditions including heart disease, cancer prevention, Alzheimer’s disease, and hearing loss among others. Every day we learn more about how vitamins and minerals help improve health. However, it is important to always be prudent about medications and supplements. Check with your healthcare provider if you have any questions or concerns about what is right for you. n
Dr. Hardy is the solo physician with Atlantic Ob/Gyn with locations in Va. Beach and Chesapeake. Call 757-463-1234 or 757-548-0044 or visit www.atlanticobgyn.com.