Folate, found naturally in foods, is one of the B vitamins; it is also known as folic acid, which is the name for the form found in supplements and fortified foods. Folic acid merits special consideration. During pregnancy, this vitamin helps to properly develop the neural tube, which becomes the baby’s spine. When taken in daily optimal amounts at least one month before becoming pregnant and during the first trimester, folic acid can help prevent birth defects of the brain and spinal cord, called neural tube defects (NTDs).
Essential: Though the Instutite of Medicine of the National Acadamies still states that the recommended intake is 400 mcg for women of childbearing age, recent studies show that to decrease the risk of birth defects, folic acid should be increased to 800 to 1000 mcg daily (the amount in most prenatal vitamins) in those attempting pregnancy. So your doctor will likely prescribe a prenatal vitamin with this higher amount.
Spina bifida, sometimes called “open spine,” affects the backbone and sometimes the spinal cord. Spina bifida is the most common severe birth defect in the United States, affecting 1,500 to 2,000 babies (1 in every 2,000 live births) each year. Anencephaly is a fatal condition in which the baby is born with a severely underdeveloped brain and skull.
Because most women do not know that they are pregnant right away and because the neural tube and the brain begin to form so quickly after conception, taking optimal amounts of folic acid on a daily basis is important for all women in their childbearing years.
Intake Requirements
Even though a woman follows a healthy, well-balanced diet, she may still not be consuming the recommended amount of folic acid each day. For this reason, in 1998 the Institute of Medicine recommended “that to reduce their risk for an NTD-affected pregnancy, women capable of becoming pregnant should take at least 400 mcg of synthetic folic acid daily, from fortified foods or supplements or a combination of the two, in addition to consuming food folate from a varied diet.” You can use an over-the-counter multivitamin/mineral supplement or prenatal supplement to make sure you get your folic acid. Check the label on over-the-counter supplements because not all contain folic acid in the recommended amounts. The intake for folate increases with pregnancy and breastfeeding. Women who have previously had a baby with an NTD may have higher folate requirements and should speak with their doctors.
Alert: Until more information becomes available, both pregnant and nonpregnant women ages nineteen years and older should not exceed the tolerable upper limit of 1,000 mcg of folate per day from foods, fortified foods, and supplements unless otherwise prescribed by their doctor.
To help women consume more folate, in 1998 the U.S. Food and Drug Administration (FDA) required that all grain products such as breads, flour, crackers, and rice be fortified with folic acid. Other very good sources of folate include orange juice, fortified breakfast cereals, lentils, dried beans, dark-green leafy vegetables, spinach, broccoli, peanuts, wheat germ, and avocados. Folate can be destroyed during cooking, so eat fruits and vegetables raw or cook them for as short a time as possible by steaming, microwaving, or stir-frying.
