The Importance of Folate in the Prevention of Birth Defects

The term folate refers to the many different naturally occurring forms of the compound, all of which are made up of pteridine ring, p-aminobenzoic acid and 1 to 6 glutamic acids. Most naturally occurring folates are in the form of polyglutamates. Food folate polyglutamates must be converted to absorbable Monoglutamates in the upper small intestine. Synthetic folic acid supplements contain only the monoglutamate form which is much more easily absorbed.

Functions of Folate:

– Synthesis of DNA

– Metabolism of various amino acids

– Cell division

– Maturation of red blood cells

Foods High in Folate:

– Liver and other organ meats

– Fortified breakfast cereals

– Legumes

– Green leafy vegetables

– Orange juice.

– Endive

– Spinach

Bioavailability of Folate

Food processing and preparation can destroy 50 – 90% of the folate in food. Folate is extremely susceptible to:

– Heat

– Oxidation

– Ultraviolet light

Recommend Daily Amounts for Folate:

Non pregnant women

– 180 mcg / day

Pregnant women

– 400 mcg / day

Why Do Pregnant Women Need Folate?

– Promotes normal red blood cell formation.

– Helps maintain the central nervous system.

– Promotes normal growth and development.

– Important for cell division.

– Synthesizes DNA. Genetic material found in every cell.

A Recent Study Revealed:

– 80% of pregnant women did not take supplements preconceptionally

– 57% had heard of folate

– 74% couldn’t define folate

– 30% could not name foods containing folate

When Should Folic Acid Be Taken?

It is essential to take folic acid:

– If you are planning a pregnancy

– Likely to become pregnant

– Possible to become pregnant

– History of neural tube defects

– Anticonvulsant medication

How Much Folic Acid?

Women who may become pregnant, who are planning to become pregnant and have no prior family history of neural tube defects should ingest no less than 400 mcg of folate daily. Women who are taking anticonvulsants, such as phenytoin, should speak to their doctor concerning the appropriate amount.

Studies show that ingestion of 4mg of folate daily, greatly reduces the chances of NTDs in women who have had a child with a NTD.

Neural Tube Defects

– In the United States each year, there are approximately 4000 babies born with NTDs.

– Anencephaly (absence of the cranial vault and cerebral hemispheres, life past several hours is rare.)

– Spina Bifida (damage to spinal cord and nerves causing varying degrees of paralysis)

Food and Drug Administration

– A ruling that took effect in 1998 that requires all grain products to be enriched with folic acid has resulted in higher folate levels in adult Americans, according to a report in the May 13th issue of the New England Journal of Medicine. 140 mcg per 100 grams of flour.

– Few women of childbearing age were included in the study, however.

An Example 2200 Calorie Meal

– 3 slices whole wheat bread, ½ banana, 1 hard boiled egg, 1 cup skim milk

– ¾ cup enriched rice, small apple, 2 oz. tuna, ½ cup cooked mushrooms

– 1 small bagel, 4 tsp peanut butter, 1 carrot

– Baked potato, 3 oz. chicken, 3 tbsp sour cream, 1 cup broccoli, 1 c skim milk

– 1 cup skim milk, English muffin, 2 tbsp jam

The amount of folate found in this diet is only 300 mcg. At least another 100 mcg is needed to satisfy the recommended 400 mcg/day.

Substitutions:

– Instead of broccoli - try asparagus. 135 mcg vs. 78

– Instead of enriched white rice - try black beans. 128 mcg vs. 7

– Instead of chicken - try liver. 187 mcg vs. 3

– Instead of wheat bread – try Product 19. 40 mcg vs. 400

Some Helpful Links on Folate:

http://www.fda.gov/fdac/features/796_fol.html

http://www.cdc.gov/nceh/programs/folic/folcamp.htm

http://www.cdc.gov/nceh/prevent/flo/ntd/preface/when.htm

By Scott Mayersohn BS, RD
Registered Dietitian
Newtritiousbeginnings, Inc.