Folic acid can help reduce birth defects


Sixty million American women of childbearing age are at risk for having a baby with easily preventable birth defects.

Many women want to have babies, but for some it happens sooner than they expect. In the United States, half of all pregnancies are unplanned, and one of every 20 girls becomes pregnant the first time she has sexual intercourse.

Within 28 days of conception, before a woman has missed her menstrual period, the baby's brain and spinal column are completely formed. It's already too late to take the simple nutritional steps that will prevent two serious birth defects -- known as neural tube defects -- that happen to one of every 1,000 infants born in the United States.

If anencephaly occurs, the baby is born with all or part of its brain missing. The baby usually dies within a few days.

The federal Centers for Disease Control (CDC) estimates the cost of such a birth at $55,000.

When spina bifida occurs, the baby is born with an open spinal column, which causes lifelong paralysis of the lower body and loss of bowel and bladder function. The cost, according to CDC, averages $324,000 per child.

I mention the cost because the price of prevention is so small.

CDC says half of these neural tube defects could easily be prevented when women consume enough folic acid. The hitch? They have to take it before they become pregnant.

Folic acid (also referred to as folacin or folate) is a B vitamin found in citrus fruit, leafy green vegetables, beans, peas and legumes, liver, whole-grain breads and fortified cereals. It is also added in 0.4-milligram doses to even the most inexpensive vitamin-mineral supplements.

In 1992, CDC released this statement: "All women of childbearing age in the United States who are capable of becoming pregnant should consume 0.4 milligrams of folic acid per day for the purpose of reducing their risk of having a pregnancy affected with spina bifida or other NTD's."

Now, three years later, the March of Dimes has released data from a CDC-funded Gallup survey -- of 2,010 women ages 18 to 45 -- designed to find out what they know about folic acid and what they do about it.

Only 15 percent interviewed had heard of CDC's recommendation.

Half had never even heard of folic acid. Of those who had heard of it, only 9 percent knew that it helped prevent birth defects, and less than half could name even one folic-acid-rich food.

Only 28 percent surveyed reported taking a daily vitamin supplement containing folic acid.

A whopping 73 percent who had children or were pregnant said they waited to see their doctor until after they thought they were pregnant.

That means women are taking unnecessary chances when it comes to having a healthy baby.

Although women who have had one NTD-affected pregnancy are at extremely high risk for a second, 95 percent of all NTDs happen to women with no prior history.

So if you're a woman of childbearing age, protect yourself by following CDC's advice.

If you've had an NTD-affected pregnancy, talk to your doctor before you get pregnant again. She'll probably recommend even higher levels of folic acid supplements to help correct built-in weakness.

All other women can get immediate insurance against neural tube defects by taking a daily multivitamin supplement. Any brand will do, as long as it contains 0.4 milligrams of folic acid. Then improve your diet. Foods rich in folic acid are naturally low in fat, high in fiber and rich in phytochemicals you can't get from your supplement.

Add these high folic acid foods to your healthy eating plan:

* Two to four dairy foods daily, including low-fat milk, yogurt and cottage cheese.

* Whole wheat, seven-grain or multi-grain bread, waffles, or English muffins instead of white.

* Cereals fortified with folic acid.

* Two to four eggs per week.

* Orange or grapefruit juice, cantaloupe, honeydew melon, strawberries or raspberries.

* 3-4 ounces of liver once a week.

* Raw vegetables, including spinach, romaine lettuce, cabbage, bok choy, broccoli, cauliflower, dandelion greens and escarole.

* Cooked vegetables, including fresh corn, asparagus, spinach, kale, collard greens, Swiss chard, broccoli, okra, brussels sprouts, cauliflower and acorn or butternut squash.

* Have beans instead of meat occasionally. Used canned beans, or cook your own from scratch. Enjoy soy beans, pintos, limas, kidneys, black beans, navy beans, lentils, garbanzos and black-eyed peas.

Colleen Pierre, a registered dietitian, is the nutrition consultant at the Union Memorial Sports Medicine Center and Vanderhorst & Associates in Baltimore.

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