What is folic acid? What is folate? What are the differences between the two, and why are they important for women of child-bearing age and especially women who are trying to conceive and pregnant women?
What is Folic Acid?
Folic acid and folate are a B vitamin, B9 (also called folacin) to be exact. Folate is naturally occurring and is found in various foods. Folic acid is synthetic and is added to vitamins, breakfast cereals, and grains. Folate and folic acid both prevent birth defects.
Folic acid, which is also known as folate, is an essential nutrient that aids the body in making healthy new cells by helping to produce DNA and RNA. Folic acid is particularly important for women who are trying or who are pregnant. If a woman has consumed enough folic acid prior to getting pregnant it can help prevent neural tube defects such as spina bifida. Spina bifida is a defect that occurs within the first week of pregnancy; it takes place when the spinal cord and the back bones do not form as they should. While most children born with spina bifida live full lives they often have lifelong disabilities and need many surgeries.
What Does the Research Say?
Fortunately research has shown that folic acid can help prevent the defects. A study by the Medical Research Council (2) looked at 1817 women who were given a folic acid supplement, a multivitamin supplement, a folic acid and multivitamin supplement or a placebo. It was found that the group that received the folic acid supplement had a 72% lower risk of having a baby with a neural tube defect. The results of the study were so overwhelming that the study was stopped early and all women were encouraged to take a folic acid supplement.
Why is it needed and when?
Correct levels of folic acid are essential to ensure that your baby does not develop neural tube defects, including spina bifida and anencephaly. These defects happen when the tube that will form your baby’s spinal cord does not close completely. Other benefits include reducing the incidence of congenital heart defects, cleft palate, problems in the limbs and urinary system abnormalities. Furthermore, it lowers the risks of premature labour, low birth weight and intrauterine foetal growth retardation, placenta separation and pre-eclampsia.
Taking folate, a B vitamin, before pregnancy reduces preterm labor.
If you are planning to become pregnant, likely you have been told by your medical providers to begin taking prenatal vitamins several months prior to conceiving your baby.
One of the main reasons for taking prenatal vitamins even before finding out you are pregnant is due to the benefits of folic acid, which is a B vitamin. Research has shown that mothers who take folic acid supplements during pregnancy significantly reduce their baby’s chance of neural tube defects such as spina bifida. Other known benefits for both men and women from taking folic acid supplements include reducing the risk of cardiovascular disease and stroke.
Now there may be even more benefit to taking folic acid for women who are planning a pregnancy. A new study points to evidence that folic acid reduces the mother’s risk of having a preterm birth.
Preterm birth is a birth that occurs at 37 weeks or earlier during pregnancy. Currently approximately 10% of all births are considered to be preterm. Preterm birth can lead to a host of complications with the baby such as respiratory distress syndrome, SIDS, temperature instability and more difficulty with feeding issues including swallowing and breastfeeding.
Preterm infants often spend weeks or even months in the NICU (Neonatal Intensive Care Unit) which greatly adds to the overall costs of medical care. Having a simple, yet effective way to reduce the mother’s chance of giving birth too soon will benefit parents, babies and even society at large. So what are the experts now saying with regard to how folic acid may, in fact, be a huge solution to this problem of preterm birth?
Nearly 40,000 women participated in this study that included researchers from both Ireland and the United States. Researchers found that women who took the folic acid supplement for at least one year prior to becoming pregnant reduced their chances of having a preterm birth between 20-28 weeks of pregnancy by 70%. Having a baby born between 28-32 weeks of pregnancy was reduced by 50% when mothers took folic acid for one year before pregnancy.
Folic Acid, Folate Lower Risk of Having Baby with Neural Tube Defect, Other Health Problems
Women who get enough folic acid or folate in their diets significantly reduce the risk of having a baby with devastating health problems, including neural tube defects (NTDs). The March of Dimes notes women who get enough folic acid reduce the risk of their baby being born with a neural tube defect by up to 70 percent.
A neural tube defect occurs when the baby’s neural tube does not close completely, which causes the brain, spinal cord, or the spinal cord’s protective coverings to not develop all the way. There are various neural tube defects. Spina bifida, one common NTD, causes leg paralysis, learning difficulties, and bladder control issues.
Other Benefits of Folic Acid
Folic acid has also been found to have benefits for men and women alike. According to the March of Dimes, folate assists in the production of normal red blood cells and can reduce the risk for a heart attack or stroke, protect against colon and cervical cancer, and reduce the risk for Alzheimer’s disease.
Since many pregnancies are unplanned, women of childbearing age should take folic acid as a matter of course. By doing so, the woman is preventing serious neural tube defects in her newborn and consequently, a life of serious complication and suffering for her child. However, men and women alike can benefit from taking folate, and should take this essential supplement every day for maximum health benefits. While folic acid can be found in a variety of food products, a supplement containing at least 400 mcg is always recommended.
Folate Deficiency Symptoms
An adequate supply of folate is obtained by eating a balanced diet. A variety of vegetables and fruits contain folate, such as asparagus, avocado, beans, broccoli, brown rice, chickpeas, lettuce, peas, spinach, yeast extract, oranges and bananas. Some people may be at risk of folate deficiency and should consume foods fortified with folic acid, such as bread and cereals, and/or take a folic acid supplement.
Reasons for needing folic acid include:
- Not getting enough folate from natural food sources
- Circumstances that increase the need for folate
- Conditions that hinder the absorption of folate
- Excreting too much folate
Pregnancy, alcoholism, anaemia, and some medications increase the need for folic acid. Symptoms of folate deficiency include:
- Slow growth rate in children
- Anaemia in adults
- Digestive problems leading to diarrhoea, poor appetite and weight loss
- Weakness and fatigue
- Sore tongue
- Abnormal heart beat
- Feeling irritable and forgetting things
How Much Folate or Folic Acid Does a Woman Need?
Women should get at least 0.4 milligrams 400 micrograms (mcg) of folic acid per day prior to conception and for at least three months after conception, according to the Centers for Disease Control and Prevention (CDC). Since many pregnancies are unplanned, it is best for all women of child-bearing age to ensure they are getting the recommended amount of folic acid.
However, in certain circumstances your doctor may prescribe you higher doses:
- If you’ve had a previous pregnancy with a baby with spina bifida
- There are cases of spinal problems in the family
- You have epilepsy, coeliac disease, diabetes, sickle cell anaemia or thalassaemia
- You are overweight (BMI>30)
How to Consume Adequate Amounts of Folic Acid
One easy way to ensure adequate intake of folic acid, is by taking a multivitamin that contains 100% of the daily value of folic acid. Supplements that contain only folic acid are also available. Folic acid is also available in many of the foods we eat. Foods that are high in folic acid include fortified breakfast cereals and fortified breads (check the food label to see the percentage of the daily value), beans, lentils, spinach, asparagus and broccoli. As there are no adverse effects of consuming too much folic acid, women only need to be concerned about consuming plenty of folic acid.
Everyone wants the birth of a healthy baby. Consuming adequate amounts of folic acid prior to pregnancy is one way every women can do their part to help prevent neural tube defects.
You need folic acid during the first 12 weeks, particularly when your baby’s internal organs are developing. During the second and third trimesters, your folic acid needs are not so large and you can stop taking these supplements.
Where To Find Folic Acid
However, a folate vitamin supplement is always recommended as the primary source of folate. Keep in mind that people cannot overdose on folic acid; the body will simply flush out any excess quantities.
What foods are rich in folic acid?
Women can get folate from various foods and folic acid from some breakfast cereals, grains, and vitamins. There are many fruits, including oranges, grapefruits, melon, avocados, and raspberries, and veggies, including spinach, broccoli, kale, asparagus, and beets, that are high in folate. Folate is also found in nuts and seeds and in liver and organ meats.
While most specialists agree that it is difficult to get enough folic acid through diet alone, women can boost their folic acid intake through a variety of food products, including:
- Lima Beans
- Brussel sprouts
- Orange juice
- Enriched whole grains
- Certain breakfast cereals
- Certain pastas
- Certain rice products
- Chicken and beef liver
The Federal Drug Administration (FDA) began requiring some breakfast cereals and grains to be fortified with folic acid in the mid-1990s. The FDA wanted to help women get more folic acid in their diets.
Women Should Make Sure to Get Enough Folic Acid, Folate
Folate and folic acid are especially important for women of child-bearing age. Making sure her diet is high enough in folate or taking a vitamin with folic acid is one of the best preventative measures a woman can take to lower the risk of having a baby with a devastating birth defect.