Folic acid is a man-made form of a B vitamin called folate. Folate plays an important role in the production of red blood cells and helps your baby's neural tube develop into their brain and spinal cord. The best food sources of folic acid are fortified cereals. Folate is found naturally in dark green vegetables and citrus fruits.
Taking a prenatal vitamin with the recommended 400 micrograms (mcg) of folic acid before and during pregnancy can help prevent birth defects of your baby's brain and spinal cord. Birth defects occur within the first 3-4 weeks of pregnancy. So it's important to have folate in your system during those early stages when your baby's brain and spinal cord are developing.
- Each year, about 130 babies who are born in New York State have neural tube defects (NTD). Nationwide, there are 4,000 NTD-affected pregnancies each year. NTDs are disorders of the development of the brain and spinal cord. The most common NTD is spina bifida, or opening of the spine. The most serious NTD is anencephaly, failure of the brain to develop.
- Up to 70 percent of NTDs can be prevented if all women who can become pregnant consume 0.4 mg/day of folic acid at least a month prior to conception and during the first trimester of pregnancy.
- Folic acid is a B vitamin that is used by the body to manufacture DNA. DNA is required for rapid cell division and organ/tissue formation in the developing baby. Folic acid can only help prevent NTDs during the first weeks of pregnancy, usually before a woman even knows she's pregnant. In fact, since 50 percent of pregnancies are unplanned, all women who are sexually active and of child-bearing age should consume folic acid every day, even between pregnancies.
- Two-thirds of women in the United States report consuming insufficient levels of folic acid. There are three ways women can get enough folic acid: Take a vitamin supplement containing 0.4 mg folic acid daily. Eat a fortified breakfast cereal daily which contains 100% of the recommended daily amount of folic acid. Increase consumption of foods fortified with folic acid.
- Folic acid-rich foods include: fortified breakfast cereals; enriched bread, rice, pasta and other grain products; orange juice; green vegetables; and legumes such as navy beans, kidney beans, lentils and garbanzo beans. A large glass of orange juice and a bowl of fortified cereal will provide 50-100% of the recommended daily amount of folic acid.
- A woman who has had prior NTD-affected pregnancy is at the highest risk for recurrence and should see a physician before planning another pregnancy. Her physicians will prescribe a higher dosage of folic acid (4 mg).
- Also at risk are women who have maternal insulin-dependent diabetes; use anti-seizure medication; have diagnosed obesity; were exposed to high temperatures in early pregnancy (i.e., prolonged high fevers and hot-tub use); are white or Hispanic; and are poor.
- Other potential health benefits of folic acid intake at 0.4 mg/day include reducing risks related to heart disease, stroke and some kinds of cancer.
- Women should keep their folic acid intake to less than 1 mg per day, unless under the supervision of a physician. High doses of folic acid may complicate the diagnosis of vitamin B12 deficiency.
The terms “folic acid” and “folate” often are used interchangeably. However, folate is a general term used to describe the many different forms of vitamin B9:
- folic acid,
- dihydrofolate (DHF),
- tetrahydrofolate (THF),
- 5, 10-methylenetetrahydrofolate (5, 10-MTHF), and
- 5-methyltetrahydrofolate (5-MTHF).
Folic acid is the synthetic (that is, not generally occurring naturally) form of folate that is used in supplements and in fortified foods, such as rice, pasta, bread, and some breakfast cereals. In many scientific studies done in countries around the world, folic acid has been shown to be effective in preventing neural tube defects.
Natural folate can be found in foods such as leafy green vegetables, citrus fruits, and beans. A woman should eat a balanced diet rich in natural folate from food. However, it is very difficult for most women to get the daily recommended amount of folate through food alone.
Supplements containing forms of folate other than folic acid (such as 5-MTHF) should not be confused with the natural food folate found in fruits and vegetables. The effectiveness of these supplements in preventing neural tube defects has not been studied.