That's one of the key messages former Surgeon General Richard Carmona promoted when he proclaimed 2007 "the year of the healthy child," and the message holds just as true now. Why? Because folic acid is important for a healthy pregnancy, especially in the very early stages when cells are rapidly dividing.
Research has shown that if taken before and during early pregnancy, folic acid can reduce the risk of serious birth defects of the brain and spinal cord, called neural tube birth defects, by 70 percent. Because neural tube defects originate during the first month of pregnancy, often before many women even know they're pregnant, consuming adequate amounts of folic acid is necessary before pregnancy occurs.
And since 50 percent of pregnancies in the United States are unplanned, the 2005 Dietary Guidelines for Americans recommends that all women of childbearing age consumer adequate synthetic folic acid daily from fortified foods or supplements, in addition to food forms of folate from a varied diet.
What's adequate? For most women, the recommended level is 400 micrograms per day. For women with a family history of neural tube defects, 10 times this amount (4 milligrams) is recommended daily. Carmona urges women at high risk of neural tube defects to get the higher level through folic acid supplements and to talk with their physician about steps they can take to keep themselves healthy during pregnancy.
For all other women, the recommended 400 micrograms of folic acid daily can be achieved either by taking a multivitamin that includes 400 micrograms of folic acid or by eating a bowl of a breakfast cereal containing 100 percent of the daily value (DV) of folic acid per serving. Total, Product 19, Cheerios Plus, Special K Plus and Smart Start are some examples.
In addition, it's recommended that women eat a healthy diet rich in natural and fortified sources of folic acid. Fruits, citrus juices, leafy green vegetables, dry beans, peanuts and whole-grain products are naturally rich in folic acid.
By including these foods as part of your daily diet, you consume not only folate but also a variety of other important vitamins, minerals and phytochemicals. "Enriched" grain products like pasta, rice, bread, flour and cereals have been fortified to various levels with folic acid. For example, one slice of bread made with enriched flour contains approximately 25 micrograms of folic acid (6 percent of the DV). Check the nutrition label on the packaging to be sure.
Besides helping prevent neural tube defects, folic acid plays other important roles during pregnancy. It helps pregnant women produce the additional blood cells they need. It's also essential in supporting the rapid growth of the placenta and fetus. In one study, women with inadequate folic acid during pregnancy were more likely to have a baby who was premature and of low birthweight.
It is important to note that cooking and storage can destroy some of the folate found naturally in foods; therefore, the amount of the nutrient available for absorption and use by the body varies widely among foods. On the other hand, the body can absorb nearly 100 percent of the synthetic form of folic acid. It's for this reason that the new Dietary Guidelines for Americans now recommend that women of child-bearing age consume synthetic folic acid, either through a multivitamin or fortified foods, in addition to what they may get from a varied diet.
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