Getting enough folic acid early can help prevent birth defects

January 22, 1997

Nearly 3,000 American babies are born each year with defects of the brain or spinal cord. It is estimated that up to half of these neural tube defects could be prevented if women consumed 0.4 milligrams of folic acid each day for at least a month prior to conception and during the first few months thereafter. Sounds simple.

Timing is crucial. Neural tube defects occur before most women even know they are pregnant, and about 50 percent of pregnancies are unplanned. Therefore, women between the ages of 15 and 45 should consume adequate amounts of folic acid in their diets every single day beginning in early adolescence.

Neural tube defects occur when the spinal cord fails to close properly. The most common neural tube defect is spina bifida. It can result in varying degrees of handicap from a mild and hardly noticeable sideways bending of the spine (scoliosis) to paralysis and loss of bladder or bowel control. With proper medical treatment, most babies born with spina bifida can survive to adulthood, but they may require leg braces, crutches and other devices to help them walk, and they may have learning disabilities. About 30 percent have slight to severe mental retardation.


The other major neural tube defect is anencephaly. Babies with anencephaly do not develop a brain and are stillborn or die shortly after birth.

Scientists first suggested a link between neural tube defects and diet as far back as the 1950s. Folic acid is a B vitamin found in green, leafy vegetables like spinach and broccoli; in citrus fruits and juices; in whole wheat and fortified breads and cereals and in dried beans and peas. It is used by the body to manufacture DNA, which is required for rapid cell division and organ/tissue formation in the developing baby.

U.S. Public Health Service recommends that all women of childbearing age consume 0.4 milligrams of folic acid in their diets each day by eating foods rich in folic acid either alone or in combination with an over-the-counter multivitamin. On food and supplement labels folic acid also can be called "folate," and the amount may be given as either 400 micrograms (mcg) or 0.4 milligrams. They are the same amounts.

Meeting the recommended amount is not hard to do. A large glass of orange juice and a bowl of fortified cereal can provide at least one half of the recommended amount of folic acid for the day.

The following are examples of foods with folic acid.

Fruits and Juices - orange and pineapple fruit juices, cantaloupe, grapefruit, strawberries, banana, pear.

Cereals and grains - fortified breads and cereals, bran muffins, ethnic starches (rice, flour tortilla, plantain, pasta.)

Vegetables - spinach, broccoli, turnip greens, brussels sprouts, asparagus, corn, cabbage, beets, Romaine and leaf lettuce, cauliflower, peas, artichokes.

Beans/legumes - lentils, black-eyed peas, chickpeas, pinto beans, lima beans, baked beans, great northern beans, kidney beans, navy beans, green beans, tofu. Canned beans are as high in folic acid as those in dried form.

Nuts - pistachios, sunflower seeds, cashews, almonds, dry roasted peanuts.

Protein foods - liver, whole egg, salmon.

Information on some food labels also can be helpful in spotting foods with plenty of folic acid. Some labels may claim that the product is "high" in folate or folic acid, which means a serving provides 20 percent or more of the recommended 0.4 milligrams. If the labels reads a "good source," one serving provides 10 to 19 percent. The exact amount will be given in the Nutrition Facts panel.

Although you are unlikely to consume too much folic acid from a combination of a multivitamin and fresh, unprocessed foods, if you eat many fortified grain products it can be a different story. Many cereals with added vitamins and minerals provide 25 percent of the daily value for folic acid (0.4 milligrams) others may contain 100 percent. So do most multivitamins. Read the labels on processed foods carefully. U.S. Public Health Service advises consuming no more than 1 milligram of folic acid daily unless advised otherwise by your health-care provider.

For information on folic acid and the folic acid content of foods, send a self-addressed, business size, stamped (32 cents) envelope to Cooperative Extension Service, 1260 Maryland Ave., Hagerstown, Md. 21740. Mark the envelope "folic."

Maryland Cooperative Extension Service's programs are open to all citizens without regard to race, color, sex, disability, religion, age or national origin.

Lynn F. Little is an extension agent, home economics, Cooperative Extension Service, University of Maryland.

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