Recently, the Center for Disease Control authored a study which was published in the Journal of Women’s Health that found that daily multivitamin use among women of reproductive age is declining. Why is this such a big deal? Two words: Folic Acid.
What is folic acid?
According to the CDC, “folic acid is a B vitamin. If a woman consumes enough folic acid before and during early pregnancy, it can help prevent her baby from having a neural tube defect”.
Why is it important?
You may have heard that it’s important to start taking prenatal vitamins even before you get pregnant. As it turns out, you should actually be taking them (or a multivitamin) even if you have no plans to get pregnant. Why? Because it can actually take months before consuming the recommended daily dose of folic acid creates a stable blood folate concentration that will help prevent neural tube defects in a growing baby. And, bad news – you can’t cheat and double up on your multivitamin to build up that concentration faster.
So, whether or not you were planning on becoming pregnant, if you do find yourself with a bun in the oven, it’s super important to make sure it’s been fortified with a sufficient amount of folic acid. Mothers who are low in folate are unknowingly putting their babies at risk for two serious neural tube defects – spina bifida and anencephaly.
What are Spina Bifida and Anencephaly?
Unfortunately, these defects which affect the brain, spine, or spinal cord happen before most women even realize they’re pregnant. The CDC defines anencephaly as “a serious birth defect in which a baby is born without parts of the brain and skull”. Sadly, babies born with anencephaly cannot survive this condition. Spina bifida can range in severity and occurs when the neural tube doesn’t close the way it should, resulting in damage to the spinal cord and nerves.
Okay, I’m sold. How much folic acid should I take?
The recommended daily dose of folic acid is 400 micrograms (mcg). The CDC has recommended that women can achieve this important daily dose either by taking a multivitamin with folic acid included, by eating fortified foods, or by combining the two and getting the best of both worlds.
Is folic acid the same as folate?
While folate can be found naturally in many foods, folic acid is synthetic and is used in supplements and fortified foods. According to the CDC, only folic acid has been scientifically tested and proven to prevent neural tube defects.
Does it occur naturally?
Great news! Folate does occur naturally in many foods (folic acid, on the other hand, is a synthetic form of folate, which is added to foods). The Office of Dietary Supplements states that folate is present in “vegetables (especially dark green leafy vegetables), fruits and fruit juices, nuts, beans, peas, seafood, eggs, dairy products, meat, poultry, and grains.”
If you’re on the hunt for folate superfoods, you’ll be happy to know that all of the foods that haunted your dreams as a kid (aka spinach, liver, asparagus and brussels sprouts) top the list.
As of January 1998, all enriched breads, cereals, flours, cornmeals, pastas, rice and other grain products were mandated to have 140 mcg of folic acid added to every 100 grams of the product.
One important thing to note is that different people process folate in different ways, due to a gene variation related to the MTHFR enzyme. While individuals with TT or CT genotypes can metabolize folic acid, the process takes longer than people without this gene variation. For these ladies, taking a multivitamin with folic acid is super important, as it can actually reduce the risk of having a baby with a neural tube defect by 85%. You can find more information on it here.
The chart below contains a list of foods that include either folate or folic acid. The Percent DV (Daily Value) shows that even the foods highest in folate just reach (at most) half of the recommended daily serving of folate. This link has a pretty extensive list of foods fortified with folic acid. Good news if you’re a cereal lover – if you’ve ever had a hard time defending your Lucky Charms addiction, you can now let everyone know that it’s one of many cereals that contains your daily recommended dose of folic acid (there are probably some healthier options on the list, too).
Takeaway
TAKE YA FOLIC ACID, LADIES! Whether or not you’re entertaining the idea of having babies, if you’re able to reproduce, it’s just a good idea. If you don’t end up becoming pregnant, at the very least, by taking folic acid you’re decreasing your risk of heart disease, stroke, and potentially even some cancers. So, do the CDC, your body, and any potential future babies a favor – dust off your multivitamins, start poppin’ those suckers, and get your 400 mg per day.
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I have a MTFHR mutation and did not find out until after my pregnancy. Although everything went well I was very disheartened to learn the folic acid I took while pregnant was basically pointless. Also if you choose to eat grains to get your folic acid (while hoping you don’t have the MTFHR mutation) you should try to buy organic to avoid glyphosate residue.
Too bad this is terrible advice for anyone with the MTHFR gene. You should add something about the importance of methyl-folate or folate for those with MTHFR rather than just talking about folic acid.
Worth noting but left out of this article is the fact that people with the MTHFR gene mutation cannot process synthetic folic acid properly, they MUST use vitamins that contain folate. (Or eat a TON of folate rich foods.) Not only can they not process folic acid, having folic acid in ones diet/supplements if you’re not able to process it can prevent actual folate from being absorbed properly.
It is estimated somewhere between 10 and 25% of the population has some variant of this mutation, and many are often unaware. It can be a cause for miscarriages because it can affect implantation and micro-clots in the developing placenta. The MTHFR enzyme working slower for those with a variant can lead to homocysteine build-up, which increases risk for clots to form.
While for many people the enriched foods are an easy way to get the folic acid they need, for many people who have MTHFR it is very hard to shop because filling yourself with the synthetic ultimately leads to more health difficulties in the long run.
Smarty Pants, Thorne Research, & Seeking Health brands all make prenatal that use Folate, NOT Folic Acid. (Seeking Health is actually a line of supplements & vitamins specifically created for those with MTHFR.)
If you have a MTHFR mutation, your body can’t convert folic acid, so folate is the necessary form of the vitamin. I personally always go with folate over the synthetic form(folic acid). I think your article is perpetuating the notion that folic acid is better without mentioning the risks to those with the mutation.
Crazy. I had no idea folic acid was so important! I’m so bad at routinely keeping up with those little vitamins everyday. Good thing there’s some of it in foods. I really need to be taking my vitamins! Thanks for the kick in the pants. Haha.