A lot of people knows folic acid as the pregnancy vitamin. But what exactly is folic acid?
Folic acid, also known as folate is part of the vitamin B group. Your body needs it to produce red blood cells to prevent anaemia and it is an important chemical component of the nervous systems. It is also essential for the production, repair and functioning of DNA. However, folic acid's role in pregnancy has been proven to be particularly important for the development of the nervous system and to prevent neural tube birth defects, such as spina bifida.
In Australia, about 70 babies per year are born with a neural tube defect, which is around 2.5 in every 10,000 babies born! It occurs in the first weeks of pregnancy, when the brain and spinal cord are forming. Women who don't get enough folate may likely increase the chance of miscarriage! (1)
When should I start taking folic acid?
Women of child-bearing age should take extra folate daily to prevent neural tube defects. Even if you are not planning to have a baby, you should increase your folate intake because half of all pregnancies in Australia are unplanned.
Recommended daily dose of folic acid should be taken at least one month before conception and during the first trimester of pregnancy.(3) By doing so, 7 out of 10 cases of neural tube defects can be prevented. Neural tube defects occur at a very early stage of development, before many women even know they are pregnant - which is why it is important to take folic acid before starting to try to conceive.
What dietary source contains Folic Acid?
Most women don't get enough folate from their diet. Many foods are naturally rich in folate. However folate is water-soluble and easily destroyed by cooking. It is best for vegetables to be lightly cooked or eaten raw. Cooking by microwave or steaming is best.
Should I take a supplement?
The recommended daily intake of folic for women is 400mcg daily. Once you are pregnant, the need for folic acid supplements increase exponentially. Women should take 600mcg of folic acid from their normal diet. If you are planning a pregnancy or in the first trimester of pregnancy, you should take a daily supplement containing 500mcg of folic acid (4)
It is BEST to take a prenatal supplement to ensure daily nutrient intake is sufficient. Getting enough folic acid is particularly important for the rapid cell growth of the placenta and your developing baby.
2. Scholl TO, Johnson WG. Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr. 2000; 71(Suppl):1295S–1303S.
All nuts have different nutrition credentials and will offer various health benefits. Frequent nut consumption has been associated with better metabolic status, decreased body weight as well as lower body weight gain over time and thus reduce the risk of obesity (1). Moreover, nut consumption has been linked with reduced risk of certain cancers (such as colorectal, endometrial, and pancreatic neoplasms) and protects against depression, mild cognitive disorders and Alzheimer’s disease.
Here's a rundown of a couple of our favourite nuts:
1. Grosso G, Estruch R. Nut consumption and age-related disease. Maturitas. 2016 Feb;84:11-6. doi: 10.1016/j.maturitas.2015.10.014. Epub 2015 Nov 2. Review. PubMed PMID: 26586104.
2. Wien MA, Sabaté JM, Iklé DN, Cole SE, Kandeel FR. Almonds vs complex carbohydrates in a weight reduction program. Int J Obes Relat Metab Disord. 2003 Nov;27(11):1365-72. Erratum in: Int J Obes Relat Metab Disord. 2004
Mar;28(3):459. PubMed PMID: 14574348.
As a mother of one, I am rather shocked that there are still many women out there who are planning for pregnancy but doesn't understand the importance of nutrient supplement for pregnancy (or rather the fetus). Folic acid, also known as folate or Vitamin B9 is one particular important nutrient that has to be taken as a supplement before conception. It is a proven nutrient to prevent neural tube birth defects (NTD), such as spina bifida (1). Why do you need it as a supplement? The reason is because it is extremely difficult to eat enough foods rich in the vitamin to supply the amount that experts recommend you take in pregnancy. In Australia about 70 babies per year are born with a neural tube defect, which is around 2.5 in every 10,000 babies born. Neural tube defects remain an important, preventable cause of mortality and morbity.
Recommended by The Royal Australian and New Zealand College of Obstetricians and
Gynaecologists, folic acid should be taken for a minimum of one month before conception and at least for the first 12 weeks of pregnancy. The recommended dose of folic acid is at least 0.4mg daily on top of a normal diet to aid the prevention of NTD. Where there is a known increased risk of NTD (patients taking anticonvulsant medication, pre-pregnancy diabetes mellitus, previous child or family history of NTD or BMI>30), or a risk of malabsorption, a 5mg daily dose is recommended. Deficiency in folate not only increases the chances of miscarriage but also causes abnormalities in both mothers (anemia, peripheral neuropathy) and fetuses (congenital abnormalities).
Because folic acid is so important, fortification of grain products with folic acid has been mandatory in the United States since January 1998 and in Canada since December 1998. The many other benefits of folic acid in pregnancy includes: prevention of anemia, prevention of preterm birth, prevention of congenital heart diseases and oral clefts (2).
The recommended upper limit for folate supplementation is currently at 1mg for a normal pregnancy but more research is needed in terms of the risks of high dose folate supplementation. Early data suggest supplementation with l-methylfolate (a derivative of vitamin folate) rather than folic acid may mitigate these risk.
Please note that folic acid in foods is destroyed by overcooking, so opt for a big bowl of green leafy salad daily to top up your folic acid requirement.
1. Greenberg JA, Bell SJ, Guan Y, Yu Y. Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention.
Reviews in Obstetrics and Gynecology. 2011;4(2):52-59.
2. Bailey LB, Berry RJ. Folic acid supplementation and the occurrence of congenital heart defects, orofacial clefts, multiple births, and miscarriage. Am J Clin Nutr. 2005 May;81(5):1213S-1217S. Review. PubMed PMID: 15883454.
Dr Nicole Ng (MBBS) is a medical doctor with a passion in women's health and medical research