Young women not getting enough folic acid

Feb 18 2008

Despite the fact that folic acid can prevent some of the most common birth defects, young women aren't getting enough of it.

Only one in three women ages 18-24 takes a daily supplement containing folic acid, according to statistics from the Centers for Disease Control and Prevention in Atlanta, Ga. This age group accounts for roughly 30 percent of all births in the United States.

“Everyone needs folic acid, but it is especially important for women of childbearing age,” explains Heather Hamner, MS, MPH, a nutritional epidemiologist for the CDC's National Center on Birth Defects and Developmental Disabilities Prevention Research Team. “Folic acid has been found to reduce a woman's risk of having a baby born with a serious birth defect of the brain and spine by 50-70 percent if taken before and during the first three months of pregnancy.”

Because many of these brain and spinal defects occur early in the first trimester, before many women are aware they are pregnant, it is important that all women of childbearing years take folic acid – regardless of whether or not they are pregnant.

Folate is a water-soluble B-vitamin that occurs naturally in foods including leafy-green vegetables, certain fruits, dried beans and peas. Folic acid is a synthetic form of folate that is found in fortified foods and supplements.

The Recommended Dietary Allowance for folate is 400 micrograms per day for everyone age 14 and older. For pregnant women, the recommendation is 600 micrograms; for women who are breastfeeding, it is 500 micrograms. Despite these recommendations from the Institute of Medicine of the National Academy of Sciences, it seems the message just isn't getting out.

“Many women have heard of folic acid, but they don't know that it can help prevent serious birth defects of the brain and spine,” Hamner said. “In 2007, only 12 percent of women ages 18-45 knew that folic acid can help prevent birth defects.” The numbers were even lower for women ages 18-24.

According to the CDC, folic acid consumption is an area of special concern for Hispanic women. Hispanic women are less likely to have heard about folic acid, to know it can prevent birth defects, or take vitamins containing folic acid before pregnancy. As a result, Hispanic women have lower blood folate levels and their children are 1.5 to three times more likely to have a neural tube birth defect, such as spinal bifida, than the children of non-Hispanic white women.

Here are a few tips from Hamner for women to make sure they get all the folic acid they need:

• Include fortified foods in your diet (breads, pastas, breakfast cereals with folic acid).
• Try some new recipes that include folate-rich foods (orange juice, beans, dark leafy green vegetables, such as spinach).
• Make taking a supplement containing folic acid a habit.
• Tell a friend how important it is to take folic acid, especially if she may become pregnant some day.

In addition to folic acid, women of childbearing age should consume adequate amounts of calcium with vitamin D and DHA omega-3, an essential fatty acid and building block of infant nutrition that may promote a healthy pregnancy and prevent late preterm birth.

The National Osteoporosis Foundation recommends that pregnant and nursing women consume 1,000 milligrams of calcium per day and between 400 and 800 international units of vitamin D per day. Vitamin D helps the body absorb and retain calcium. Pregnant and nursing women should consume at least 200 milligrams per day of DHA omega-3, which is the same recommendation for the general population.

Soccer star and new mom Mia Hamm has teamed up with the Society for Women's Health Research to provide women with information about these nutrients. Hamm is featured in a series of television and radio public service announcements, which began airing nationwide in February. A Web site, http://www.TheBig3.org, provides more information on the nutrients.