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How Folate Can Help Prevent Birth Defects

Folate is a B vitamin found in a variety of foods and added to many vitamin and mineral supplements as folic acid, a synthetic form of folate. Folate is needed both before and in the first weeks of pregnancy and can help reduce the risk of certain serious and common birth defects called neural tube defects, which affect the brain and spinal cord.

The tricky part is that neural tube defects can occur in an embryo before a woman realizes she's pregnant. That's why it's important for all women of childbearing age (15 to 45) to include folate in their diets: If they get pregnant, it reduces the chance of the baby having a birth defect of the brain or spinal cord.

"Adequate folate should be eaten daily and throughout the childbearing years," said Elizabeth Yetley, Ph.D., a registered dietician and director of FDA's Office of Special Nutritionals.

Folate's potential to reduce the risk of neural tube defects is so important that the Food and Drug Administration requires food manufacturers to fortify enriched grain products with folic acid. This will give women one way to get sufficient folate: by eating fortified breads and other grain products, such as enriched pasta, rice, waffles and cereal bars.

"When choosing snack foods, I advise my clients to figure out what is more important to them--eating a larger portion of the reduced-fat version or eating a smaller amount of the full-fat version," Diekman says. "For instance, if a serving of potato chips is 1 ounce (28 grams), there maybe 16 chips per serving for the full-fat version and 30 for the fat-free version." Diekman adds that many of her clients incorporate their favorite snacks into their diets by giving up other things, such as not putting dressing on their salads.

She finds that "most people are interested in a particular product attribute--the number of calories or sodium content--and may base their snack food choices on the one factor."

Being Upfront About Nutrients

Other ways to do this are:

  • Eat fruits, dark-green leafy vegetables, dried beans and peas, and other foods that are natural sources of folate.

  • Eat folic acid-fortified enriched cereal grain products and breakfast cereals.

  • Take a vitamin supplement containing folic acid.

Nutrition information on food and dietary supplement labels can help women determine whether they are getting enough folate, which is 400 micrograms (0.4 milligrams) a day before pregnancy and 800 micrograms a day during pregnancy.

Neural Tube Birth Defects

The technical names of the two major neural tube birth defects reduced by adequate folate intake are anencephaly and spina bifida. Babies with anencephaly do not develop a brain and are stillborn or die shortly after birth. Those with spina bifida have a defect of the spinal column that can result in varying degrees of handicap, from mild and hardly noticeable cases of scoliosis (a sideways bending of the spine) to paralysis and bladder or bowel incontinence. 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.

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