We already know that folic acid is key to reducing the risk of most neural tube defects. But what is folic acid?
Folic acid is a simple, but very important B vitamin (Vitamin B9). Like other B vitamins, folic acid is water soluble, which means that it’s important to get a fresh intake every day because our body can’t maintain its own stores. Folic acid/folate is a micronutrient which is essential for healthy cell growth and development, and to providing the basic building blocks for DNA. This is why folic acid is so important during the early stages of pregnancy when cell growth and development is at its most rapid. Under normal circumstances it would be possible for most adults to get enough folate through natural sources by maintaining a healthy balanced diet, however the increased demands placed on a woman’s body during early pregnancy mean that higher intakes are essential in order to support the mother, and the healthy development of her baby.
Folic acid is commonly found in the form of vitamin supplements and is also widely used around the world as both a mandatory and voluntary fortificant to improve the nutritional content of staple foods, such as bread and cereals. In simple terms, folic acid is a man-made form of folate, a nutrient which occurs naturally in foods, such as spinach, broccoli (and other green leafy vegetables), and yeast extract, with smaller amounts being found in some fruits i.e. oranges and bananas. However, folic acid differs from natural folate, in that, as a ‘pro-vitamin’, it needs to be metabolised by our bodies first, to convert it into a form that we can make use of.
This may make folic acid sound a lot more complicated than natural folate, but in many ways it is much more simple and straightforward. Whilst it’s very important to eat a diet rich in natural folates, natural folates are very unstable, meaning that like other vitamins, their potency starts to diminish as soon as the fruits and vegetables are picked, and decreases even further if they are cooked or stored for long periods of time. You can see how this then makes it impossible to know exactly how much folate an individual has consumed. Furthermore, most dietary sources only contain very small amounts of folate, making it almost impossible to achieve the amounts necessary to support a healthy pregnancy through diet alone.
Folic acid provides a very simple solution. It’s easily absorbed by the body, it’s more stable and cheaper than natural source folate, and it can also be added to staple foods to increase the nutritional value of processed foods. For most people around the world, the primary sources of folic acid are supplements and fortified breads and cereals.
World Folic Acid Awareness Week
Every January the International Federation for Spina Bifida and Hydrocephalus will work with its member organisations, partners and supporters to promote World Folic Acid Awareness Week as part of their Global Prevention Initiative to reduce the worldwide risk of NTDs and Hydrocephalus. Still far too many women remain unaware of the need to take folic acid at the critical time BEFORE they get pregnant.
In 2017, the World Folic Acid Awareness Week took place from 9th - 15th January.
Folic acid Facts and Misconceptions
- All women that could get pregnant need to take a supplement containing 400mcg of folic acid daily.
- Folic acid/folate is essential for cell growth and development and provides the building blocks for DNA.
- Up to 72% of neural tube defects could be prevented if all women took folic acid at the correct time and dose.
- Folic acid is water soluble so it needs to be taken every day.
- Some women have an increased risk of NTD and will need to take a higher 5mg dose of folic acid. In some countries this may only be available on prescription from a doctor. (See our section on high risk women)
- Folic acid is something optional that you can take ‘WHEN you are pregnant because it’s good for the baby.’
- Women who have a healthy balanced diet don’t need additional folic acid as they get enough in their diet.
- Women don’t need to take folic acid until their pregnancy has been confirmed.
- My previous pregnancy was OK and I didn’t take folic acid then, so I don’t need to take it this time.