Why is folate so important?

Wednesday, June 29, 2005
Pregnant woman in gym
Folate (folic acid from food sources) is a B group vitamin that's vital for healthy foetal growth and the prevention of some birth defects. To make sure your baby has the best start in life, you may need to top up your folate intake before you conceive. You can do this by increasing the amount of folate in your diet as soon as you decide to have a baby (usually recommended three months prior to becoming pregnant until the end of the first trimester).

According to the Australian and New Zealand Food Authority, up to two-thirds of neural tube defects in babies can be prevented if women consume sufficient (400 mg per day) folate at least one month before becoming pregnant and during the first three months of pregnancy. Because about 50 percent of pregnancies are unplanned and not necessarily unwanted, it is recommended that all women who could fall pregnant take a folic acid supplement.

Folate plays an important role in cell division and growth. By preventing damage to cellular DNA, folate may reduce the risk of some cancers. In pregnancy it reduces the incidence of serious malformations of the brain and spine (neural tube defects), such as:

  • Spina bifida
  • Anencephalous
  • Encephalocele

In 2001, the prevalence of neural tube defects among live born and stillborn babies was 0.5 per 1,000 births.

A decline of 35–45 percent in the prevalence of neural tube defects since 1996 has been reported by the Victorian, Western Australian and South Australian birth defect registers. Before this, the rate was steady at about 1.6–2.0 per 1,000 births (Bower 2003). This decline has been associated with increased peri-conceptional folic acid intake through the fortification of selected foods and through health promotion campaigns aimed at encouraging women to take folate supplements before and during early pregnancy (Owen et al. 2000; Chan et al. 2001; Bower et al. 2002).

The baby's neural tube is formed in the very early stages of pregnancy, before most women even know they're pregnant. That's why it's important for women to make sure they have enough folate before they conceive as well as in the first 12 weeks of pregnancy.

Who is at risk?
Some couples are at greater risk of having a baby with a neural tube defect, especially if either partner:

  • has a neural tube defect
  • has had a baby with a neural tube defect
  • has a family history of neural tube defects
  • takes medication for epilepsy or seizure (some medications affect the absorption of folate).

If you're at a higher risk of neural tube defects, don't panic. Just make sure you consult your GP before trying to have a baby. You'll probably need to take high doses of folate supplements.

Should I eat more folate?
If you're trying to conceive you need about 0.5mg of folate daily. Foods rich in folate include:

  • liver
  • yeast
  • green leafy vegetables
  • legumes
  • oranges
  • bananas
  • asparagus
  • cereals
  • breads
  • wheat germ

Folate supplements
If your diet includes at least five servings of fresh fruits and vegetables, and at least six servings of breads and cereals a day, you're probably getting enough folate.

Most doctors advise that folate supplements are a good idea if there's any chance of you getting pregnant. Supplements are readily available from supermarkets, chemists and health food stores and are marketed as folate or folic acid. Check the label to make sure it contains 0.4-0.5mg of folic acid.

Taking a multivitamin may not be enough. If your multivitamin doesn't contain 0.4-0.5mg of folic acid, you'll still need to take a folate supplement as well as your regular multivitamins.

Information kindly provided by Family Planning Victoria.

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